"Quiet" Healthcare Reform Moves Forward

July 2, 2012
Below the level of the page-one news headlines, healthcare leaders have quietly been moving forward to create the new healthcare, with or without the help of official Washington. The Supreme Court's affirmation of the constitutionality of the ACA only adds certainty to the landscape.

Perhaps Blair Childs, the senior vice president of public affairs at Premier Health Alliance, said it best. In an interview with HCI Associate Editor Gabe Perna regarding his response to the Supreme Court ruling Thursday, June 28 on the Affordable Care Act, Childs said, “The controversy around health reform will continue, but this at least keeps in place the reforms that frankly are bipartisan, that are essential to fix our antiquated Medicare system. These are reforms that increase transparency, patient-centeredness, and better align payment with value.”

Childs, of course, pointed to elements in the ACA that most of the general public has been totally unaware of, elements that are sometimes referred to collectively as “internal healthcare reform”—aspects involving physician and hospital work to improve patient safety, care quality, efficiency, cost-effectiveness, accountability, transparency, and an improved patient experience.

These include, among other areas, value-based purchasing, healthcare-acquired conditions reduction, avoidable readmissions reduction, and the development of such arrangements as accountable care organizations, bundled payments, patient-centered medical homes, and other innovative forms of reimbursement and contracting. And that’s not to mention the creation of the new center for innovation at CMS, and other pieces of the ACA legislation that are all about that “internal healthcare reform.”

And here’s the thing: in all of the interviews our editorial team has been doing with healthcare and healthcare IT leaders regarding the Supreme Court’s ruling, the consistent response to our inquiries has been a strong awareness that the healthcare system’s leaders need to continue to work forward to reform our system from the inside, to create the “new healthcare” that is so often talked about, including in the pages of this magazine.

And the good news in all this is that there’s virtually no controversy within the healthcare industry about the broad direction in which the industry needs to move, and move rather quickly now. The only disagreements are around strategy and tactics, not around the overall picture, around which there is very broad consensus that our healthcare system is unsustainable in its current trajectory.

That consensus was clearly on view during the annual physician symposium held this week by AMDIS in Ojai, California. Listening to the CMIOs and other medical informaticists in their discussions this year, as in past years, it reinforced for me once again how passionate CMIOs are about creating change, how dedicated they are to birthing the new healthcare.

And that of course is true of all the healthcare executives my team and I talk to every week at Healthcare Informatics. Indeed, it is both heartening and incredibly impressive how committed healthcare leaders across the industry are to bringing about meaningful change in our national healthcare system. I honestly believe this is the hidden reality that journalists from the mainstream media keep missing, and that is that “internal” healthcare reform is moving forward regardless of what happens in Washington, DC. The Supreme Court’s ruling on the ACA has helped to clear away the remaining uncertainty around federal healthcare reform, but virtually every healthcare leader we’ve been talking to in the past few months has expressed a strong commitment to moving forward regardless of what ultimately happened with the ACA.

And when it comes down to it, strategically applied information technology will be incredibly important to creating the new healthcare our industry leaders are working toward, which is putting CIOs, CMIOs, and other healthcare IT leaders in an incredible nexus position in all this, which gives them tremendous responsibility, along with some level of influence, of course.

The bottom line? The new healthcare is emerging, bit by bit, and CIOs, CMIOs, and other healthcare IT leaders are absolutely going to be in the thick of things in architecting it. And, post-June 28, things will move forward inside healthcare as they were, only now with greater policy certainty. And in this quiet revolution, the readers of Healthcare Informatics will be key players in creating the new healthcare system.  So the quiet revolution moves forward. And we, the editors of Healthcare Informatics will continue to do everything we can to support healthcare IT leaders as they work with their colleagues to create the healthcare of the future.

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