Last Thursday, September 8, the Fourth Circuit Federal Court of Appeal struck down a pair of challenges to the Affordable Care Act’s “individual mandate,” which requires individuals who can afford coverage to purchase health insurance, or they will be forced to pay a $695 penalty, or 2.5% of their income.
The individual mandate requirement is by far the most controversial portion of the Affordable Care Act and has been challenged in court on five different occasions. Overall, three appellate judges have ruled that the minimum coverage requirement is unconstitutional and five have said the requirement is constitutional. It is uncertain what happens next in the appeals process, but it appears that the government and those who oppose the law will eventually wind up arguing their cases in front of the Supreme Court.
However, if you or your organization has been putting off taking steps to remain viable in a post-reform world in hopes that the Supreme Court will rule the law unconstitutional, you may have already missed the train toward a modern and integrated future.
Whether it be Meaningful Use requirements or other federal or state initiatives urging health care providers to modernize processes, adopt electronic health records and take steps to avoid unnecessary medical procedures, there is no denying that the health care industry is well on its way to reform. While many “old dogs” are undoubtedly holding out hope for a life raft and paying way too much attention to the political theater around the Affordable Care Act, they are forgetting to “follow the money” to see what the future holds – and we all know there is plenty of money to follow in regards to health care.
Forget ACOs and Meaningful Use for a moment — huge U.S. corporations will save billions in an efficient, integrated health care system that focuses on providing the best possible care for patients. Self-insured employers will save millions in medical bills if the new, integrated system can manage chronic diseases, reduce unnecessary procedures and emphasize preventative care.
Corporations that purchase health insurance from outside vendors continue to pass on a larger percentage of care to their employees; in this economy, employees are beginning to realize that the escalating cost for health benefits are taking away their hard-earned wages, which have remained stagnant for the greater part of the past decade.
Who stands to benefit the most financially from a reform of the health system? Large corporations, health insurance providers and the federal and state governments. I have a feeling they will find some very real ways teach the old dogs a few new tricks, and it begins with the letter “$.” The added benefit for the rest of us, of course, is a renewed focus on the patient and what’s needed to keep ourselves and our loved ones in the best possible health.
Healthcare IT is laying the tracks for this long train ride and health care reform is irrelevant when it comes to implementing IT within a care provider organization, because many of the changes need to occur, regardless of regulations or policies. By modernizing their processes, health care organizations will be able to provide efficient workflows throughout the system and higher quality of care for patients.
Question: As part of your health IT strategic plans and initiatives, how much focus have you placed on what happens with health care reform?
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