Health Care Reform Beyond the ACA

The United States is in the process of the most dramatic health care reform it has ever experienced. The Affordable Care Act is the most important and controversial health legislation since the passage of Medicare and Medicaid in 1965. It seems as though we have been in a continuous state of health care reform with our efforts to reverse the fact that although we are spending more on health care delivery than every other country, we rank very low in health care outcomes compared to most other industrialized countries. Those who pay the health care bills keep asking for a change in reimbursement methods in order to improve our system of health care delivery.

Carroll, Chapman, Dodd, Hollister, and Harrington (2013) point out that health care costs are continuing to rise, and by the year 2020 these costs will total $4.6 trillion, representing almost 20 percent of our GDP. This cost escalation will occur despite the fact that the new health care reform law will have been fully implemented by 2020. The reforming health care sector is not only a result of new government laws and regulations but also represents a long overdue interest by consumers in health care services and how they are delivered to consumers and to their family members. This new interest in reform is a result of the patient of health care services being transformed into a consumer of health care services. This transformation was nudged along by more of the costs of health care being passed on to the consumers of these services in the form of higher deductibles and copayments. This is a critical turning point for the consumers of health care services, because changing their passive role to a more active voice in health care decisions is vital if we are going to reduce costs and improve the quality of health care services in our country.

According to Schimpff (2012) the purchasers of health care are demanding the same quality offered with the purchase of any other good or service. This means that they want a product or service that works, that is delivered on time by courteous employees who are responsive to their needs, and that is produced at an affordable price. The sad part is that many health care facilities are still not aware of the wave of consumerism that has hit health care services delivery. They are still living in their bureaucratic world, unaware of that their former patients have now become consumers with various competitors to choose from when purchasing health care products and services. Health care organizations must learn what the consumers of their services desire and then find out the best way to deliver these services at an affordable price. This represents an entirely new way of thinking for the managers of health care facilities.

Christensen et al. (2009) point out that disruptive innovation usually involves three elements: a technological enabler, a business model innovation, and a value network. In short a technological enabler allows the health care organization to take a solution to a problem and routinize it. A business model innovation allows a simplified solution to the problems associated with the costs and convenience of health care services delivery. The creation of a value network entails successful implementation of the disruptive economic models. Christensen et al. (2009) believe that since these elements of disruptive innovation have been successfully brought together in other large industries, they can also work their magic in health care services delivery.

technological enabler

New technology that contributes to radical change in a product or service.

 
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