The health care reform legislation that was recently passed includes many provisions that reflect the American Hospital Association's Health for Life reform framework.
Specifically, it expands coverage to 32 million people through a combination of private and public sector insurance expansions. It also puts in place important insurance reforms that will go a long way toward ensuring people can access coverage.
The legislation also includes delivery system reforms that hold great promise for improving quality, including allowing hospitals to play a leadership role in forming accountable care organizations; establishing pilot and demonstration programs for bundling services and gain-sharing; establishing a hospital value-based purchasing program consistent with AHA principles; and allowing the U.S. Department of Health & Human Services to waive regulatory barriers to clinical integration and delivery reform efforts under the ACO and demonstration projects.
It takes other steps to increase efficiency and affordability by simplifying administrative requirements, which will cut down on the red tape that is choking today's health care system.
In addition, it takes significant steps to shift focus toward prevention and wellness by providing Medicare beneficiaries with annual wellness visits and access to evidence-based preventive services with zero cost sharing. It also creates a $12.9 billion prevention and public health fund, a new public health council, an education/outreach campaign and various initiatives to create healthier communities.
Does the bill include everything we want? No. It is not perfect, but it lays a solid foundation upon which we can continue to build. The alternative was an immediate focus exclusively on deficit reduction and budget cutting with no significant coverage expansions.
The debate in Congress may be over, but the hard work for hospitals has just begun. Rest assured that the AHA will be there to support hospitals at every step of implementation and it will continue to work with the administration, Congress and all stakeholders to make the necessary refinements that will be inevitable given the scope of any reform of this magnitude.
Stephen Smart, D.D.S. (email@example.com), is COG chair and chair of Medical Center of South Arkansas in El Dorado, Ark.