Four Themes to Successfully Navigating the Supreme Court Decision
Today’s decision by the U.S. Supreme Court to uphold the controversial Patient Protection and Affordable Care Act confirms the direction of healthcare reform that had already begun a few years ago. Many payers and providers, responding to the slowly emerging regulatory architecture of the law, have embarked on large scale transformational initiatives which will fundamentally change their business models forever. Even before the first draft of the health reform law was complete, a radical shift was already gaining momentum and leaders of healthcare organizations were facing mounting pressure to reinvent the healthcare system.
In such a "whitewater" world, the capacity to adapt quickly to continual, unpredictable and demanding forces of change may ultimately determine the survival of many healthcare organizations. Coping with the law's core tenets - greater accountability and transparency - coupled with the trends already underway including capitated reimbursement models, shifts in demographics, personalized medicine, and the proliferation of technology will require making tough decisions and taking bold actions at a time when unpredictability and ambiguity are greater than at any period in the last century.
Successfully navigating this new normal will hinge on four key themes:
- Horizontal Clinical Integration – Aligning care delivery along the same continuum the patient experiences will shed new light in the gray areas where cost, efficiency and quality gaps tend to live.
- Bridging the Divide Between Care Delivery and the Business Office – Every organization must be able to achieve real-time synchronization of the best care delivery decisions with the business office and patient needs of predictability, documentation, logistics, and varying reimbursement requirements.
- Engaging the Staff – “Doing more with less” is a team sport. Working to build collaboration across the entire enterprise to unearth and improve breakdowns and performance gaps will result in increased efficiency and effectiveness in every aspect of the organization.
- Changing the Playbook – Often organizations faced with unfamiliar circumstances or highly complex challenges fall back on what they know best. Success in today’s environment will only be achieved by engaging experts from both inside and outside the organization to bring new levels of creativity and problem solving to address needed transformations which leaders may have never envisioned or experienced before.
The next decade will continue to challenge the entire healthcare community's ingenuity with unprecedented transformation in this country's healthcare system. Change of this magnitude will require organizations to abandon the familiar before the new is completely defined. We look forward to sharing the insights, best practices, tactics and tools to help you and your organization thrive and grow as the new healthcare landscape continues to evolve.