Patient Protection and Affordable Care Act (“PPACA”) is overwhelming considering the depth and breadth of changes to healthcare. Traditional quantitative analysis is unlikely to yield optimal solutions. HRMSI recommends a fluid, incremental, and flexible approach. The reality is the impact on your business will be both positive and negative but the real threats and rewards lie in the unintended consequences of PPACA.
In order to survive and thrive, you must focus on the critical action items. In converting to Health IT, transmission and distribution changes are being made so healthcare is accountable over a massive network of providers and financiers. Systems must be standardized, coded, and documented properly while meeting strict industry standards. Benefits have been modified and standardized while conditions to coverage have been severely restricted. Risk pools, rating and pricing have been significantly changed.
Our critical issues list is:
Infrastructure changes are in process to make Health IT a reality. Mandated changes include the conversion to transmission standards HIPAA Version 5010 and ICD-10 coding changes. These changes impact all companies with health benefits.
The next critical concerns are PPACA provisions effective prior to 2014. For more details refer to the Health Care Reform Implementation Date Article. Unintended consequences of PPACA like the increase penalty for data security and privacy lapses (cyber liability risk) or the expansion of 1099 reporting for future tax initiatives.
PPACA will continue to be defined through regulation and future legislative and judicial action so interested parties must build flexibility into their planning process. Failure to adapt rapidly and comply with these changes can result in huge financial losses and/or penalties.
HRMSI and their network of experts can help you assess, plan and implement the changes due to Health IT and PPACA.