Although many healthcare leaders say the long-awaited Supreme Court ruling had little effect on their long-term operational and strategic plans, others believe this is not the time to rest on laurels.
The PricewaterhouseCoopers whitepaper "Implications of the U.S. Supreme Court Ruling on Healthcare" advises providers to steadily respond to the ruling with the following 19 steps. These are organized by actions providers should take, items providers should assess, and attitudes and behaviors providers should quit.
Act
1. Begin communication with state policymakers on options for Medicaid expansion.
2. Formulate your communication plan on the ruling to employees and patients.
3. Compete for newly insured patients by being aware of subtle market and competitors' changes.
4. Understand how to report on new quality measures.
5. Use the most effective mix of clinicians to manage cost structure, balancing new Medicaid and privately-insured patients.
6. Use technology to enable better quality and more efficient care.
7. Establish care coordination to better serve patients and to hedge against readmission penalties.
8. Continue physician alignment as a key strategy to improve quality and reduce expenses such as physician preference items.
Assess
9. Investigate payor mix and opportunities for enhancement; make sure to model with and without state Medicaid expansion.
10. Assess your digital strategy to compete successfully for patients in the new healthcare retail environment.
11. Ensure your capability of managing populations of patients, including risks, to increase revenue.
12. Explore partnership opportunities, including acquisitions and alliances, to fill capability gaps.
13. Focus on electronic medical record implementation to secure full meaningful use reimbursement.
14. Prioritize quality measurement and programs or risk losing direct reimbursement through value-based purchasing and/or community reputation.
15. Assess your patient access and experience metrics to protect existing patient base.
16. Assess your level of integration to meet rising consumer interest in integrated delivery networks.
Stop
17. Stop using a model focused on acute care. Most new reimbursement models reward outcomes, not volume.
18. Discontinue the "wait-and-see" approach. Doing nothing puts you at a competitive disadvantage.
19. Stop ignoring variation in clinical practice.
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The PricewaterhouseCoopers whitepaper "Implications of the U.S. Supreme Court Ruling on Healthcare" advises providers to steadily respond to the ruling with the following 19 steps. These are organized by actions providers should take, items providers should assess, and attitudes and behaviors providers should quit.
Act
1. Begin communication with state policymakers on options for Medicaid expansion.
2. Formulate your communication plan on the ruling to employees and patients.
3. Compete for newly insured patients by being aware of subtle market and competitors' changes.
4. Understand how to report on new quality measures.
5. Use the most effective mix of clinicians to manage cost structure, balancing new Medicaid and privately-insured patients.
6. Use technology to enable better quality and more efficient care.
7. Establish care coordination to better serve patients and to hedge against readmission penalties.
8. Continue physician alignment as a key strategy to improve quality and reduce expenses such as physician preference items.
Assess
9. Investigate payor mix and opportunities for enhancement; make sure to model with and without state Medicaid expansion.
10. Assess your digital strategy to compete successfully for patients in the new healthcare retail environment.
11. Ensure your capability of managing populations of patients, including risks, to increase revenue.
12. Explore partnership opportunities, including acquisitions and alliances, to fill capability gaps.
13. Focus on electronic medical record implementation to secure full meaningful use reimbursement.
14. Prioritize quality measurement and programs or risk losing direct reimbursement through value-based purchasing and/or community reputation.
15. Assess your patient access and experience metrics to protect existing patient base.
16. Assess your level of integration to meet rising consumer interest in integrated delivery networks.
Stop
17. Stop using a model focused on acute care. Most new reimbursement models reward outcomes, not volume.
18. Discontinue the "wait-and-see" approach. Doing nothing puts you at a competitive disadvantage.
19. Stop ignoring variation in clinical practice.
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Poll: 61% of Physician Leaders in Hospitals Support Supreme Court's PPACA Decision