Health care law’s innovations taking hold, panelists say

Sen. Sheldon Whitehouse, D-R.I. Sen. Sheldon Whitehouse, D-R.I. Larry French/AP

Despite uncertainty about the coming U.S. Supreme Court decision on its constitutionality, the 2010 health care reform law already has triggered a long-term transformation in the way U.S. health care is delivered and paid for, a panel of specialists said Tuesday.

“There’s a spirit out there in the country, and it starts with the great people who work hard every day to deliver health system reform, not in Washington,” said Dr. Richard Gilfillan, director of the Innovation Center at the Health and Human Services Department’s Centers for Medicare and Medicaid Services. “The Affordable Care Act put the seeds out and they’re blossoming.”

Speaking on a panel titled Obamacare at Work: Innovations to Deliver Better Care at Lower Cost and put on by the liberal Center for American Progress, Gilfillan cited as an example “the incredible response” his office received -- some 3,000 applications from private health care providers nationwide -- to a CMS grant offer soliciting models for interpreting data on the cost savings from bundling medical care payments.

He also mentioned as “emblematic” a productive conference CMS held two weeks earlier attended by 100 representatives of 51 health insurance companies, from seven markets representing 500,000 customers. Instead of sticking with “fragmented, siloed, inefficient care,” he said, the industry is “poised, ready and starting” to create a new form of interaction between providers and payers that will create a “rapidly learning, accountable” health care system. “The world is shifting, and the marketplace brimming with new ideas and opportunities under the Affordable Care Act,” he said.

Sen. Sheldon Whitehouse, D-R.I., whose state has pioneered health care reforms, said, “You either see health care as a problem of benefits or as a system problem. If you see it as a benefits problem and are wrong, you’ve made a terrific mistake and harmed a lot of people,” he said, referring to current Republican proposals to repeal the health care law and refashion Medicare. “It is a system problem, and we will continue on the path to system reform.”

Citing potential cost-savings estimates from $700 billion to $1 trillion dollars, Whitehouse said a sizable 45 sections of the health care law give CMS responsibilities for pilot programs. He noted progress in Rhode Island on lowering hospital readmission rates, which requires better coordination between doctors and hospitals.

The programs that are not performing well are the ones Congress didn’t properly fund, Whitehouse said. Greater use of nursing homes, which are less expensive than hospitals, he said, could be achieved under “meaningful use” provisions of the law, and he urged CMS to pursue it.

Asked about the impact of a court ruling striking down all or part of the health care law, Whitehouse said, “The only part of the massive bill being challenged is the individual mandate. That’s the only aspect that, some say, the federal government can’t do, only the states, which is a very narrow question,” he said. “So if the mandate falls, there is some logic -- not great logic, but if you stretch, some logic -- to that. But there is no logic” to going after the pilot programs that CMS is pursuing, he added, or repealing benefits from the law such as families being allowed to keep children on their parents insurance plans until age 26.

“That would be a sign that the court has really gone off the rails,” Whitehouse said. “We shouldn’t be stalling and dawdling while waiting for the Supreme Court to act. We don’t have that luxury.”

Dr. Ezekiel Emanuel, vice president for global initiatives at the University of Pennsylvania, said the coming movement toward bundling of payments is “the most promising way to cut costs because it’s easy for doctors to adapt to it. They can figure out how to reengineer their care process.” Ten years from now, Emanuel added, “all will be better in the field of health care, unless the Supreme Court does something silly.”

Gilfillan reiterated HHS’ position on the court’s looming decision. “We’re confident that law will be upheld, and we’re moving forward,” he said.

Stay up-to-date with federal news alerts and analysis — Sign up for GovExec's email newsletters.
Close [ x ] More from GovExec

Thank you for subscribing to newsletters from
We think these reports might interest you:

  • Sponsored by G Suite

    Cross-Agency Teamwork, Anytime and Anywhere

    Dan McCrae, director of IT service delivery division, National Oceanic and Atmospheric Administration (NOAA)

  • Data-Centric Security vs. Database-Level Security

    Database-level encryption had its origins in the 1990s and early 2000s in response to very basic risks which largely revolved around the theft of servers, backup tapes and other physical-layer assets. As noted in Verizon’s 2014, Data Breach Investigations Report (DBIR)1, threats today are far more advanced and dangerous.

  • Federal IT Applications: Assessing Government's Core Drivers

    In order to better understand the current state of external and internal-facing agency workplace applications, Government Business Council (GBC) and Riverbed undertook an in-depth research study of federal employees. Overall, survey findings indicate that federal IT applications still face a gamut of challenges with regard to quality, reliability, and performance management.

  • PIV- I And Multifactor Authentication: The Best Defense for Federal Government Contractors

    This white paper explores NIST SP 800-171 and why compliance is critical to federal government contractors, especially those that work with the Department of Defense, as well as how leveraging PIV-I credentialing with multifactor authentication can be used as a defense against cyberattacks

  • Toward A More Innovative Government

    This research study aims to understand how state and local leaders regard their agency’s innovation efforts and what they are doing to overcome the challenges they face in successfully implementing these efforts.

  • From Volume to Value: UK’s NHS Digital Provides U.S. Healthcare Agencies A Roadmap For Value-Based Payment Models

    The U.S. healthcare industry is rapidly moving away from traditional fee-for-service models and towards value-based purchasing that reimburses physicians for quality of care in place of frequency of care.

  • GBC Flash Poll: Is Your Agency Safe?

    Federal leaders weigh in on the state of information security


When you download a report, your information may be shared with the underwriters of that document.