Health Reform at 2: Why American Health Care Will Never Be the Same (Washington Post)

The Affordable Care Act is most associated with expanding health coverage to 30 million more Americans, but it’s also an overhaul of America’s business model for health care. The 45 changes to how doctors deliver health care, and how patients pay for it, shift from a pay-per-volume system to one that rewards costly and more effective care. The industry was already headed toward a bundled system–a patient pays a lump sum for treatment of a condition instead of paying for each procedure involved–but the reform law means Medicare–America’s biggest health-care spender–is moving toward it, too. In an Advisory Board Co. survey of 69 hospital executives in November, 16% said they had bundled payments in place. Of those who didn’t, 75% expected to within two years. Two-thirds expected they would have bundled payment arrangements with Medicare.