By Leah Binder
Employers are divided on the merits of healthcare reform, but they are unanimous in expressing uneasiness about its business implications. Many purchasers have absorbed hefty costs in complying with reform’s most immediate provisions.
Purchasers worry that if key quality and costcontrolling provisions in the legislation—provisions that many purchasers supported and some lobbied for—fail to deliver promised results, the business community will be on the hook for more cost increases in the future.
Now in the wake of the midterm elections, Congress may give the business community a new platform to air those concerns.
Why are purchasers so worried? After all, Congress and President Barack Obama articulated as a core goal of the legislation “bending the cost curve.” Yet purchasers know from years of experience that the strategies in the legislation are far more challenging to implement than they seem, and if they don’t work as intended, it is not clear who will be held accountable.
Taken together, most of the cost and quality strategies in the legislation rely on a significant excess readmissions. The law also calls for new financing arrangements that would attempt to sideline hospitals among the many providers patients encounter.
For instance, accountable care organizations would presumably weight financing incentives toward primary care and other services that are less expensive rather than hospital care. And for those times when hospitals can’t be avoided, the law imposes financial penalties on those that fail