Repeal and Replace: Managing the Uncertainty

The replacement of the Affordable Care Act (ACA) began last week with Republican lawmakers releasing their first proposal for a reconciliation package – the American Health Care Act. And, we’re learning there are some thorny issues to work through.

It’s a very uncertain time but we can all agree that changes are needed to the ACA.

Despite all of the developments we’ve seen over the past eight years, we still have a system that allows payer decisions to override a physician’s judgment, is micromanaged with outdated regulations that undermine innovation, and has perverse incentives that encourage volume over value and sickness over health.

But we shouldn’t return to the days of millions of uninsured, coverage locks outs for people with preexisting conditions, emergency rooms being used for primary care and unsustainable cost increases.

So, how do we progress?

We must prioritize achieving measurable improvement, patient-centered care, and provider-led innovations. Healthcare providers are working with Premier to do this by being effective advocates to Congress and the administration, as well as working together to test and scale new value-based models of care delivery.

A few things we are certain about is that providers are moving forward on these efforts by:

• Better managing costs and finding new sources of revenue. This includes improving productivity, reducing supply chain inefficiencies and pharmaceutical costs, and removing unjustified variation, as well as expanding their systems to create a high value network.
• Seeking meaningful insights from all their data. Health systems are moving beyond recording data in electronic health records toward integrating and combining data to streamline analytics on supply chain, financial and clinical care for evidence-based decision-making.
• Engaging in risk-based contracts and developing effective population health models. Providers are being incented to be accountable for cost and quality of care in ways they have never faced. They want this change, but it requires new skills, care delivery infrastructure, data and analytics, and capabilities.

If we partner together and bring scale to help solve local problems, we can be certain we’re taking the right steps to continue to improve the cost and quality of healthcare, as well as the health of our communities.

To learn more about how Premier can help you navigate the change at your organization, CLICK HERE.