Regardless of court ruling, reform under way (USA)

Citation

(2012), "Regardless of court ruling, reform under way (USA)", Leadership in Health Services, Vol. 25 No. 3. https://doi.org/10.1108/lhs.2012.21125caa.005

Regardless of court ruling, reform under way (USA)

Article Type: News and views From: Leadership in Health Services, Volume 25, Issue 3

Keywords: Healthcare reform, Change management, Clinical integration, Healthcare and quality improvement

Will health leaders revamp their organizations if the constitutionality of the individual mandate portion, or even if the entire Patient Protection and Affordable Care Act, are rejected by the Supreme Court?

Will they, perhaps, cancel expansion plans needed to take care of 30 million newly insured, or withdraw resources from improving patient experience scores? Might they scale back efforts to improve discharge planning to reduce readmissions, since the sections requiring penalties will be invalidated?

No. Not at all, several said, after hearing portions of the arguments this week. Whatever the Supreme Court decides will have little effect on current reform trajectories already underway.

“Even if the entire law disappears, healthcare reform will continue because it’s become part of our DNA,” says Michael Dowling, president and CEO of North Shore-Long Island Jewish Health System. “Everyone is talking about it now.”

Dowling adds that his organization has been working toward bundled payments, greater transparency, and preventive medicine, and away from fee-for-service “for years before the law.”

“Innovators will continue to move forward, no matter what happens with the Supreme Court,” he says.

Chris Van Gorder, CEO of Scripps Health in San Diego says that, “In the end, (the justices’ decision) might not matter, and it might not significantly change the direction of healthcare. We all know that too many people are uninsured, the current system is broken and is too costly. Much of the work, in fact all of the work, Scripps is doing right now to improve quality, access and lower cost will continue, regardless of the final decision.”

And Stephen L. Mansfield, president and CEO of Methodist Health System in Dallas, says a “complete transformation” of the healthcare system is still the only viable alternative, even without the Supreme Court decision.

So Methodist is moving ahead with plans to form an accountable care organization (ACO), and is working to achieve clinical integration with its physicians.

“We have begun transitioning our primary care clinics to medical homes and enhancing our focus on the health of the community, beginning with our own employees,” he says. They are working to reduce costs and improve quality at the same time.

Like many executives of hospital systems, Mansfield hopes the Supreme Court will not reject the law. “I believe the healthcare reform legislation as proposed is this country’s best opportunity to take healthcare value in America from mediocre among industrialized nations to superior,” he says.

“If we believe healthcare is indeed a right rather than a privilege, dramatic reforms are needed.”

“If this legislation is not upheld, I challenge our legislators to present an equally strong alternative, because I do not believe the current trajectory is sustainable.”

If the law is struck down, it may be up to the states to interpret their own rules for reform. If that comes to pass, Dowling says, “How real reform is achieved will be different from place to place, but it’s too much a part of our collective consciousness to disappear.”

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