"I can give you many examples of organizations that did not proceed with an MSSP application or bundled payment application because of that," he says. "They began second-guessing their investments, or perhaps hedging a little bit more."
The Supreme Court's role in healthcare became decisive. "If the whole thing had been struck down, it could have thrown things into a deep level of disarray," Childs says.
Given the partisan threats and the tensions building to the November election, there is still uncertainty over healthcare reform, he says. "But this is the one very big question mark that is now out of the way. There's a sense that this direction is constitutional."
Although the election could change that direction again, hospital leaders participating in Premier don't think it will be very significant, Childs says. In the event of a repeal, "people realize that part of the replacement would be around the same things, payment reforms that were Republican ideas initially."