keep calm and carry on

Here we go again.

In November, the Supreme Court announced that it would hear one of the cases challenging the legality of premium subsidies in states where the federal government is operating health insurance exchanges. Because those subsidies are a linchpin of the Affordable Care Act (ACA), this puts the future of the AGA in question, much like two years ago, when the individual mandate to purchase health insurance survived a separate Supreme Court challenge. The latest court announcement comes on the heels of midterm election results that changed the political landscape and reopened the door to continued legislative challenges to the healthcare reform law.

My purpose here is neither to debate the legal question around the subsidies nor to speculate on how the political environment might impact the ACA. I have a straightforward message to share that you should find relevant whether you think the ACA should be repealed and replaced, "repaired," or kept as is. It's very similar to the message HFMA sent its members in early 3013, when the nation awaited the Supreme Court decision about the individual mandate: Don't wait for Washington to sort itself out. Keep moving forward.

The forces that drove healthcare reform-focused so strongly on improving access to insurance coverage and enhancing the value delivered to care purchasers-are even stronger than they were two years ago. The private insurance market will keep moving toward care transformation, which will ultimately be the most effective way to drive value.

At the same time, consumers will continue to bear more of the financial responsibility for their health care, which will drive their engagement in value-based decision making. In other words, the consumerism train has left the station.

In this new era of consumerism, people expect better information, better processes, and a better understanding of what they're getting for their money. This goes way beyond the superficial consumerism of the past. It's time to close the gap between the financial information and support consumers need and what providers can deliver. The groundswell of consumer dissatisfaction being expressed on social media will increasingly be voiced more directly to providers-and reflected in providers' bottom lines. As Moody's Investors Service put it recently, today's high deductibles are tomorrow's bad debt. Taking it a step further, it's easy to see how today's patients with high deductibles could become tomorrow's dissatisfied customers.

But it doesn't have to be that way. Finance leaders have the power to change it.

Over the past year, HFMA has developed a comprehensive approach to addressing consumers' needs in this new era of health care. From providing price information on the front end to resolving medical accounts on the back end, HFMA's Dollars & Sense(TM) initiatives provide a roadmap for finance leaders to navigate toward a consumer-centered future-no matter what happens on the ACA front. So take a look at your revenue cycle processes through the eyes of a patient. Evaluate honestly the difficulty of navigating your organization's billing and payment process. And then make a commitment to improvingyour patients' financial experiences. Visit hfma.org/dollars to get started. *

ABOUT THIS COLUMN

This is the third in a series of columns about the Affordable Care Act in this space.

Follow Joe Fiferon Twitter: @HFMAFifer.

Joseph J. Filer, FHFMA.CPA

President and CEO, HFMA