Are You Reform Ready?

July 2013

I was intrigued recently by an article from Jeff Gourdji entitled, “Reform Readiness: Are You Really Ready for The Long Term?” Even though the article was written primarily for health insurers, I think it has great applicability for us as providers.

As Gourdji points out, on October 1, the nation’s network of health insurance exchanges will be open for business, and with the individual mandate set to take effect in 2014, millions of people who were previously uninsured will flock to the system, including nearly 20 million Americans who will become eligible for subsidies. Gourdji goes on to discuss this watershed moment for the nation’s health insurers.

Today, many insurers and providers are leaders in their markets, but this incumbent mindset might impede the ability to retain such a position in the face of change. Those who possess a revolutionary mindset, he argues, will be best positioned to adapt to the new market realities and win in the long-term.

While the incumbents are in maintenance mode, the revolutionary mindset aims to secure victory by changing the model. Revolutionaries must be scrappy, open to invention and leverage resourceful, out-of-the-box thinkers just to remain in the game. Being ready for reform in the long-term will require most insurers and providers, even the incumbents, to adopt a revolutionary mindset. This certainly applies to us! I think we have some great opportunities for revolutionary change if we continue our transformational journey from the traditional, fee-for-service hospital care to outcome-focused, community based accountable care. In other words, care that is focused on improving the health of people and communities. 

We have a great opportunity to align with our clinicians to redesign the care we deliver. We have a great opportunity to expand our patient-centered medical homes, home care services ambulatory services and chronic disease management programs. We have a great opportunity to connect directly with patients and caregivers to inform them of new choices for coverage offered by health exchanges and to advocate for those who are poor and vulnerable.

We are proud of our care quality and outcomes; our caring spirit and our brand reputation and look forward to extending our ministry to those who will soon have greater access to the system.

In short, we look forward to the revolution!

 Michael A. Slubowski, FACHE, FACMPE
 President and Chief Executive Officer
SCL Health