Guest Blogger: Advancing the ACA during the first 100 days
Author: Alex Go, Co-Founder & CEO, LivWell Health
This will be the third time I’ve rewritten this blog.
My first draft was intended to follow the election results, welcome Mrs. Clinton as the new President-elect. It was filled with hope and anticipation that we will continue to make the transformative progress driven by the Affordable Care Act. This first version obviously did not make it to press.
I wrote my second version immediately after the election results. In addition to the economy, healthcare policy was a key topic for me and President-elect Trump has made it clear that he will pursue the repeal of the ACA starting “on day one.” I wrote draft 2 when I was swirling with emotions of surprise, fear and uncertainty for our country.
This is my third and final effort. I am resigned to the course our country has chosen, and hope our President-elect sets aside all of his rhetoric and quickly demonstrates why he deserves to stay in office for his full tenure. While not perfect, the ACA has momentum, improving digitization of EMRs and making insurance more affordable for many Americans that would otherwise go without.
In the spirit of healing and in Johnny Carson-like fashion, I have compiled a list of the top 10 actions for Trump’s first 100 days to advance healthcare IT:
- Stop the rhetoric – and limit the bus trips on Ground Force One. We all know how the last one ended.
- Overhaul data security standards – punish ransom-ware severely. This needs to be massively upgraded to be more prescriptive than HIPAA if we are ever to get to the same interoperability as financial institutions. HITRUST is headed in the right direction.
- Speaking of security, its time to retire the fax machine. The HITECH Act has made EMRs ubiquitous. Say it with me, “you’re fired!”
- Convene a cross-industry consortium of advisors to create a series of recommendations based on the best practices from banking, education, services and the airline industries. This would make a great Apprentice episode. You could channel all proceeds to those who cannot afford insurance.
- Develop a series of strategic plans covering topics such as health consumerism and consumer transparency. High deductible health plans, Millennials and the sharing economy are driving “new normals,” yet within healthcare, we have only seen pockets of innovation.
- As health consumers, we need to improve cost estimator tools. It’s confusing and frustrating for health consumers to pay at the point of care, then get an Explanation Of Benefits (EOB) “this is not a bill” statement, followed by a real bill 45 days later for a visit the consumer barely remembers.
- Develop a plan to move us toward real-time data and reporting. Let’s invite our friends from the banking and retail industries to help us. In my experience, 90% of the effort is cleaning up the data. Lets start with common data standards, patient identifiers and terminology. Provide toolkits for data governance and data stewards. Phase-1 can start with financial estimator tools and billing infrastructure to advance the revenue cycle.
- Virtual care, transitional care management and chronic care management (CPT 99490) incentives need to be revisited. Current incentive levels are not enough to address the up front change management costs. The payback will be tremendous.
- Healthy Communities. Raise awareness and accelerate national programs around Social Determinants of Health. Approximately 10% of outcomes are impacted by direct medical care, whereas estimates ranging from 40% – 60% are impacted by social determinants of health – where we live, genetic disposition, personal goals, nutrition, housing and transportation. This offers a significant opportunity to impact the patient experience and cost-of-care for underserved populations. The time is right, tightly linked with health consumerism and improvements in analytical tools. [Transparency statement: I’m personally invested here through my relationship with LivWell Health.]
- Build a great team. This one is obvious.
Thank you for reading, I invite my colleagues to chime in with more ideas for President-elect Trump’s first 100 days.