Patient Protection and Affordable Care Act On Trial
By Dr. James Palermo // March 27, 2012
The Future of U.S. Healthcare
BREVARD COUNTY–The United States Supreme Court is deliberating over a constitutional challenge to the Patient Protection and Affordable Care Act (PPACA) after hearing oral arguments in March, and a ruling is expected from the Court prior to the June 30, 2012 end of its term. The lawsuit, brought by 26 states and the National Federation of Independent Business (NFIB), claims that Congress exceeded its power by requiring most Americans to buy health insurance starting in 2014 (Individual Mandate Provision).
Though many provisions of the PPACA are already in effect, the Court decided to expand beyond just examining the constitutionality of the individual mandate and also review and rule on other issues including the Medicaid expansion in the law, the role of the Anti-Injunction Act, and what provisions must be struck from the law if the mandate is ruled unconstitutional.
Whether its upheld, struck down, or specific elements are maintained while others are not, this is shaping up to be a landmark Supreme Court decision that will impact the provision of healthcare and health insurance in America for decades to come.
However, the transformational redesign of how care is delivered and wellness maintained that is baked into the PPACA has already become a primary strategic goal of most healthcare providers and payers. The fact is that, no matter how the Supreme Court rules in June, the train that requires legitimate collaboration and highly effective partnerships between historically self-centered sectors of the industry has left the station and there’s no going back.
Unlike three years ago, when PPACA was being debated, hospitals, health plans, physician practices and other affiliated healthcare providers have already begun building the structures that will deliver more value for the patient and payer.
The imperative for this transformation is a culture of continuous improvement, which requires healthcare providers and payers to focus on synergies with the ultimate goal being an integrated approach to all aspects of care across the continuum—wellness and health maintenance, acute hospital care, transitional care from hospital to home, and appropriate and compassionate long-term and end-of-life care.
As the reimbursement environment transitions from volume-based reimbursement to a value-based one (see Aug/Sept 2011 SCM Editor’s Note) focusing on quality, safe care and efficiency, providers will be expected to assume more risk for the health of a defined population, held accountable, and will lose out financially if the health of their patients doesn’t improve.
Space Coast Medicine magazine and SpaceCoastDaily.com will be your source for information related to the judicial fate of PPACA, and to the preparation, progress and success of our Space Coast hospitals and healthcare systems as they strategically engage and position themselves to best meet the comprehensive healthcare needs of the community in this new era of collaboration and accountability.