• 28-JUN-2012

  • SOURCE: PricewaterhouseCoopers LLP

Supreme Court Decision to Uphold Healthcare Law Means "Game On" for Health Industry: Crunch Time for Those Who Waited, Says PwC

NEW YORK, June 28, 2012 – Today's Supreme Court ruling upholding the Affordable Care Act gives extra punch to the market forces pushing healthcare toward convergence, transparency and greater influence for consumers, according to PwC US. The ruling upholding the 2010 law means that health organizations need to step up efforts to form alliances, collaborate and develop new ways to deliver care and measure and improve performance. The decision will continue a transformation of healthcare that has been driven not only by the law but also by market dynamics.

"Despite the political uncertainty, private-sector initiatives, accentuated and accelerated by the health reform law, are moving forward," said Kelly Barnes, Leader of PwC's U.S. Health Industries Practice. "The pressure for innovative ways to provide higher-quality, more affordable healthcare continues. Healthcare organizations that have been sitting on the sidelines will now have to get in the game and play catch-up."

Leading health sector participants have been devising new ways to conduct business and move ahead of the competition in the face of impending deadlines under the Affordable Care Act. Among the provisions that are scheduled to take effect soon are new reporting and disclosure obligations for employers, benefit design changes for certain health plans, penalties for hospitals that have unnecessarily high readmissions, and a requirement that insurers devote 80-85 percent of their premiums to medical care or refund the difference. In addition, participants will need to accelerate efforts to be competitive for federal funding that will be available for innovation, health insurance exchanges, new quality measures and other provisions of the law.