Hayes' Healthcare Blog

“They’re like the dog that caught the bus.” 

That was the comment from Senate Minority Leader Chuck Schumer in a January episode of This Week with George Stephanopoulos referring to the GOP and their pledge to repeal and replace the Affordable Care Act aka Obamacare.

In the more than six years after the passage of ACA, the House of Representatives voted to repeal it 60 times.[1] In December 2015, the Senate used a special budgetary procedure to approve one of the bills with simple majority vote instead of the 60-vote threshold normally needed for major legislation. As expected, President Obama promptly vetoed the bill. But the GOP had finally made a statement.

With the election of President Trump and a majority in both houses of Congress, Republicans can now make policy and do what they have been promising to do since the controversial law was passed in 2009. The GOP has finally caught the bus.

By Kelly Barland, Chief Information Officer, St. John’s Episcopal Hospital, New York City

The pros and cons of the Affordable Care Act (ACA) continue to be debated, but one point appears to be beyond dispute: the ACA has significantly contributed to the explosive growth of the Medicaid program. In FY 2015 – the first full year of ACA coverage expansion – enrollment and spending in Medicaid across the 50 states and DC increased by an average of nearly 14%.[1] Combined federal and state spending for Medicaid was more than $500 billion in 2015 and is projected to reach $750 billion by 2020.[2]

Many initiatives are being implemented to help stem the rising costs and improve patient outcomes including increasing the value and quality in managed care contracts, instituting home health for individuals with chronic conditions, and testing innovative delivery and payment models.

One of the more promising efforts has been the Delivery System Reform Incentive Payment program (DSRIP). Rolled out in 2010-11 in California, Texas, and Massachusetts followed by New Jersey and Kansas, in 2012, DSRIP originally focused on funding for safety net hospitals and resulted from negotiations between HHS and the states on how to pay for hospital care. The program has evolved into a way to initiate payment and delivery system reforms and provide the states with funding to support hospitals and other providers in changing methods of providing care to Medicaid beneficiaries.