BY THE TIME MOST OF YOU ARE READING THIS, it is likely that the Supreme Court ruling on the challenge to the Accountable Care Act (ACA) will be public knowledge. It was this week of June 25-June 29 that the ruling was expected to be announced.
Obviously, there are three potential rulings:
1) to allow the Accountable Care Act to stand as enacted;
2) to invalidate the entire ACA on constitutional grounds as argued during the hearings; or,
3) to invalidate selected portions of the law, most likely to include invalidating the controversial requirement of the “individual mandate.”
What I would like to put forth to you today is that, regardless of the decision, passage of this legislation has already set in motion transformational forces that will not be greatly affected if the Supreme Court invalidates some or all of the Accountable Care Act. Take the example of some larger payers. Just days ago, UnitedHealth, Aetna, and Humana told journalists that they intend to keep some of the popular elements of ACA. These include offering preventive services without co-pay requirements, covering children on the parents’ policies until age 26, and the elimination of lifetime benefit caps, to name a few.
As I see it, a Supreme Court ruling invalidating the entire ACA will not stop the formation of accountable care organizations (ACO) nor the momentum to more tightly integrate the delivery and management of healthcare to patients. It is equally true that such a court ruling will not derail nor delay the federal program to incentivize hospitals and physicians to adopt and use electronic health record (EHR) systems.
Assume that my prognostications are accurate. What does this mean for hospital laboratory administrators and pathologists? There is plenty of evidence that our healthcare system is already embarked on a transformation that will not be derailed. These pages have discussed all the trends in great detail—ranging from proactive and personalized care to the tighter integration of care delivery and healthcare informatics. Thus, for my money, pathologists and lab managers should continue to anticipate more change and position their laboratory organizations to add the kind of value that is rewarded with ample reimbursement. That is the path to sustained clinical and financial success.