|By Showalter, J Stuart|
With the future of the Affordable Care Act more certain, hospitals and health systems should focus on initiatives that improve the patient experience, enhance population health, and reduce healthcare costs.
Despite vigorous legal challenges, last June, the
It has been a bumpy ride for healthcare reform from
A Brief History of Reform
Reforming our healthcare system has been on the nation's policy agenda for more than a century. No fewer than nine presidents and one former president have wrestled with the issue in one way or another. Except for wars and taxes, healthcare reform may be the single most recurring major policy topic in the nation's history.
As the chronology in the sidebar on page 67 shows, a familiar adage should perhaps be amended to read: "Nothing is certain but death, taxes, and controversy over healthcare reform."
In its latest iteration, the controversy began immediately after the AGA was enacted. At least 2,8 states challenged the law, including ?6 that filed a joint lawsuit. A few introduced or even passed statutes that purported to nullify some or all of the reform law's provisions. Constant disputation and verbose jangling ensued until June 2,8, 2012, when a 5-4 majority of the justices ruled that the ACA is a valid exercise of
The decision- a complex, confusing, and rather remarkable opinion written by Chief Justice
The practical effect of the case,
* Elimination of annual and lifetime benefit limitations
* Prevention of policy rescission due to illness
* Coverage of children to age 26 on their parents' plans
* Guaranteed coverage for children with preexisting conditions
* Preventive services at no cost to
* Phase -out of the
* Incentives for the development of accountable care organizations (ACOs)
* Reforms of underwriting practices (e.g., medical loss ratio)
* Increased financing for antifraud enforcement
* A ban on physician- owned hospitals
* Changes to the Stark physician self- referral law
* The "individual mandate" to buy insurance or pay a penalty/tax
* A state option to expand
* Creation of state-based health insurance exchanges