I think most hospital executive leaders are keeping their head down on this. I don't mean to minimize the impact of this decision. Yes, they're following the decision, because it could cause a crisis in healthcare. Many variables will be thrown back into the mix if the law is gutted, but the new goal will not change.
Whoever is paying for healthcare is tired, and in many cases unable, to subsidize the old status quo of volume being the key success factor for healthcare businesses. They can't, or won't, suffer double-digit premium increases anymore and they won't write blank checks to “do stuff” to the patients they cover.
Instead, many healthcare executives know that they have to figure out how to work with their partners to absorb some of that risk. This would have sounded absolutely insane around the time PPACA was first being debated, but those partners now include the employer, the patient, the health plan, the physician, and many others in allied care. All will share risk. The multiple pilot programs going on across the country with almost every payer is evidence of that.
The problems a rejection of the legislation will cause will be severe, but it won't change the work you need to be doing.
In fact, it will make delivering on value even more important.