Making Health Care Reform Work

The health care reform laws enacted as the Patient Protection and Affordable Care Act (ACA) and the Health Care and Education Reconciliation Act of 2010 will have widespread and in some cases seismic impacts that will unfold and evolve over more than a decade. This new legislation will transform the health insurance industry, and its impact will be felt by citizens, state governments, and every organization involved in the health care delivery system. Now that health care reform is law, it is in the interests of all health insurers and organizations and professionals that provide health care (hereafter, “providers”) to navigate through the changes and make sure the law works for all North Carolinians. It took decades for our current health care payment system to develop and evolve, and it will take some time to move in a new direction that addresses costs, improves quality, and benefits patients. But even with the changes brought on by the ACA, the system is not sustainable. Doing nothing is not an option. This commentary discusses the factors leading to our current health insurance system, how the ACA might affect that system, the role of medical costs in driving up health insurance premiums, and the need for everyone in the health care system to work together in order to fulfill the letter and spirit of health care reform and overcome some of the challenges to achieving sustainable reform. Blue Cross and Blue Shield of North Carolina (BCBSNC), a not-for-profit insurer, has worked for years to reform the health care system in North Carolina through initiatives that encourage improved quality and efficiency from providers. But the ACA requires substantial new insurance reforms in the future, and much more progress in improving our health care system must be made to support these reforms. BCBSNC believes that, going forward, real reform can only be successful if there is collaboration among stakeholders from across the health care spectrum, including insurers, physicians, hospitals, pharmaceutical companies, employers, patients, and others. To that end, BCBSNC is already having conversations with leaders from around North Carolina to lower costs and ensure that health care reform works in our state. This collaboration is occurring in many forms. Some will be creative arrangements within BCBSNC’s provider network, but significant collaboration must occur across the wide range of stakeholders in the public and private sectors.