Fierce reflects on anniversary of healthcare reform ruling

On Wednesday, the U.S. Supreme Court made two major rulings furthering gay rights, putting all eyes on the Supreme Court this week. So, what better time to look back on its ruling on healthcare reform? In fact, today we hit the one-year mark of the high court's decision to uphold most of the Affordable Care Act as constitutional.

This time last year, hospitals were preparing for reimbursement changes under healthcare reform but with much uncertainty about how the law would affect revenues and operations.  

On top of uncertainty, dissatisfaction and ignorance surrounded healthcare reform and the court's ruling last summer. Sixty-eight percent of physicians had given the reform law a C, D or F grade, while 45 percent of the public had no clue what the court decided.

With a year of rulemaking and implementation behind us, do hospitals, providers and patients have less uncertainty or fewer unanswered questions?

When it comes to public awareness, it's a case of déjà vu: As of May, 42 percent of the public didn't know the Affordable Care Act is still law and is being implemented. According to a new report from the U.S. Government Accountability Office, the feds' slow consumer outreach has helped most consumers remain unaware of the reform law or its benefits.

Meanwhile, for hospitals, the one-year mark brings a mixed bag of results. While the ruling cemented the ACA as law of the land, hospitals still don't know how its provisions will unfold.

"I think it is still somewhat unclear as to how each of its parts play out," said Mina Ubbing, president and CEO of Fairfield Medical Center in Lancaster, Ohio, and FierceHealthcare advisory board member. "In Ohio, the issue of Medicaid expansion is still unanswered, which leaves a degree of uncertainty as to where payment will be provided," Ubbing, who runs the 222-bed, nonprofit hospital, told FierceHealthcare.

Despite these unknowns, the Obama administration continues to defend the healthcare law, maintaining it's working as planned.

And Ubbing would agree, noting she has seen some good during the past year in terms of changing and improving how care is delivered. Since the ruling, her hospital has stepped up efforts to reduce cost and enhance healthcare collaboration, as well as put more focus on population healthcare.

Similarly, the Supreme Court ruling meant SSM Health Care, a 17-hospital system based in St. Louis, Mo., could move full steam ahead with its transition to population healthcare.

"While the steps we are taking are small and deliberate, having clarity that the ACA was here to stay has enabled us to move forward rather than second guess our approach," noted FierceHealthcare Advisory Board Member Gaurov Dayal, SSM Health Care's chief medical officer and senior vice president of physician innovation and integration.

While the healthcare landscape hasn't drastically changed since the Supreme Court's ruling, hospitals and providers have kicked implementation efforts into full gear. The ruling officially challenged hospitals to make population health a top priority. And as evidenced by Ubbing and Dayal--not to mention the more than 250 hospitals and physician groups that joined the reform law's accountable care program aimed at improving population health--they're doing just that.

How do you think things have changed since the ruling on healthcare reform? With deadlines quickly approaching, how has your hospital's implementation progressed? - Alicia (@FierceHealth)