With All Due Respect, We’re not on the Edge of Our Seats.

Washington, DC is literally abuzz with speculation about the imminent Supreme Court decision on the Affordable Care Act.  Certainly, the decision and the part that individual justices play on it will be endlessly analyzed for political purposes.

Here’s the thing, though: the Supreme Court decision isn’t really going to make a difference from the perspective of population heath organizations.  Why?  Because the transformation of health care delivery in this country began over a decade ago and will continue regardless of this ruling. The real determinants of the evolution of health care are the various components and strategies of population health management.

The ACA reinforced what many health care industry segments already knew:

  • Volume is not quality.
  • Acute care is, in many cases, too late.
  • Technology has changed the way care is delivered, coordinated, and measured.

Many of the concepts the ACA champions had been tested and proven successful in places like Geisinger, Mayo Clinic, state Medicaid programs and through pilot programs spearheaded by numerous national and regional health plans.

The fundamental business model of health care was already changing when the ACA was enacted. We will not divert from many of its pillars such as prevention and health promotion, quality and outcomes over volume, and the role of technology and innovation to expand capacity.  Population health management strategies support and have evolved considerably to advance the new care delivery goals of better outcomes, improved health and lower health care expenses.

Last month, I had the honor of discussing new payment models for innovation and technology at an innovation forum organized by a CCA member company.  No such discussion can take place without recognizing that fee-for-service and component-based payment structures are being replaced by new structures that reward coordinated, collaborative models. The key goals of these new models are improved quality and health outcomes and lower costs. In closing, I addressed the potential impact of the Supreme Court decision: upheld or invalidated in whole or in part, the decision will not roll back health care delivery transformation.  That horse has left the gate.

-Tracey Moorhead, President & CEO

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