The Impact of the Patient Protection and Affordable Care Act on Physicians and Hospitals

Overview: This program will go through each of the major components of the PPACA and highlight the key provisions that were created to drive the changes necessary to address the poor quality and high costs positioned to bankrupt our healthcare system and national budget. Finally, changes that top performing physicians and healthcare organizations will be described to illustrate how you and your organization can re-position itself to not only take advantage of the PPACA but to achieve the Institute of Healthcare Improvement (IHI) triple aim of better service, lower per capita healthcare costs, and better quality outcomes for defined populations.

The Patient Protection and Affordable Care Act of 2010 was passed by a democratic majority for the following reasons:

• The insurance industry could deny coverage to anyone it chose through the inclusion of 'pre-existing conditions'
• Fee for service reimbursement causes physicians and healthcare organizations to over-perform ancillary tests and elective procedures and relatively poor quality for high costs
• The high number of uninsured and underinsured individuals in the country causing massive cost-shifting to everyone else
• Impending bankruptcy of Part A of the Medicare Trust Fund

Thus the Patient Protection and Affordable Care Act has the following components:

• Insurance Reform
• Quality Improvement
• Reimbursement Cuts
• Healthcare Reform

Why should you attend: The Patient Protection and Affordable Care Act of 2010 (PPACA) is politically contentious but makes some of the changes necessary to move away from fee for service and towards a more capitated reimbursement system that focuses on health and disease prevention and not on the care of sick people with medically unnecessary ancillary services and elective procedures. The law is deeply flawed and its implementation an example of political hubris and incompetence; however, we as a nation will either make the necessary changes or lose market share to the thirty six other industrialized nation that provide higher healthcare quality services at half the cost.