The Supreme Court in June largely upheld the Affordable Care Act, healthcare reforms passed in 2010. Some parts of the law already are taking shape, such as the creation of health-benefit exchanges. Individuals and small businesses will be able to buy health plans through exchanges, using federal tax subsidies and credits, starting in 2014. The Business Journal’s Vita Reed asked some Orange County hospital and health plan executives to discuss the effects of reform on their operations and planning.
Gene Rapisardi
Vice president and general manager, Cigna Southern California Region, Irvine and Glendale
The Supreme Court has done its important work, but we believe more work remains to provide secure and affordable healthcare for every American.
The court’s ruling provided the entire healthcare industry with greater clarity and ended uncertainty and questions about certain aspects of implementation. But other important systemic changes that were already under way, regardless of the ruling, will continue and accelerate.
That’s because we believe the only way to manage healthcare costs is to improve health. We aim to change the delivery system from one that focuses on “sick care” and paying for volume to one that is centered on prevention and wellness and paying for value.
Cigna has been very active and a leader nationally since 2008 in working with healthcare professionals to establish collaborative accountable care programs that seek to expand patients’ access to care, improve care coordination and achieve the “triple aims” of improved health outcomes, lower total medical costs and increased patient satisfaction.
We recently launched our first collaborative accountable care program in California and expect to announce additional programs during 2012 and early 2013.
Cigna is now engaged in 32 collaborative accountable care initiatives in 16 states, encompassing more than 300,000 Cigna customers and more than 4,500 primary care physicians.
We have a goal to have 100 collaborative accountable care programs with 1 million customers in place by the end of 2014.
Marcia Manker
Chief executive, Orange Coast Memorial Medical Center, Fountain Valley
While the Supreme Court’s decision provided further clarity on healthcare reform, we were already moving ahead with our long-term strategy.
Long before the Supreme Court upheld health reform, (we and other) healthcare organizations began implementing substantial changes. They are moving from a system of caring for the sick to one focused on improving each individual’s health and wellness.
Many changes under way in healthcare are gaining greater momentum as a result of reform initiatives. Our efforts to forge closer partnerships with physicians throughout Orange and Los Angeles counties, expand our continuum of care and better manage patients with chronic conditions position us well as reform continues. MemorialCare is growing our capacity to improve healthcare in our communities while healthcare organizations are challenged with the economic climate, declining reimbursement and payers moving to value-based purchasing.
We’re opening new ambulatory care facilities, broadening outpatient and retail health offerings and adding hospitals. MemorialCare’s hospitals continue to expand with advanced technologies, treatments and techniques.
Our financial strength allows substantial investments in our centers of excellence in heart disease, cancer, orthopedics, emergency medicine, women’s health, diabetes, pulmonary medicine, neurosciences and other areas.
We continue to recruit world-class specialists who perform the most advanced and least-invasive surgical procedures and offer treatments and techniques available only at a handful of Southern California (healthcare) facilities.
MemorialCare is expanding our wide geographic coverage in Orange and L.A. counties. This coverage is important to health plans that are increasingly adopting narrow networks, which only include providers demonstrating they can offer excellent care while managing costs.
Dave Anderson
Chief executive, UnitedHealthcare Southern California, Cypress
We have been working over the past two years on implementing the law as effectively as possible for our customers and the people we serve and will continue to do so.
But healthcare modernization did not begin and must not end with the enactment of the Patient Protection and Affordable Care Act. The underlying currents that drove the creation of health reform legislation are still swirling through the U.S. healthcare system.
The need for easier access to healthcare, the need to deal with rising costs, the need to make the system more effective and to use limited resources more efficiently and the need to improve overall quality—all these must still be addressed.
Reform expanded coverage, but the American healthcare system requires transformational change:
n Changes in the way we pay for healthcare with incentives for better outcomes, not just the quality of care.
n Changes in the alignment of the healthcare system with physicians, hospitals and other care providers enabled to access patient information instantly and communicate with one another effectively and often.
n Changes in transparency in quality, comparative effectiveness and costs for healthcare consumers so they have the ability to make smarter choices.
n Changes in the ways individuals take responsibility for their personal health and healthcare … along with much more.
It is as important now as it has ever been that we continue to offer practical innovations that enhance quality, improve access and promote better outcomes while reducing the costs of care and to apply proven solutions and best practices to help build a better healthcare system.
Barry Arbuckle
Chief executive, MemorialCare Health System, Fountain Valley
The decision on healthcare reform certainly provided more clarity.
Yet MemorialCare has been focusing on comprehensive quality and cost-effectiveness measures for many years.
Healthcare reform challenges those providing service to continually address the government’s “triple aim” of improving quality, reducing costs and enhancing patient experience.
Our momentum toward those goals is so significant that changes to health reform will not stop us from advancing.
Health systems focused on these issues well before reform. MemorialCare two decades ago brought together physicians, nurses and clinicians from all our hospitals in Orange and Los Angeles counties to ensure access to the best medical care.
Supporting evidence-based medicine is our early adoption as Orange County’s first healthcare provider with comprehensive electronic medical records. Evidence-based protocols are integrated into every medical record with each action checked to ensure the safest, most effective care.
Consumers increasingly adopt personal health records through our patient portals and more actively participate in their care.
Our goal of “perfect” care is furthered by integrating more doctors into our MemorialCare Medical Foundation through MemorialCare Medical Group and Greater Newport Physicians. These 2,000-plus and growing affiliated physicians and MemorialCare Physician Society members partner with us to ensure optimal care is available at every location.
