For reform to work, patients need to get a clue


Now that the Supreme Court has upheld the reform law, the industry's attention turns to implementation. But while providers and payers prepare for what's next, an astounding 45 percent of the public has no clue what's actually going on with the reform ruling, according to the Pew Research Center for the People & the Press' latest poll.

In that poll, 30 percent said they didn't know how the Supreme Court ruled, while 15 percent incorrectly thought it rejected most of the Patient Protection and Accountable Care Act's provisions. (And where might they have gotten that idea?) 

"The public really does not understand the ACA, how the system works, how the healthcare spending is tied to the federal budget deficit, and that more care can often be harmful rather than helpful to the patient," Kent Bottles, senior fellow at the Thomas Jefferson University School of Population Health, told FierceHealthcare.

"Part of the problem is that healthcare is not like any other 'product.' Most people do not think about their health and wellness until they have a problem or a crisis," noted Bottles.

Moreover, people don't seem to understand what that healthcare "product" is. And that lack of understanding and education can drive healthcare costs even higher--there's countless research showing informed patients tend to make better healthcare choices than their uninformed counterparts, which not only affects individual outcomes but also system-wide costs.

Looking back to Kaiser Family Foundation statistics collected before the law passed, you can see there was a wide gap between what the public believed and what industry experts believed about payment and delivery reform provisions in the ACA.

It's been more than three years since those polls and more than two years since President Obama signed health reform into law, and some of public still doesn't understand why healthcare costs are rising so fast or how the ACA's encouragement of coordinated, accountable care aims to keep them in check.

According to safety net hospitals and health systems, the administration hasn't done a very good job of getting the message out about the law's impact. More than two years later, "many parts of the country still have no idea what's in there," Shawn Gremminger, vice president of Legislative Affairs at the National Association of Public Hospitals and Health Systems (NAPHHS), told FierceHealthcare.

What can hospital executives and other industry leaders do to help patients get a clue? 

A lot.

Here's just one example: Since hospitals and their employees are often considered "neutral informers" about the state of healthcare, they have an opportunity to let people know what the ruling means and what it doesn't, noted Gremminger.

Embracing that opportunity, hospital executives at safety nets are doing their best to let people know the new rights they have under the law, as well as educating people about what it means if their state chooses to opt out of Medicaid expansion, he said.

Whether you agree with the high court's ruling, reform, in some way or another, is here to stay. And as hospitals continue to update policies and procedures to adhere to reimbursement changes that will kick in under the law, they need to keep patients involved and informed.

So what are you doing to keep your patients reform-informed? We'd love to hear your thoughts in the comments below. - Alicia (@FierceHealth)

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