The Affordable Care Act (ACA) lives. So, what comes next?
That is the big question the healthcare industry faces in the wake of last month's failed vote in the US House of Representatives to repeal the ACA. I'm not here to discuss the pros and cons of the ACA or the American Health Care Act. That's a discussion for politicians and policymakers. But I am here to breathe a sigh of relief that value-based care initiatives will continue.
I think we can agree that any significant change in process takes time to plan, to implement and to measure. Then more time is needed to tweak the process, if necessary, in response to those initial measurements. During the relatively short lifetime of the ACA, dozens of care and reimbursement initiatives have been put into place. Some have shown their worth, and others haven't. But the largest share of the initiative pie is occupied by those programs where the jury still is out.
Centers for Medicare & Medicaid Services set ambitious goals for moving from fee-for-service to fee-for-value, and health systems have been quick to respond to the changing pay and care dynamics. Hospital readmissions are down across the board, as are rates for hospital-associated infections, where penalties were attached to poor performance. Systems are experimenting with new care models such as accountable care organizations and patient-centered medical homes that truly do place the patient front and center.
Technology investments begin to pay off
But such close care coordination also requires closer coordination with the appropriate technologies to tease out the differences among patients and among care scenarios. Health systems have made considerable investments in technology beyond Meaningful Use mandates – all with an eye toward improving outcomes and the quality of care while keeping overall healthcare costs as low as possible.
We talk with our customers and prospects every day and remain amazed at some of the work they are doing. Getting the "Golden Record" for each patient is the goal, with relevant clinical information alongside preferential data to create a 360-degree view of each patient, with their individual conditions, comorbidities, medical outlooks, challenges and goals.
Getting a clearer picture of each patient helps providers better understand that person on an individual basis, which truly gets to the heart of healthcare. Simple things, like remembering that Mr. Jones may require transportation assistance or that Mrs. Smith only wants to be contacted by email, can help form a stronger bond between provider and patient. Those bonds can reduce no shows that hit the bottom line and compromise patient care, while keeping the patient actively involved in his care.
I don't think anyone believes the ACA is the cure-all for the US healthcare system. For example, the question of whether the ACA is actually bending the cost curve remains to be answered. But it's clear that innovation is happening everywhere, and much of the work shows promise. And that's what excites me about the future of healthcare.
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Bio: Damon Auer, Vice President, Health and Life Sciences, Tribridge
Damon Auer is a 20-year technology and consulting services executive specializing in helping health and life sciences organizations achieve business performance improvements. As Vice President of Tribridge's Health and Life Sciences practice, he oversees projects ranging from cloud-based Care Coordination and Electronic Medical Records systems implementations to process and systems integration consulting for healthcare delivery, pharmaceutical and medical device organizations.
An expert in transformational ERP and CRM programs, Damon has worked with organizations in the healthcare and life sciences industries for 15 years. He was instrumental in the development of Tribridge Health360™, a patient-centric, population health management solution built on the Microsoft Dynamics CRM platform, and recently helped a major metropolitan healthcare provider enable the largest commercial Accountable Care Organization (ACO) in the country.
Prior to joining Tribridge, Damon was a partner at an IT services firm, where he served customers in the healthcare, transportation, consumer products, life sciences, media/entertainment and professional services industries. He held leadership roles in global Siebel, ORACLE, Peoplesoft and BI process improvement and systems implementation projects for several Fortune 500 companies. Earlier in his career, Damon was a principal at PriceWaterhouseCoopers and a senior consultant at Andersen Consulting.
Damon frequently collaborates with Microsoft's Healthcare Strategy teams on the development and implementation of new healthcare solutions. He is a regular speaker and presenter on topics ranging from Care Coordination and ACO initiatives to Microsoft and cloud-based technologies.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.