There have been countless articles and posts in recent weeks predicting the implications of the recent Supreme Court decision upholding the Affordable Care Act (ACA), and it has been very interesting to see the various interpretations, and in many cases over-simplifications, of the Act and its impact on the U.S. healthcare system.
One eWeek article last week listed 10 predictions for ways the decision would stimulate healthcare IT. Several of these predictions had to do with the advent of health insurance exchanges mandated to come online at the end of next year, and several had to do with how the healthcare system will cope with the estimated 30 million additional lives predicted to get health insurance in the next couple of years.
A few of the predictions made some very interesting connections between these changes and HIT. For example, the idea that consumers who have hitherto been unable to get insurance under now-defunct pre-existing condition rules will soon be stampeding into the market was connected to a predicted need for better chronic-care management technology. Readers of this blog will be aware that we subscribe to the opinion that effective chronic care management -- including early detection and prevention -- is essential to health reform at both the macro (population health) and the micro (individual practice/patient) levels. As Kaiser CEO George Halverson, pointed out in his book Health Care Will Not Reform Itself, and in his HFMA ANI keynote a few weeks ago: Diabetics spend roughly 32 percent of the total cost of Medicare; if just 40 percent fewer people became diabetic, half the job of saving the Medicare Trust Fund would be done.
Advanced, intuitive EHRs that capture comprehensive patient data and support practice-wide and population-wide analytics to identify groups and individuals at risk -- particularly EHRs that flexibly support multi-disease management at both of these levels -- are key to making ACA work. Much more than that, they are key enablers for transforming U.S. healthcare from an unsustainable, unaffordable and ineffective “sector” into a sustainable, affordable and effective “system.”
Another prediction in the article was that ACA (and the court’s decision that clears the way for its continued implementation) will be the final straw for many small practices that still hesitate over EHR adoption despite HITECH and its meaningful use incentives. We sincerely hope that is true because those small practices are still the bedrock upon which U.S. healthcare is built. Because of the impact of these practices in moving the needle on care cost and quality, we are dedicated to developing and delivering technology for small practice providers who are the true “medical homes” where care is originated, coordinated and implemented for the majority of patients.
To me, it seems that if these important predictions – that population health, disease management and small practice EHR adoption – are now about to accelerate, it looks like we are finally reaching a “tipping point” for U.S. healthcare.