The Supreme Court's decision to uphold most of the Patient Protection and Affordable Care Act certainly was stunning. Who really expected Chief Justice John Roberts to side with the liberal wing of the court? How many people thought that the reasoning would be that the individual mandate was a legal exercise of Congress' power to levy taxes?
Similarly, the decision was polarizing. Plenty of President Obama's supporters narrow-mindedly thought that the ruling assures that millions of currently uninsured Americans would now be guaranteed access to good healthcare. A lot of wacko detractors claimed that the Supreme Court killed freedom and set the United States upon a path to fulfill Comrade Obama's supposed desire to turn this nation into the Soviet Union.
Neither, of course, is true. The best insurance coverage in the world doesn't assure quality care, and the insurance expansion really is just throwing more money at a broken system. By the same token, the ACA leaves the long-established private insurance system in place for Americans of working age. This isn't a government takeover, nor is it a silver bullet.
But it is a starting point for reform and a plea for disruptive innovation. You wouldn't know that if you only paid attention to the national media, which have been fixated on insurance coverage, not care improvement and efficiency gains. But since you're reading MobiHealthNews, you do know that healthcare is a lot more than just insurance. You know that the Affordable Care Act, certainly a flawed piece of legislation, contains real elements of care reform, not just insurance reform.
The ACA created the Center for Medicare and Medicaid Innovation within CMS and appropriated $10 billion to this innovation center. More importantly, this provision gives CMS the authority to ramp up pilot programs that prove successful at saving money or producing better patient outcomes. In the past, CMS would have to go back to Congress to expand successful "demonstrations," a process that could take years. This should be great news for the many m-health innovators who have come up with low-cost, easy-to-implement ways to improve healthcare.
Likewise, mobile health will have an important role to play in Accountable Care Organizations, another key aspect of the ACA that is hard to explain to the masses in a catchy soundbite. The shift to bundled payments that ACOs herald, coupled with Medicare's new policy of not reimbursing for certain preventable hospital readmissions within 30 days of discharge, puts the onus on providers to coordinate care and manage patients outside traditional settings.
That sounds like a golden opportunity for wireless monitoring and patient-provider communications. So get to work. Real health reform is just starting, and mobile technologies are well-positioned to shake the establishment that has stood in the way of improvements for far too long.
