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The Election is Over, A Discussion on What Lies Ahead

November 9, 2012
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How policymakers and providers will look ahead in lieu of Tuesday's results

It has been a momentous week for healthcare, to say the least. The election is over. The President is back in office for another four years, the House is still in the hands of Republicans, and the Democrats have maintained the Senate. In healthcare, a status quo election may not appear to mean much, but every expert I’ve talked to over the past three days seems to think this election will have implications for various policies going forward.

Let’s start at the top– the Affordable Care Act (ACA). While the ACA remains a controversial piece of legislation among Americans, experts I’ve spoken to about the election, such as The Advisory Board’s Rob Lazerow, say the result of the election means the law is pretty much safe. To that end, I’ve read similar things in the mainstream media.

“I don’t think there will be much conversation about repeal and replace any more,” Lazerow said in a podcast interview with me this week. “Any uncertainty around the ACA has largely been lifted.”

It should be smooth sailing then, right? Hardly. I believe that there will still be debates over the law. More specifically, Lazerow tells me there will still be a question at the state level of whether or not governments will implement parts of the law or have the federal government do it for them. This will include taking a look, from a state level, at the Medicaid expansion and health insurance exchanges. At the federal level, he expects Medicare to be a sharp focus of the “fiscal cliff” negotiations in the coming months.

On a more specific healthcare IT policy level, things seem to be a little more stable. Sharon Canner, the senior director of advocacy programs at the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), says that “[President Barack] Obama’s reelection has reaffirmed the very solid foundation that’s been created for IT.” Check out Canner’s complete interview with HCI’s Mark Hagland. Others, such as The Advisory Board’s Robin Raiford, said the re-election of Obama means “the healthcare IT agenda defined to support the Accountable Care Act and The American Recovery and Reinvestment Act will regain momentum lost to the distraction of the campaign.”

There is definitely optimism from government leaders in terms of healthcare IT. In a meeting of theHealth Information Technology Policy Committee (HITPC), Farzad Mostashari, M.D., the National Coordinator for Health IT, said the re-election gives the industry a chance to continue to make strides.

Yet despite the optimism of Dr. Mostashari and other leaders on this continued progress, and an end to the uncertainty surrounding the ACA, providers may not be feeling as confident about the future. This point was brought up to me by Lindsey Jarrell, a principal at PricewaterhouseCoopers (PwC), in a recent interview.

“In terms of the providers’ ability to meet future demand for IT services, I don’t think it will feel very stable,” Jarrell told me. He said as accountable care organizations (ACOs) are created, as the other health IT-related aspects of the ACA are implemented, and naturally, as EHRs are implemented through the meaningful use initiative, health IT resources will be stretched thin.

Furthermore, as Jarrell said, since President Obama has been re-elected and the ACA is now the reality for providers, for many of these providers, “time is up.” What he means is, many were moving slowly with implementation with the various initiatives, unsure of whether or not the legislation had a future. Now that it does, he says, they have to focus on implementation.

In other words, it’s time to get to work.