Is Reform Predictable?

It's good to be back after an early-July recess. Prior to it, the big news was the Supreme Court ruling in favor of the health reform bill. Since we began writing about the transformation of health care in 2007, there have been detractors who claimed reform was not important, nobody cared, that it would all go away or that no one could know how it would unfold anyway ... "no one has a crystal ball". At last, it seems, we've put to rest the notion that it would all go away. And hopefully we agree by now that reform is important, even for eye care and beyond the Medicare fence.


The question remains though, is health care reform predictable? If we can go back 5 years and see predictability, is that helpful while we consider the next five? Or even the next two or three? Our answer, of course, is a resounding "Yes!"


In our original white paper, Medicare Pay-for-Performance & Value-Driven Health Care published June 2007, we explained the basic tenets of health care reform. It's still a good read today (in our humble opinion!) and gratifying to see very little we would change, nothing that was "way off in left field" or that proved to be wrong.


So what? Why is that important now? Well because we're still making statements about where this is all going. Are our assertions trustworthy? We think they are.

• 2011, the year of the EHR. EHRs were only the beginning.
• 2012, the year of the HIE. It's time to move beyond EHRs to sharing health information, paying particular attention to the DIRECT standard.
• Exchanging health information sets the stage for team delivery of care and care coordination.
• Coordinated care means bundled payments, marking the obsolescence of fee-for-service reimbursement. 
• You cannot qualify for the new models of reimbursement if you're not playing the new game by the new rules.
• Coordinated care pilot projects all around us are the open doors through which we must go individually and as a profession.

Alistair Jackson, M.Ed.

Jim Grue, O.D.