Challenging journey ahead
Implementing reforms will be daunting, thrilling
We are rapidly approaching the halfway point between enactment and implementation of the most sweeping provisions of the Patient Protection and Affordable Care Act. While many changes are already under way, the work ahead for the public and private sectors is both daunting and thrilling. It also is abundantly clear that this reformation remains essential.
As demonstrated in the recently released report by the Commonwealth Fund Commission on a High Performance Health System, the current U.S. health system gets a barely passing grade of 64% on a series of rudimentary benchmarks, and in a number of critical areas, its performance has deteriorated since the previously released report card.
At the federal level, thousands of pages of regulations are at various stages of adoption. The recent changes to the accountable care organization final rule are a reminder of how difficult it is to craft regulations to apply across the entire country with sufficient flexibility to allow for innovation, and enough rigor to protect the pub- comments about unintended consequences.
Equally challenging is the difficulty federal agencies sometimes have in coordinating their efforts across silos. The Affordable Care Act places huge expectations on agencies and departments to act as one and to do so swiftly. Truth be told, I am surprised at how well managed that process has been, at least from an outsider’s perspective, but there remain many diffi-