3 steps hospitals can take while Congress grapples with ACA repeal

Healthcare policy expert Paul Keckley offers steps hospitals should take while Congress works out the details of a repeal and replacement plan for the Affordable Care Act.

As Congress hashes out plans to repeal and replace the Affordable Care Act, hospitals are left in a vulnerable position, unsure of what actions to take in the meantime.

But the worst step hospitals can take is to do nothing, wrote health policy expert Paul H. Keckley, Ph.D., in a piece for Hospitals & Health Networks.

“For hospital boards and management, the paralysis of inaction is a bigger risk than proactive pursuit of initiatives that are imperatives, even as the dust settles,” he wrote.

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Keckley suggested that hospital leaders include seven actions on their punch lists. Here are three of his suggestions:

  1. Move ahead with shared risk arrangements: Despite fears that the new White House might hinder value-based payment programs, Keckley believes these initiatives, such as bundled payments, will likely continue as voluntary programs
  2. Review all opportunities to reduce fixed and operating costs: Consider all possibilities to reduce costs, including outsourcing, revenue cycle, supply chain and compensation
  3. Take part in advocacy efforts: Hospital leaders must advocate for their organizations and patients at the local, state and national levels, Keckley wrote. But it’s vital that they present clear and relevant policy platforms to the public and lawmakers.

Hospitals are already following the third action. Last week, the American Hospital Association and 71 state, regional and metropolitan hospital associations sent letters to President Donald Trump (PDF) and Congress (PDF), urging them not to repeal the ACA without a replacement. If that can’t be achieved, the lobbying groups said that lawmakers must restore the reductions to hospitals and health systems included in the ACA to make sure they have enough resources to care for the uninsured.

Earlier that week, the AHA joined more than 100 healthcare systems, associations and insurers urging the new White House administration to support efforts to transition from fee-for-service models to value-based care models.