The passage of the Patient Protection and Affordable Care Act (PPACA) represented the beginning of landmark changes to America’s healthcare delivery system. PPACA aimed to drive down healthcare cost by slashing reimbursement rates of providers and encouraging healthcare providers to become more accountable for patients’ care and costs.
All stakeholders in the healthcare system have begun to see a new emphasis on coordinating care, improving quality while reducing costs and managing chronically ill, high-cost patients that are currently responsible for the majority of total healthcare spending in the United States. Between now and 2013, a series of adjustments to payment models and reimbursement rates will mean that already-thin margins will evaporate.
Post-acute providers are standing at a critical crossroads in terms of their business strategy–they must choose between two pathways, and the decision will have serious ramifications for a company’s strategic direction and its future valuation. The paper describes the choice providers have between becoming a vendor of services or becoming a specialized solutions provider in managing high-cost patients.
We will discuss the steps necessary to evaluate a company’s capabilities, explain how best to maximize opportunities found in the reform legislation and explore ways to discover how a company can fit in the new healthcare environment. We review the benefits and risks of each option, explore case studies of providers that have already made this decision, explain the issues every provider should consider, and map the questions a company’s leadership should ask as the calendar moves closer to 2013 and implementation of health reform.