ACA changes?  What changes?  No one knows specifics on what's coming for healthcare policy over the next few months, let alone the next year.

A colleague recently asked me "Any tips to share with hospitals on what they should be doing now while the fate of Obamacare is still up in the air?"

My answer was yes.  And my advice?  Plan for the worst and hope for the best.  But I didn't just throw out that tired phrase.  Here are my three specifics:

(1) plan for a payor mix change

  • Probably a worst case scenario regarding the ACA is that, whether repealed or replaced, more Americans will go uninsured.  Either a lack of inexpensive insurance products, or an decreased number of available ones that are unattainable owing to a patient's pre-existing condition, may be on the horizon.  My bottom line:  prepare as if we'll be taking care of more patients who have no insurance or means to pay.  (This is my plan for the worst portion of the advice.) Hopefully, this will not happen under whatever comes next in healthcare policy.

(2) improve quality to improve / maintain margin (and more importantly to give better patient care)

  • As you've heard me share before, high-quality care is also typically the least expensive care.  In fact, most quality improvement projects in healthcare (as discussed here) recover a median of $250,000+ of waste that was previously disappearing owing to the Cost of Poor Quality (COPQ).
  • So, not only is improving quality the right thing to do for patients, but it also usually helps eliminate a great deal of waste.  In the face of possible changes in payor mix and other P&L effects of ACA repeal/changes, that will be a key to success.  The ability to eliminate waste may become more important than ever.  More important than the financial side is that improving quality, on behalf of patients, is just the right thing to do.

(3) Realize you have about year before changes hit.

So, just as I shared with my colleague earlier, please join me in hoping for the best as changes come to US healthcare.  As that happens, in the face of uncertainty, I recommend preparing for the worst--just in case.