The health reform beta test is (almost) over!

by Amy Myers

I’m sure by now most of you have seen this commercial for the Nokia Lumia 900 where the announcer declares that all of us who have owned a smartphone in the last few years were simply part of a beta test and now the real smartphone has arrived—resulting in looks of chagrin and disdain from many a smartphone user in the commercial, unaware that had simply been test subjects.

I couldn’t help but think of that commercial as I read through this article published by Kaiser Health News/The Washington Post early this week. It discussed the uncertain future of health care innovations that were a direct result of already-implemented ACA provisions. As Adrianna discussed earlier, we know this could go several different ways (cue already hyped health media outlets!), but I’m left to wonder if we are potentially throwing the baby out with the bathwater, cutting off our nose to spite our face, or [insert other overused cliché here].

The KHN article touched on a number of good points – the first being one I think we can all agree upon – something had to change. The ACA was just the impetus we needed to put the weight and money of the federal government behind some of the more substantial change-making ideas that have been floating around for decades. So what happens if SCOTUS throws out the entire law?

“Thanks for playing 65 collaborations already working as ACOs – but you were a beta tester!” or…

“About all that reducing payments based on physician and hospital quality of care business… GOTCHA!”

It’s no small thing that the wheels have been in motion now for over two years. Several provisions have been implemented, many more are on the brink. If I were an ACO collaborator, I think I’d be a little nervous that those promised bonuses from CMS might be in jeopardy.

Recently we’ve seen intention from the likes of United Healthcare, Aetna, and Humana to continue the some of the most popular provisions on the commercial insurance side; Karan covered some of those plans here. But, as the KHN article points out, much of what the private payers put forward is modeled after what CMS does—so there’s concern in Washington about losing momentum. The author implies that it may be possible for them to persist as demonstration projects, but according to a former Medicare administrator, that will require new legislative authority to expand them nationwide.
The article is definitely worth a read, and surely worth further speculation and discussion. Can these monumental changes exist outside of the ACA? And even if Medicare and others can keep them going – can we fund them?

What are your thoughts? What provision do you think would be the biggest loss? What will survive the beta test?
Amy earned her MHA from the University of Missouri and works in healthcare market analysis and strategic planning.


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