Chal­leng­ing jour­ney ahead

Im­ple­ment­ing re­forms will be daunt­ing, thrilling

Modern Healthcare - - OPINIONS EDITORIALS -

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-

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