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Either health care bill will mean big IT changes

As reaction to the Senate’s health care bill reverberates, we have yet to fully understand how any final legislation will affect individuals, institutions and, very notably, state governments.

Leaders in the House and Senate have said that they will have a final bill for the President to sign by the end of January.  If they succeed, the US will begin implementing one of the most far-reaching health care programs ever enacted. States will undoubtedly play a significant role in the expansion and management of coverage to 30 million Americans.

The Senate bill differs from the House version approved a few weeks ago in many ways, including increasing coverage through Medicaid, placing a cap the tax exclusion for employer provided health insurance, Medicare and Medicaid savings and how the new exchanges are structured.  As the House and Senate work to reconcile these and other differences, it is almost certain that the final bill will increase the demands on states through Medicaid and the new Exchanges. States must be prepared to devise new ways to manage these new responsibilities and the cost that comes with them.

Whether we end up with something closer to what the Senate or the House approved, large pieces of both health care bills add up to a big impact on information technology and delivery systems. Significant coverage increases will mean close examination of quality, enrollment and coverage comparisons. Providers and insurers certainly will seek strategic methods of managing enrollment and costs. There will be rapid changes in the way Medicare and Medicaid are managed. States will be scrambling to come up with approaches to the many problems and opportunities that will come as a result of this bill.

No matter the final version of the bill, it’s clear that the demand for advanced information technology solutions will accelerate and such solutions have the potential to play a huge role in designing the changing face of health care in this country.  For most of us, enactment of a health reform bill is just the beginning – the implementation of a very complex and challenging set of changes in the way we pay for and deliver health care will evolve over the next few years and States will play a lead role in making them a reality.


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