Ten things to know about the Supreme Court decision and how it affects Appointment scheduling.
The US Supreme Court also known as SCOTUS upheld the decision that provided tax credits to all qualifying persons whether they have insurance on federal or state run exchanges basically leveling the playing field for all Americans who did not have insurance prior to Patient Protection and Affordable Care Act-PPACA. The proponents of this case argued that the tax credits should only be applied to the state run exchanges but the majority decision from SCOTUS stated that the letter of the PPACA law was meant to provide affordable healthcare for all whether the health exchange was state run or federally run. This made it very interesting because one could argue that the exchanges were the store where the patients did business but the product bought from the store was the same. Should a Target store in Sacramento, California charge more money for toothpaste than a Target store in Atlanta, Georgia?
The PPACA has increased almost 16,400,000 new members in the healthcare system since its enactment and almost 30% of the new entrants were on the verge of being thrown back to land of no insurance because these members were on federally-run exchanges and their rebates would have been revoked.
With the ruling, almost 5,000,000 members get to keep their insurance using either the federal or state-run Exchanges and still earn the rebates. The was some tense moments in various healthcare companies board rooms what this decision will mean had the SCOTUS gone the other way.
Imagine that we have 16,400,000 new members in the state run exchange and the rest of the federal run exchanges had to charge more or not be privy to earn the rebates and paid more. It would have created an uneven playing field and made the federal run exchanges ineffective and the PPACA in general lose its spark in which case we risk a situation where we were turning back to clock to the way it used to be prior to PPACA.
With these new members, we have a situation where we have to find ways to book an appointment for the population and now they can start to enjoy the benefits of having health insurance. We cannot continue to use old thinking to support new members and also treat members the way we made decisions about their healthcare. Appointment scheduling is one of those moments of engagement that needs to be revamped and provide new tools for patients and providers to interact.
What does this mean to Appointment scheduling?
1. 16,400,000 members get to keep their plans and not pay any more. ACA is here to stay.
2. The PPACA and the exchanges are here to stay and very unlikely a new administration in the White House will overturn the PPACA.
3. The new members are benefiting from the PPACA and the SCOTUS used common sense law than legal sense to make this crucial decision.
4. The poor and vulnerable population will continue to have an impact to the healthcare system. While this population is poor and some below poverty levels, a random poll showed that they have access to mobile technology. The mobile technology needs to be leveraged engage patients in new ways than before.
5. We need to address healthcare for the new patients the way they need to be engaged using newer technology devices, i.e. mobile phones, tablets, wearable, and internet.
6. Mobile technology will play a role in healthcare of the future, if we are to serve this poor and vulnerable population.
7. The new patients will have a say in their healthcare decisions than before, which means we need to provide systems and tools that enables this population to do business with healthcare providers.
8. The old ways of doing business is out the door and now we need to engage the new population in new ways with new systems: appointment scheduling, bill paying, enrollments and eligibility, premium determination and collections.
9. The SCOTUS decision sealed the long standing notion that the SCOTUS only follows legal jurisprudence and not common sense. In this case the SCOTUS – Justice Elena brought a breathe of fresh air to the court and puts it very clear that the federal and state run exchanges must play on the same field.
10. Finally the new entrants will not be undermined and not given excellent healthcare services because they cannot afford it, they don’t have a medical history or they might have an preexisting condition.