Health IT

It’s time to answer the big payment questions of the ACA

Whether you interpret the election results as a referendum on healthcare reform or not, in terms of execution and strategic planning, the election results mean that the real work begins in earnest on provisions and innovations in the ACA now that it is the unchallenged law of the land. Many organizations and investors that were […]

Whether you interpret the election results as a referendum on healthcare reform or not, in terms of execution and strategic planning, the election results mean that the real work begins in earnest on provisions and innovations in the ACA now that it is the unchallenged law of the land.

Many organizations and investors that were holding their collective breath to see what happened in the election will now begin to plan concrete steps from now through 2016, when the law’s last major provisions take effect. Before Tuesday night, it might have been optional to consider ACOs or state insurance exchanges in your strategy – whether you are a provider, purchaser, or payer. Now it seems mandatory.

Similarly, the election results may give a jolt of energy to the provisions of ARRA’s HITECH act, drawing attention back to the progress underway in information exchange and meaningful use and how they are transforming the provision of care.

However, big question marks remain. How will the innovations in payment reform stimulated by the ACA will be successful in moderating out of control cost increases? What it will take to transform a payment system dependent on FFS into one that rewards outcomes? How will we measure the value we get for our healthcare investment in the public, private, and not-for-profit sectors?

The Pacific Business Group on Health focuses on how the landscape of employer-sponsored insurance benefits will change. While there’s no clear indicator that there will be a significant change in most large employers offering health benefits, how these benefits are organized, administered, what they will cover, and how much control and “skin in the game” the consumer will have are all being re-assessed.