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Accountable Care Organizations and SCOTUS

Posted on June 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The Supreme Court ruling on SCOTUS is likely to come sometime this month. There are all sorts of opinions out there about what’s going to happen to the ruling, but a recent tweet caused me to stop and think about the real impact of SCOTUS. The tweet (which sadly I can’t find again) said something about the Supreme Court’s ruling on Obamacare and SCOTUS really doesn’t matter to healthcare since the change in care model has already been started.

I take one slight exception to this comment. I agree that the ACO (Accountable Care Organization) movement and all that it embodies is already upon us and won’t be affected by the Supreme Court’s decision on SCOTUS. However, I think the SCOTUS legal decision does matter and will still have an impact on healthcare. Not to mention the politics related to the decision. Although, I’ll leave both of those topics for a different blog.

I do think it’s worth exploring ACOs and why SCOTUS or NO-SCOTUS, ACOs are here to stay in healthcare.

Dave Chase recently said in a Forbes article that “More than 80% of the newly formed ACOs are driven solely by private sector efforts.

I believe that Dave Chase got these numbers from an ACO Watch article about a Leavitt Partners study on ACO growth and dispersion. It’s a powerful number to consider that despite all the efforts by government to move to accountable care organizations that only 20% of the newly formed ACOs came from the government. What a healthy thing and a great illustration of why SCOTUS won’t impact ACOs in any major way.

Dave Chase in the above linked article adds this additional quote from Philip Betbeze:

As Philip Betbeze stated, “In their day-to-day-lives, it [the SCOTUS decision] largely won’t affect the 180-degree shift they’re making in reimbursement philosophy. For most systems, those changes are taking place largely at the behest of commercial plans and local employers.” The fee-for-value train has left the station. Woe is the health system that hasn’t made aggressive moves to reinvent themselves.

We’re still early in the reimbursement philosophy switch, but the winds of change are upon us. Personally I’m excited to see how health systems reinvent themselves. I think this reinvention will be around these key pillars:

*Communication – ACO’s will drive better communication. This will include patient to doctor, doctor to doctor, and even patient to patient. The beauty is that in an ACO, the goal will be for the patient not to come to the office instead of the de facto, come to the office answer most practices give today.

*Data – Practices better be preparing for the tsunami of healthcare data on the horizon. How an ACO takes that data and uses it to improve patient care is going to be key.

If you look at these pillars of an ACO, are they even possible to deal with without technology?

No EMR Mandate in HITECH or ACA – Meaningful Use Monday

Posted on April 16, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m going to veer off a little bit from the regular Meaningful Use Monday topics to cover something that I think needs to get more coverage and is related to the EHR incentive money and meaningful use. Let me start by making something extremely clear:

There is NO EMR mandate. There is NO EHR mandate.

For those of you who want a broader post on the subject, you should read my post from a little over a year ago about the 2014 EHR Mandate. The key is that there’s no EHR mandate and no one is going to put an EHR mandate in place. Certainly there are incentives to use EHR and penalties if you don’t use EHR, but that’s not a mandate.

For those that don’t want to click to the full post above, in it I give five other reasons to implement EHR and an explanation of each. These reasons together could feel like a mandate. Here they are:
* Ability to Sale Practice
* Government Mandated Reporting
* Reimbursement Requirements
* Patients
* ROI for Your Practice

I’m sure that people are still confused on this subject. In just the past 7 days, this website has gotten 250+ people searching terms related to EHR mandate. A lot of people are starting to get concerned about what they’re hearing on the street about EHR. Will this fear of an “EHR Mandate” push many into EHR adoption?

HITECH and Obamacare (ACA)
Related to this mandate for EHR, many people are also confused by the EHR incentive money and the supreme court case for Obamacare. Many people confuse Obamacare, otherwise known as ACA, with the HITECH act (which was part of the ARRA legislation).

What you need to know is that when 99% of people talk about EHR incentive money, meaningful use, EHR mandates, EHR penalties, etc, they are talking about ARRA and more specifically the HITECH act. ARRA and the HITECH act aren’t going before the supreme court and so they’re not at risk. ARRA and HITECH could be affected if the republicans win the Presidency, Congress and the House, but most people argue that HITECH is pretty bipartisan. Although, that’s a topic for another post.

ACA is what’s gone before the supreme court and we’re awaiting a ruling. If ACA is declared unconstitutional, then there will be some affect on healthcare IT programs in general but most EMR programs won’t be affected.