Payors line up to carry the reform mantle if ACA falls

Some healthcare entities have no plans to discard health reforms even if the Accountable Care Act is wholly struck down—because they’re saving too much money.

Scripps Health has spent the past two years implementing quality improvement initiatives, including measures to pinpoint redundancies, restructure operational processes and consolidate purchasing. The restructuring efforts have recouped about $77 million in savings and quality improvements during FY11, Scripps announced today.

The company’s 25 separate sites have been restructured into one interconnected system, implementing best practices and care operations across the board. Consolidating the supply chain and revamping the contracting process could save Scripps a further $22.6 million over the next three years.

Earlier in June, UnitedHealth Group, one of the largest insurers in the country, pledged to retain the reform-based provisions for eliminating the co-payment on certain preventative healthcare services, such as annual exams, diabetes screening, vaccines and others.

“The protections we are voluntarily extending are good for people’s health, promote broader access to quality care and contribute to helping control rising healthcare costs. These provisions make sense for the people we serve, and it is important to ensure they know these provisions will continue,” said Stephen J. Hemsley, UnitedHealth’s president and CEO, in a press release. “These provisions are compatible with our mission and continue our operating practices.”

Aetna and Humana have pledged to retain co-pay-free offerings of preventive health services and to keep coverage in place for dependants up to age 26, among other reforms. Humana also agreed to forego lifetime limits on coverage limits on policies.

Scripps’ President and CEO Chris Van Gorder says payors and providers need to continue to restructure healthcare’s processes. “Regardless of what the court decides, healthcare in this country is already changing and must keep evolving, because it’s broken,” Van Gorder noted in a company statement. “This crisis presents a challenge and an incredible opportunity for physicians and hospitals to fundamentally reshape the future of healthcare.”


Topics: Accountable Care Organizations (ACOs) , Executive Leadership , Medicare/Medicaid , Regulatory Compliance