With the re-election of President Obama and the control of both houses of Congress remaining the same, we expect to see ongoing debates about policy, but with few substantive changes. Implementation of the Affordable Care Act (ACA) will likely continue.

Many elements of how the ACA will be implemented are still not definite, as was the case before the election. There are and will continue to be many unknowns for consumers and health care providers. However, here’s what we do know: 

• Government reimbursement for health care services will continue to decline. Providers will be expected to deliver care that is more cost-effective and demonstrates quality outcomes for patients. 
• Wheaton remains committed to providing high-quality, cost-effective care to our patients. 
• We will continue to work to ensure our policymakers understand the issues that impact our hospitals and providers. 

As always, we will monitor developments as rules and regulations are finalized to implement various portions of the ACA.

Here are some highlights of areas of focus going forward:

Being “accountable” for care
Several provisions in the ACA focus on allowing Medicare opportunities to develop methods of paying health care providers – shifting payments toward models that reward coordination of care, increased communication, patient engagement, patient satisfaction and improved health outcomes. 

Affordable insurance
A goal of the ACA is to provide consumers with value for their insurance premium dollar, while keeping the cost of insurance affordable. Provisions in the ACA related to this include:

• Initiating a review process for “excessive” premium increases, 
• Requiring that at least 80% of insurance premium dollars be spent on medical expenses 
• Creating tax credits to offset premium costs for low-income families 

Ramping up for 2014
Provisions that are scheduled to take effect in 2014 include expanding coverage in most states and implementing insurance exchanges. Many states will be making final decisions about health insurance exchanges in the near future. Health insurance exchanges are intended to be virtual market places where consumers can shop online for insurance products if they aren’t covered by an employer plan. By mid-November 2012, states must be able demonstrate how they will run their exchange. All states must have an exchange open for business in the fall of 2013. Questions remain about the rules of exchanges, and many governors including Wisconsin Governor Scott Walker indicated that they would delay development of an exchange until after this week’s elections.  

Watch for more information and updates from Wheaton Franciscan Healthcare as major ACA developments and milestones occur.

In the meantime, these consumer-friendly website have more information about the Affordable Care Act: