Jay Warden, Senior Vice President, The Camden Group, shares his thoughts on how the Supreme Court's decision on the constitutionality of the individual mandate will impact healthcare reform and delivery.
1) Provider partnerships with local and regional health plans and the huge momentum behind CMMI programs in bundled payment and shared savings will continue to help providers prepare for achieving the "triple aim" regardless of the Supreme Court ruling.
2) Improving primary care access and designing primary care practices to more efficiently and effectively manage care for populations will continue to be one of the biggest challenges facing provider organizations. The Supreme Court ruling will impact the specifics of how care is paid for, and by whom, but the need for local providers to improve access to primary care will remain a constant.
3) No matter what happens with the health reform law and the federal insurance mandate, provider organizations need to incorporate payor strategy and network development strategy into their strategic planning activities, and they need to continue operations improvement efforts to reduce readmissions and manage the cost of care. Many of our clients have been having proactive discussions with local and regional health plans for several months regarding narrow networks, bundled payment, and accountable care organizations. In many cases, payors are "taking sides" and forming significant partnerships with large health systems at the expense of other providers. As a result, competing payors are funding ACO infrastructure development to help smaller health systems develop the networks and care management capabilities they need to compete with the bigger systems.
More Articles on Healthcare Reform:
Hospital Executives Undaunted by Supreme Court Arguments
How the Supreme Court's Decision Will Impact Healthcare Delivery: Q&A With Dr. Jeffrey Lobosky of UCSF
Two Hours May Determine Fate of Healthcare Reform's Individual Mandate
1) Provider partnerships with local and regional health plans and the huge momentum behind CMMI programs in bundled payment and shared savings will continue to help providers prepare for achieving the "triple aim" regardless of the Supreme Court ruling.
2) Improving primary care access and designing primary care practices to more efficiently and effectively manage care for populations will continue to be one of the biggest challenges facing provider organizations. The Supreme Court ruling will impact the specifics of how care is paid for, and by whom, but the need for local providers to improve access to primary care will remain a constant.
3) No matter what happens with the health reform law and the federal insurance mandate, provider organizations need to incorporate payor strategy and network development strategy into their strategic planning activities, and they need to continue operations improvement efforts to reduce readmissions and manage the cost of care. Many of our clients have been having proactive discussions with local and regional health plans for several months regarding narrow networks, bundled payment, and accountable care organizations. In many cases, payors are "taking sides" and forming significant partnerships with large health systems at the expense of other providers. As a result, competing payors are funding ACO infrastructure development to help smaller health systems develop the networks and care management capabilities they need to compete with the bigger systems.
More Articles on Healthcare Reform:
Hospital Executives Undaunted by Supreme Court Arguments
How the Supreme Court's Decision Will Impact Healthcare Delivery: Q&A With Dr. Jeffrey Lobosky of UCSF
Two Hours May Determine Fate of Healthcare Reform's Individual Mandate