Vituity

Healthcare Reform Upheld — What’s Next for Providers?

While the rest of the country debates the political and legal ramifications of the Supreme Court’s decision to uphold the Accountable Care Act (ACA) almost in its entirety, what’s next for those of us on the front lines of providing care?

Hospitals, physicians, and other providers have had mixed strategies for responding to the ACA as we all waited for the Supreme Court’s decision. Some organizations have moved full steam ahead with implementing some of the changes required by reform, while others – already overwhelmed with other initiatives – have waited for this decision before making any moves.

There are two key provisions of the ACA concerning hospitals and physicians that will go into effect on October 1:

  • Medicare’s value-based purchasing program
  • Medicare payment reductions based on readmission rates

Both of these initiatives are significant because they begin the transformation from ‘pay for procedures’ to ‘pay for performance.’ Hospitals will now be at risk of losing up to 2% of their Medicare reimbursement if they do not meet quality improvement guidelines – with the funding percent at risk increasing in future years.

Like others, I have long believed that this transformation would take place regardless of the outcome from the Supreme Court, but now we can use the clear roadmap outlined by the ACA — at least as far as Medicare patients go. For a clear outline of the ACA’s roadmap, the Kaiser Family Foundation has a great timeline of when various provisions go into effect.

Over the next several weeks, we will be posting reactions to the Supreme Court ruling, with a focus on the impact of the law on providers of acute care — including the institutions and individuals on the front lines of healthcare. I invite you to share your perspective as well in the comments or by emailing our editor Daniel Schmid.