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Providers, Payers Largely Favor PPACA Decision

Cheryl Clark, for HealthLeaders Media, June 29, 2012

The law's expanded healthcare coverage "will allow patients to see their doctors earlier rather than waiting for treatment until they are sicker and care is more expensive," he said. And, Lazarus said, the court simplifies administrative burdens, including streamlining insurance claims, so physicians and their staff can spend more time with patients and less time on paperwork."

David Goodman, MD, co-principal investigator of the Dartmouth Atlas, whose research on national healthcare cost variation influenced the legislation by demonstrating that high quality care does not have to be expensive, said the ruling "identifies the legislative branch as the locus of policy development for these important problems."

The Atlas "showed that healthcare differs widely from place to place in  volume of services, much of it unnecessary, is an important driver of healthcare costs. The fee-for-service payment has been permissive of that rapid growth," he said. Now, sections of the PPACA incent healthcare organizations to minimize duplication and maximize care in the patients' best interests with bundled payments and care continuation models long after they've left the hospital, thereby preventing their deterioration.

The health plan trade organization, America's Health Insurance Plans, issued a mixed response.

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1 comments on "Providers, Payers Largely Favor PPACA Decision"


R Daniel King (6/29/2012 at 4:33 PM)
First, how does an inefficient, quality challenged government agency provide the leadership in designing a path to an efficient, quality-driven health care delivery system? ObamaCare is a coffin not vehicle to the Golden Age of Medicine and it appears some are blinded by the idea that there will be more patients paying $7 for a service costing $100. What the Supremes have upheld is the right for government to limit freedoms, limit profits and dictate what medical services will be given for free. Today it is only health insurers, tomorrow everything else. Once government claims everyone has "government" insurance and cost shifting is something in the past, nothing stops CMS from limiting hospital CEO salaries based on a factor times the average nurses salary because "it's fair" and all his hospital patients now pay. How about creating profit ceilings to" make it fair" by controlling the profit range between specialist and primary care physicians? Or say that a hospital that exceeds a 5% profit threshold has to give the excess to a competing hospital that is not close to the threshold to "make it fair." We are knee deep in an entitlement culture that wants governmen to "make it fair." Which is exactly what health care leadership is presently doing, waiting for government. Remember, four Supremes found the WHOLE law unconstitutional. Roberts had to import a reference to taxes which is unprecedented. Now, there is nothing stopping government from adding the "tax" to FICA for subsidizing the uninsured poor so all your patients can pay. Remember, Democrats stated during the ObamaCare debate, "it would be so much easier if we could just tax like we do Medicare." Robert's has granted their wish. With profit controls and mandated free services on private insurers, how many do you think will be left in five years? What will be left will be "Medicare" for everyone with universal price controls, hundreds of oversight agencies and hundreds of thousands of regulations, all freedom killers, quality killers and inflation builders. The Democrats are presently on a full court press to attach anyone who makes reference to "the tax" and mandate in the same sentence, because they do not want the voters to connect the dots before November. I do not feel the tingle up my leg that the individuals in this article are feeling.