The uncharted waters ahead: navigating the ACA
We are now navigating across uncharted waters. The ocean of the Patient Protection and Affordable Care Act, conventionally called the Affordable Care Act (ACA), is now before us.
No one knows how the American public will respond.
- Will businesses downsize to reduce health coverage?
- Will the State of North Carolina eventually go with the Medicaid expansion?
- Will individuals without healthcare coverage get coverage through a healthcare insurance exchange?
- Will the public reduce the demand for health services?
- Will the public seek primary care, or continue to access care through the local Emergency Department?
- What will happen to physicians as their reimbursement rates decrease under the Affordable Care Act?
- What will happen to independent community hospitals, with reduction in governmental reimbursement rates including Medicare, Medicaid, and TriCare?
- What will happen to the reimbursement rates of commercial insurance payers?
- What will happen to bad debt and charity care?
- What will be the impact of transparency in selecting care?
- Will lifestyle accountability become relevant?
At the local level there are many things that will have a significant negative impact at Onslow Memorial Hospital and our community, including the following:
- Medicare reimbursement rate reduction
- Medicaid reimbursement reduction
- TriCare reimbursement reduction
- Rising demand for Primary Care – but lack of access
- Rising demand for ED services due to lack of Primary Care access
- Coverage issues due to the lack of Medicaid expansion
- Less than optimal knowledge in the community about the Affordable Care Act
- Less than optimal knowledge about Health Exchange Program
- Rising cost of IT and IT demands
As we chart our course across the ACA, there are some basic principles that we should follow:
- We must be a positive team
- We must work together
- We must stick together
- We must communicate more
- We must problem-solve together
- We must treat everyone with dignity and respect
- We must ensure a culture of sensing others’ needs
- We must strive every day to improve quality, safety, and the patient experience
- We must reduce cost
- We must support patient- and family-centered delivery of healthcare services
- We must chart our course to a port of call that will ensure our future sustainability
- We must show our pride in all we do
As the saying goes – “We can’t change the direction of the wind, but we can change how we set our sails.” This is certainly true as we navigate our course across uncharted waters.
Ed Piper, Ph.D.
Former President & Chief Executive Officer, 2000-2016
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