Neither did it meaningfully address patient noncompliance, I was told by dozens of healthcare executives, both in educational sessions and outside in the hallways. But most importantly to them, the law represented an irresistible tide of change coming their way, as they sought ways to compete for a shrinking reimbursement pie. Thus the long faces. One theory had it that the bill would hasten and even worsen the healthcare crisis, leaving a true opening for single-payer healthcare—something favored by many Democrats—to pass later on as the crisis spun out of control.
The jury's still out on that prediction, but I must say that the mood at ACHE has improved significantly, and I'm pretty sure it has nothing to do with the beautiful, summerlike weather we had this week in Chicago.
Two years into healthcare reform, the roof hasn't caved in. In fact, many healthcare organizations are doing just fine, thank you, in making the transition to a new business model of healthcare based on value instead of volume. I sense a genuine optimism among the group (though it's hard to get a true handle on how a thousand or more people are feeling without a scientific poll). I have talked to several executives in the hallways, however, and what's different is that healthcare administrators truly seem to believe that they are getting the tools to turn around a wasteful, harmful healthcare system.
Not that credit necessarily is given to the legislation, mind you. Employers, health plans, and other payers were already hard at work on the problem in a piecemeal fashion, but when your biggest payer (CMS) still pays by the procedure, it's hard to get traction. Now that the government will no longer be writing the equivalent of blank checks, a burning platform has been created, as business types like to say.