The Fallout

What the midterm election results mean to healthcare providers.

As the final votes are tallied it is clear the Republicans have gained tremendous ground in the fight for control of our government. Voters made it known that they wanted change because of the job losses, pending tax increases and healthcare reform bill. As a result, Republicans have gained control of the House of Representatives, gained seats in Congress and won governors’ races in many states.

Some exit polls have shown that voters did not want President Obama’s healthcare reform bill, with 45 percent in one national poll saying their vote was a direct message opposing it, 27 percent neither in opposition or support and only 28 percent in support.

With the intent of the healthcare reform bill being to reduce cost and increase access of care, one area where cost is skyrocketing is employer provided health insurance. It is estimated that premiums will see double digit increases for employees and more than that to employers for their share of the premium.

The Congressional Budget Office has scored the healthcare reform bill as a cost-saving measure. This will make it very difficult for the Republicans to truly repeal and replace the legislation like so many Tea Partiers have demanded. The Republicans could proceed with a plan to delay the implementation of the provisions and most likely continue to fight funding provisions.

So what does all this mean to our nation’s hospitals, health systems and forming ACOs? That is the $3 trillion question, isn’t it? It seems clear that the reform of how Medicare and Medicaid reimburses hospitals will proceed as planned, as states legislate in support or opposition of the healthcare reform legislation. Until the bill is repealed (if ever) payment reform proceeds.

We will continue to see healthcare providers of all types, sizes and disciplines morph into ACOs, even though the definition today is a little foggy. The challenges these emerging organizations face are many, but the evolution is imperative to survive in a post-payment reform era.

In a short few weeks we will have more information as Health and Human Services releases guidance on ACOs, and know more on how our healthcare system will evolve. All of us at the Journal of Healthcare Contracting look forward to keeping you “in-the-know.”

John Pritchard About John Pritchard

John Pritchard is the publisher of The Journal of Healthcare Contracting as well as The Major Accounts Exchange (The Max).

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