July 10, 2012
(Editor’s Note: This is part four of a four-part installment on “How the New Health Care Plan Has Been Misunderstood, Misrepresented, and Mismanaged.”)
The Affordable Care Act has now been ruled constitutional by the U.S. Supreme Court, except for a section of the Act that could be used to penalize states for not expanding their Medicaid programs as provided for by the Act.
After two years of flawed implementation efforts for the new national health Plan, the potential exists to shift to recovery from past failures and relaunch of the Plan with improved strategies.
Recovery strategies are essential to improve implementation of the Plan. All organizations in the Health Care System will be affected by the need to examine their activities over the past two years and improve their strategies for the Plan.
Relaunch efforts must be carried out in order to build more effectively on the situation that exists today, with organizational strategies that have increased potential for success.
Over the past two yeas, implementation efforts for the Health Plan largely focused only on the “actions” created by the new statutes, with minimal consideration of organizational “reactions” that needed to be anticipated and dealt with through outreach, flexibility, communications and incentives.
The Health Plan has experienced a general “failure to thrive” during the first two years of implementation.
Delays in taking necessary actions have resulted from many causes, including an insufficient understanding of critical activities that should have been initiated, organizational hesitancy to act, and a “slowdown” effect during the past year, as some individuals and organization have chosen to “wait and see” pending the outcome of the legal challenges to the Plan.
Now that the Health Plan has been ruled generally constitutional by the Supreme Court, it will now be necessary for all organizations to reassess their present status and begin to recover from the delays and missteps of the past two years.
There is an urgent need for organizations to recover (from the past inaction, delays and missteps) and relaunch (to move with full energy and effort to start over with a new implementation drive.)
Organizations are likely to seek changes in regulations and schedules that are to their advantage; lobbying for changes is likely to be intense.
Efforts to move forward with successful implementation are likely to coexist side-by-side with efforts to prevent such a success.
The relationships between the Health Plan, Medicare, and Medicaid will be a major consideration by all organizations as the Plan continues to evolve; Medicare and Medicaid must be considered for redesign as part of the broad efforts to change how health care services are delivered.
A detailed analysis of the new Health Plan may be found in a recent book (Legal Practice Implications of the New U.S. National Health Care Plan, 2011-2012 Edition, by Mitchell and Mitchell, published by Thomson Reuters/WESTLAW). Supplementary discussions by the authors regarding implementation of the Plan are also available through subsequent blogs (at www.westlawinsider.com) and a Thomson Reuters podcast (at www.legalcurrent.com).