Health reform: Done deal? Not yet

March 23, 2013 in Medical Technology

At Bon Secours Medical Group in Richmond, Va., Robert Fortini has put in motion substantive changes during the last three years.

Many health systems have as well, in fact, since the Patient Protection and Affordable Care Act was signed into law March 23, 2010.

“We have redesigned care delivery to a team model and embedded case managers in the practices,” explained Fortini, Bon Secours vice president and chief clinical officer. “In addition we are aggressively using registries for population management.” To name just a few examples.

Indeed, there’s little question that the Patient Protection and Affordable Care Act, ACA for short, has demonstrable benefits already — even if as a Kaiser Poll found this week Americans still don’t understand them.

[See also: Obama wins, future of ACA, HIT uncertain.]

What’s less clear is how the ACA will fare long-term given this tumultuous political environment. One thing to be gleaned from the budget Wisconsin Rep. Paul Ryan proposed last week is that the GOP-controlled House is showing signs it will continue trying to repeal the law or certain provisions of it.

Uncharted territory

“Pushing ACA over the finish line on time would be hard enough even if there were a playbook ready for the taking,” which of course there is not, according to Claudia Page, co-director of Social Interest Solutions, a non-profit focused on health IT and policy.

That is perhaps more apparent in the health insurance exchange and Medicaid expansion provisions, the two most contentious pieces of the law right now, and the areas requiring the most technological heavy-lifting.

Rattling off a list of associated IT projects, Page pointed to security, identity resolution, program rules, systems integration between existing state and county systems, federal systems, other agencies, new call centers, and more. “IT systems transformation of this scale in this amount of time is like nothing the public benefit world has ever seen.”

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