Culture shift: Affordable Care Act impact still unclear for hospitals, but change is going to come, analysts say

February 6, 2014

By Sara Gilgore


Though more than a month has passed since certain Affordable Care Act provisions went into effect Jan. 1, the law’s impact on daily operations of hospitals remains unknown.

However, health care culture will change, as more people become insured and health systems adapt, analysts say.

Because people who previously did not have health insurance are now required to have coverage under the ACA, methods for seeking treatment might change, according to Kevin Scanlan, CEO of the Metropolitan Chicago Healthcare Council. 

“There are so many examples of hospitals working in their communities from a proactive basis to improve the health of their community so that, in fact, they don’t see them in their emergency department,” Scanlan said.

New enrollment has led to an uptick in hospital activity on the national scale, according to Jeff Goldman, American Hospital Association spokesman.

“Hospitals made preparations in advance of January, and we are not hearing of significant issues from the hospital field,” Goldman said in a prepared statement Thursday.

Emergency room traffic has been recognized as an element of hospital care that could look different moving forward. But it is too early to determine whether ER visits will decrease, Scanlan said, and that won’t be known until the impact of flu season and cold weather have been examined, too.

The increased focus on preventive care is among changes attributable to the ACA, Scanlan said.

“We’re seeing a shift in how care is being paid for, with a heightened interest in the outcome of the care,” Scanlan said. “That whole landscape is changing. It’s much more cost-effective to pay for preventative care, especially with the uninsured.”

The council works to improve health-care delivery and comprises more than 170 hospitals and organizations. Scanlan said its members have “changed dramatically” over the past few years.

“Health-care providers getting prepared for life under the ACA has been a significant driver of that,” Scanlan said. “So it becomes very much of a challenge for single, stand-alone hospitals to survive and compete in a very competitive healthcare marketplace.”

While long-term implications of the ACA in hospital operations are still largely unknown, several components have been in practice since 2013 – namely, the extension of family coverage until age 26 and the elimination of barriers against covering pre-existing conditions. 

“Some of the aspects of the ACA that went into effect prior to Jan. 1 have the potential to have benefits that our hospitals will see,” Scanlan said. 

As the open enrollment period continues through March 31, Goldman said hospitals are pleased that newly insured people are “now getting the care they need.”

“Significant work went into preparations and helping people get enrolled,” Goldman said. 

In Illinois, hospitals continue to adjust to functioning under the new health care law.

“I don’t think we’ll really get a grasp on some of the impact until probably the third quarter of this year,” Scanlan said. “There are additional elements that go into effect next year, so we’ll be preparing for those also.”