Supreme Court ruling or not, health reform is here to stay

(HARRY CABLUCK - AP) AUSTIN, Tex. —

This week, the Supreme Court took up a major challenge to the legality of the nation’s new health reform act. But as the justices begin hearing the closely-watched case, businesses won’t be waiting around for the ruling -- they’re already working to meet the new mandates.

And because those changes would be hard to reverse, according to a smart piece in Tuesday’s New York Times, even a ruling against the law won’t keep the Affordable Care Act from making a lasting impact on the health care industry.

A lot of this is happening in a state that’s no friend to the health reform law: Texas. I’ve spent the past few days here, and nearly every health care company official I’ve interviewed said that the company had shifted its business strategy because of the Affordable Care Act. Health systems are becoming more integrated, preparing for payment reforms like Accountable Care Organizations, meant to prize quality of care over quantity.

“There’s a lot changing [with the health reform law], and the only thing we can focus on is improving quality and behaving more like an integrated system,” says Jose Camacho, executive director of the Texas Health Community Centers.

Health insurance plans, meanwhile, have started aiming to lower increases in premiums. What’s driving that? A health reform provision requiring reviews of all double-digit rate hikes.

“We’re not seeing a lot come in above 10 percent,” says Jared Wolfe, executive director of the Texas Association of Health Plans. “From that perspective, you can can say it’s been an early success. Insurers are working hard to come in under that threshold.”

Not everyone in the health care industry here welcomes the act’s mandates. Arlene Wohlgemuth, executive director of the Austin-based Texas Public Policy Foundation, is “fearful of the consolidation” that occurs when health systems become more integrated. That could reduce competition, she said (others have also voiced this concern).

In outlining their strategies, no industry group mentioned the latest news in health reform: the impending Supreme Court decision on the constitutionality of the law. They don’t believe they can hold off preparing for the new federal requirements. In setting business plans for coming years, they have to work off of the law that’s standing now--and, whether they like it or not, that’s the health reform act.