Leadership and Clinical Challenges with the Affordable Care Act (ACA)

To say that life under the ACA requires an adjustment in the way we do business would be a big understatement. The ACA has turned how healthcare does business on its head. Every single role within the healthcare enterprise from the top down is affected, including patients and their families. The increased pressure for lower cost and higher quality must be addressed with limited resources and budgets. For those who fill leadership roles within an organization, ushering change throughout the enterprise falls squarely on their shoulders.

When I speak to leaders at healthcare organizations the one thing they all have in common is their concern about whether the changes they make are going to lead to long-term success. Change management is not easy. Every healthcare enterprise is different so what strategies are deployed and how they will vary, but in the end, the goal is the same: reduce costs and improve quality. As we transition away from the legacy systems where reimbursements were tied to volume, the accountable care model places a greater emphasis on outcomes, specifically the outcomes that result in lower rates of readmission and never events such as pressure ulcers

Labor is a major expense so all accountable-care measures are influenced by workforce quality. Regulatory compliance factors such as overtime, agency use and acuity management impact cost containment, and workforce satisfaction influences health outcomes and care coordination.

For hospitals and health systems that are managing change over an entire enterprise with several moving parts, an agile approach to change management is worth serious consideration. This is because the ACA and its effects are still evolving. For healthcare leaders, the affects of change are two sided. First, there is the obvious impact on the care delivery model. Moving from a system that emphasizes volume to one that is more quality-centric requires an enormous amount of effort. However, in addition to the impact on the clinical side, these enterprises are also employers that offer healthcare insurance benefits, which may need to be adjusted to comply with new requirements. To achieve success on both fronts, clinical and finance, which includes Human Resources, must partner closely.

What’s an ‘agile approach’? First and foremost, it means flexibility. Unique challenges will likely appear on a consistent basis. Leaders will need to analyze the challenge and respond, which may be different each time depending on the challenge. An effective agile strategy should include steps that identify the required outcome, identify which departments or processes will be impacted, and identify the steps needed to achieve the desired outcome. While this is a very simplistic breakdown of the process, it’s important to understand and accept that it is perfectly reasonable to not have all the answers up front and that guidance may need to be sought from regulatory and other industry leaders.

There are so many unanswered questions at this stage that it is impossible to know everything that will come our way. An agile approach encourages flexibility and thrives on communication. This more often than not yields the greatest results both in the short and long term.watch full Wonder Woman 2017 film online

What challenges is your organization facing as a result of the ACA? What strategies were deployed to achieve success, and what strategies did your organization deploy to tackle change management?


Back to All Posts

Permanent link to this article: https://www.apihealthcare.com/blog/healthcare-trends/leadership-and-clinical-challenges-with-the-affordable-care-act-aca

1 comment

  1. ACA Track

    That is very interesting information thank you for posting it.

Comments have been disabled.