Evolve and Embrace

Part of the concern for those in business is not the fact that there is healthcare reform taking place but rather the uncertainty of what the new system will look like.  Companies can adjust and adapt if they know exactly what the rules are and see how things will all work together.  We all know that there are a ton of changes that needed to be implemented because of the Affordable Care Act and it seems like things are right on target for full implementation by 2014.  Last week there was some clarity given to the insurance industry by HHS about the new regulations and this article in HealthLeaders Media shows how comfortable everyone is becoming.

It is interesting that as things get implemented there seems to be a greater understanding of the benefits of the ACA and all of the concerns seem overblown and even at times trivial.  I recognize that so much of the debate was really “politics as usual” but now it is time to move on.  Everyone seems to love those changes that have taken place so far.  Having young adults stay on their parents plan has not hurt any insurance companies and it was clearly a boom for the pharmaceutical industry as this age group was the fastest growing patient group last year.  Seniors are not complaining about the donut hole savings and many of us have gotten rebates from insurance companies based on the ratio of medical vs. administrative costs being favorable.  Nobody seems upset about lifetime limits going away or all the other changes implemented to date.  So far so good.

The accountable care organizations were going to be impossible to get started and everyone was going to avoid them like the plague.  Well, after some flexibility from the government they are up and running.  Many more groups are registering for the program for next year and even the commercial insurers have embraced the movement.  There have even been some early wins noted from the pilot organizations.  Look at all the publicity that is out there about hospitals doing everything possible to prevent readmissions now that there are financial incentives in place.  The bottom line is providers see the possibility of making money by practicing better, higher quality medicine and they are embracing the challenge.  So far so good.

So now things are being put in place for the final stages of implementation.  Healthcare insurance companies are working through the changes and feel more comfortable in being able to thrive in the new environment.  Health exchanges, either state or federally run, are right on schedule.  This is a safety net that will help everyone as it will break that unhealthy tie many have with their employer because they fear not being able to get insurance if they are downsized or quit.  This should be a real boom for entrepreneurship in the coming couple of years.  This coupled with the fact that the 129 million with pre-existing conditions will not be discriminated against provides another level of security.  Now insurance companies must insure in addition to not being allowed to dump those who are sick.   Again, so far so good.

As the final stages of reform are coming perhaps it would be wise to think they will go just as smoothly as what has happened so far.  Insurers will do just fine.  Providers will not be totally overwhelmed.  There will not be a mass exodus of physicians because they can’t make money.  There will be no death panels.  The system won’t explode because the previously uninsured will be flooding offices for stress tests and hospitals for MRIs.  Exchanges and ACOs will work.  The health system will get better and with more people getting care earlier, even preventative care, costs may even go down.

Wise business people will prosper significantly from the changes while those who fight them will lose.  As healthcare professionals perhaps the most important question to ask yourselves is whether you are living in the old world or are leading the charge to win in the new world.  Look at history.  Embrace the change.  Evolve.  Don’t become a dinosaur.

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