Affordable Care Act is Changing the Healthcare Administration Landscape

Last Updated September 24, 2018

From new insurance regulations prompted by the federal Affordable Care Act (ACA) to new avenues for delivering basic medical services, the healthcare industry is poised to undergo transformative changes in the coming years. Still, as patients head to their local pharmacy for a consultation, upload blood pressure readings to their physician’s database via smartphone or take advantage of employer incentives to improve their fitness, the profession’s core mission remains unchanged: to keep people healthier, longer.

Delivering the highest quality care for the lowest possible cost will be a constant challenge for the healthcare leaders of tomorrow, particularly as the nation’s biggest population segment, the baby boomers, transition into their senior years.

The good news is that because of medical advances people are living longer than ever. That brings its own set of challenges, however. How can we prevent, treat and manage the diseases and conditions of old age, while still keeping health care affordable for all?

As ACA continues to take effect, sweeping changes to health insurance will follow. Insurance companies will be prohibited from denying coverage for pre-existing conditions, which will be offset by the requirement that everyone must have insurance or face a financial penalty. Many states will be expanding Medicaid to cover more low-income people, and states are also establishing online exchanges, where individuals and small businesses can go to purchase health insurance.

Some of the other ACA measures scheduled for implementation through 2020:

  • The Independent Payment Advisory Board will begin overseeing Medicare payments to health care providers, medical device firms and insurance companies.
  • Larger employers (those with 100 or more workers) will be able to purchase insurance through exchanges beginning in 2017.
  • Senior citizens no longer will be responsible for the coverage gap (the so-called “donut hole”) between their initial limit and the catastrophic limit in their prescription drug plans administered through Medicare.

The Future of Health Care Policy

Beyond the impact of government-mandated changes such as ACA, the evolution of healthcare in the United States may be driven by a variety of industry initiatives. For example, advanced computer systems are allowing for the wholesale adoption of electronic medical records. Digital technology, such as mobile apps and telemonitoring, is shifting the delivery of medical care away from hospitals and into patients’ homes.

Meanwhile, more physicians may earn a salary rather than the traditional fee-for-procedure pay model, with bonuses for keeping patients healthy.

All of these will necessitate responses from local, state and national policymakers to guide health care providers, insurance companies and patients. Meeting the challenge of the massive changes facing the healthcare industry will require a concerted and coordinated effort among healthcare administrators and managers, service providers and the nation’s millions of dedicated healthcare workers.

Highly skilled leaders will be needed to work toward improving the quality of patient care and controlling costs. Frontline workers, from ambulatory care technicians to registered nurses, may assume new responsibilities and train for new roles.

For healthcare personnel, the future appears likely to include working on interdisciplinary teams, using increasingly sophisticated technology, processing more information and dispensing care in nonhospital settings. As always, training and education will be key components in preparing professionals to meet the coming challenges.