SCOTUS Decision Lands with a Thud! Now what?

---Terri Bernacchi, PharmD, MBA,  Cambria Health Advisory Professionals 

Now that ACA has been upheld, most parties will be specifically focused on how CMS and other federal agencies will interpret and regulate the day-to-day facets of the law.

The devil is always in the details in these kinds of things (consider, for example, how complex the “Coverage Gap” operational roll out was over the course of late 2010 and 2011.)  Federal and state bureaucrats and those of us who are the workers in the system must now proceed toward implementation of the individual mandate in 2014 and the thousands of rules which are both specific and vague, as laid out in the law.  Reading the fine print will become part of our daily ritual as changes in regulations are developed. 

PriceWaterHouseCoopers has a summarized snapshot of the implications of the forward momentum of the ACA, available for download on the internet. 

In my opinion, it is a thoughtful summary of the impact of the bill on various key stakeholders, including hospitals and providers, payers, employers, and pharmaceutical/device manufacturers.  Unfortunately, the “unintended consequences” of this far-flung regulatory outline are still not going to be understood for some time.  And because of the massive unpopularity of the law, it may end up being repealed.  In any case, health care entities need to forge ahead and become better prepared because the “easy-out” has been removed.  Now the hard work begins.

http://pwchealth.com/cgi-local/hregister.cgi/reg/implications-of-the-US-Supreme-Court-ruling-on-healthcare.pdf

Terri is the founder of Cambria Health Advisory Professionals. Among her current clients: a large health sciences firm serving payers, pharmaceutical and device manufacturers and other stakeholders, a small special needs health plan as a 5 Star Consultant, and several other health related clients. The thoughts put forth on these postings are not necessarily reflective of the views of her employers or clients nor other Health Advisory Professional colleagues. Terri has had a varied career in health related settings including: 9 years in a clinical hospital pharmacy setting, 3 years as a pharmaceutical sales rep serving government, wholesaler, managed markets and traditional physician sales, 3 years working for the executive team of an integrated health system working with physician practices, 4 years as the director of pharmacy for a large BCBS plan, 12 years experience as founder and primary servant of a health technology company which was sold to her current employer three years ago. She has both a BS and a PharmD in Pharmacy and an MBA.