(This article was written by J. Marc Ward, a member of the board of trustees at Broadlawns Medical Center in Des Moines.)
Since the Affordable Care Act (ACA) was enacted, the media have expounded on its landmark patient protections. Most Iowans probably know that the ACA ended health insurance discrimination against those with pre-existing conditions. Parents are generally aware that adult children can stay on their health plan until age 26.
These were great advances, but many of the long-range benefits of the ACA haven’t received much attention. Nonetheless, new structures have taken hold behind the scenes and they’re working to improve care quality, increase innovation and even boost the economy.
The advantages of the ACA are readily apparent at Broadlawns Medical Center, where I serve on the board of trustees. Prior to the ACA, Broadlawns had already started to transform itself by creating a culture of excellence and accountability resulting in dramatic reductions in cost (lowest in Iowa); implementing innovative methods to deliver high-quality care; recruiting exceptional physicians and staff and began the process of repairing and replacing its worn-out buildings without raising local taxes.
The advent of the ACA then further allowed Broadlawns to accelerate these efforts. There, a new medical plaza houses family medicine, mental health and dental care. Mental health services have expanded with a larger inpatient unit and the first psychiatric urgent care in Iowa. A new walk-in clinic was strategically located in eastern Polk County, with public transportation to its doors. Still forthcoming are enhancements to intensive care, oncology, hematology and maternity centers.
From mobility-preserving ankle surgeries to infection-prevention robots, this county hospital is now cutting-edge. The investments required, however, would have been impossible without the ACA and Iowa’s Medicaid expansion.
For years, medical providers were devoting substantial funds to what’s known as “uncompensated care,” serving uninsured people who simply can’t pay. Charity care will always be part of our mission, but without addressing the inequities in health insurance access, it would have remained a drag on our innovation.
Thanks to the ACA, US health care dollars are being more wisely invested. As the saying goes, an ounce of prevention is worth a pound of cure. For example, early-stage skin cancer can be removed with a scalpel and survival chances are excellent. In melanoma’s later stages, however, it costs tens of thousands of dollars to give a patient a shot at a few months of life.
We’re better off putting our money into check-ups, disease screenings, smoking cessation programs, and other wellness efforts. And that’s exactly what ACA-empowered health plans are doing. Investing in preventive care costs relatively little and saves a lot down the road — including patients’ lives.
Efficacy is among the reasons Broadlawns chose to partner with Medicaid health plans as an Accountable Care Organization. Together we’re incentivized to deliver integrated care and achieve the best health outcomes for patients.
In our experience, such value-based models promote positive change. For instance, we introduced a digital patient portal, which gives families secure, 24/7 access to lab results, appointment scheduling, medication information, and more. Under the ACA, health providers and insurers will continue to find new ways to put great care at Iowans’ fingertips.
Thanks to efficiencies and advancements, the US has slowed health care spending growth. At the same time, our industry, which comprises about one-sixth of the US economy, is expanding. Broadlawns itself is a key employer in an area often lacking in opportunity. Resting on a stronger financial foundation, the health care sector is adding hundreds of thousands of well-paid jobs each year. And as we help patients get healthier, we’re contributing to an upswing in labor force participation for all types of businesses.
It’s possible to find fault with any system, but the ACA is better than anything that’s gone before. I would invite those who persistently attack it to do something more productive than complain — join with those of us on the front lines of health care to improve on the ACA. That way, we can give Iowans what they deserve, the best health care all of us can imagine.