The Supreme Court's Ruling on the Affordable Care Act and Its Impact on HIE

Date: July 11th, 2012Category: CORHIO e-NewsletterTopics: HIE, Healthcare Policy

Supreme Court Recent Ruling Does Not Affect CORHIO’s Funding, But Will Speed Up the Demands for Robust Exchange in the Immediate Future

At the end of last month, in one of the most widely anticipated decisions in decades, the U.S. Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (ACA). With health care reform in the spotlight, many Colorado health care professionals are wondering how the recent ruling will affect health information exchange (HIE). It is important to know that regardless of the Supreme Court’s ruling, and any potential future appeals of the ACA that may occur, CORHIO’s future and sustainability are not impacted.

Funding for HIE Has Always Been Secure

CORHIO’s funding for HIE is from two grants – a grant from The Colorado Health Foundation and an American Recovery and Reinvestment Act (ARRA) Health Information Technology for Economic and Clinical Health (HITECH) Act grant. The ACA legislation is completely separate from ARRA and HITECH, so regardless of any Supreme Court decisions, funding for HIE has always been secure.

ACA Institutes Initiatives Designed to Improve Payment and Delivery Systems

While the ACA’s 900-plus pages have many implications for the nation’s health system as a whole, including health insurance coverage for individual consumers, some of the most transformative involve payment and delivery system reform. The ACA creates a number of pilot opportunities and demonstration projects to test out emerging systems and methods for delivering and paying for care. Many of these demonstrations involve bundling services, measuring services and outcomes, and rewarding providers for delivering comprehensive and high-quality care.

For example, ACA legislation helped to accelerate the formation of Accountable Care Organizations, or ACOs, which create incentives for health care providers to work together to treat Medicare patients across multiple care settings. The goal is to reduce the overall cost of health care by rewarding providers who are successful in keeping patients healthy and engaged in their care. To facilitate this, providers participating in ACOs will be financially incented to manage their patients’ overall care through a Shared Savings Program. Several ACOs, or ACO-like initiatives, such as Regional Care Coordination Organizations, are already underway in Colorado.

ACA Accelerates Demand For Robust HIE

Demand for fully-integrated and state-wide HIE has been strong in Colorado for many years now and that demand has recently accelerated, in part, due to the ACA and the formation of ACOs. As compared to other states and regions, Colorado’s health care leaders are trailblazers when it comes to community collaboration, and have been striving to improve care coordination using electronic medical records and HIE long before the ACA was enacted. In fact, to some degree, this collaboration led to the formation of CORHIO.

In Colorado, support for HIE has been popular for its capacity to improve care coordination because it helps providers exchange comprehensive patient information across the care continuum in a safe and secure way. Furthermore, once HIE is effectively in place, it provides communities with the technical foundation to explore the use of data analytics to effectively tackle important public health objectives, such as better management of chronic conditions.

With June’s Supreme Court ruling finalized, doubts about the ACA have dwindled, and demand for HIE to support payment reform initiatives like ACOs has accelerated. By connecting physicians with disparate clinical systems, and enabling patient-centered care across multiple health providers, HIE is key to ACO’s success. Furthermore, it will help all providers improve care, streamline administrative operations and lower health care costs.

To learn more about the ACA and its impact on HIE and health IT, please visit the following websites:

Why HIE is Indispensable to ACO Success