Hospital Leaders Ponder Impact of Political Uncertainty

And it even means a 200-bed expansion at University of Colorado Hospital.

"Regardless of what happens, we know there's going to be a demand for those services," Stacey says.

However, Blair Childs, vice president for public affairs for Premier Inc., a purchasing and quality collaborative with 2,500 hospitals, has a different view. He believes the Supreme Court's decision changes the landscape for hospitals.

Between March of 2010 when PPACA was passed and signed, and the time the Supreme Court decided to review the lawsuits filed by the states and others, hospitals were working toward goals of reducing costs and quality improvements and joining some of the models and programs the law offered, Childs recalls.

They had little doubt about which direction they should steer their organizations. "There was a flurry of activity," he says.

Then, almost overnight, hospital leaders began to slow down. "There was this thinking, 'Oh my gosh, the Supreme Court is going to take this up,' and 'Oh my gosh, they might actually strike this down'"—a sense that gained traction after oral arguments in March, Childs says.

"We've been hearing from our members that a lot of folks were tapping their foot on the brake for the last six months for all practical purposes," he says, such as holding back on applying for demonstration projects.