Theory is now reality. Welcome to the future.

We all know that politicians are still fighting about health reform, but health providers (including Texas Health Resources) have made their decision: The big overhaul is coming regardless of what happens in the November elections.  There has been an acknowledgement of the inevitable - and the unsustainable.  Health spending has reached a high of 18% of GNP, up from 12% in 1990.  Accountable Care is not just a theory anymore... it's reality.

Providers are feeling the pressure of offering more consistent care at a lower price.  Accountable Care Organizations are a big part of health law - get the right treatment at the right time at the right price; and keep patients healthy by bringing together primary care doctors, specialists, hospitals, pharmacy, and more.  This is the beginning of the end of our crippling fee-for-service system.

Texas Health Resources facilities treat one in four patients in this region.  The group has already spent $200 million on electronic medical records systems and a data analysis company, Healthways.  The tracked health data will identify congruent health issues among patients and the most effective protocols; smartphone tools will record follow-up treatments, medications and several other measurable effects.

Cost control efforts are being seen across the spectrum.  Next month Medicare will enforce new policy for hospitals with high re-admission numbers to be paid less than hospitals with fewer preventable re-admissions.  A New England Journal of Medicine study shows that 20% of Medicare patients return to the hospital within 30 days of discharge - their conditions still serious and costing the U.S. about $17 billion each year.  34% of patients are re-hospitalized within 90 days of discharge.

Admittedly, many of the returning patients are high-risk; they may be frail, have chronic conditions, or are unable to get to their follow-up medical appointments.  To add another layer, hospitals tend to transfer patients to less costly settings once their conditions are stable.  Follow-up care at home or through a skilled nursing facility is an option many patients prefer, but their condition needs to be carefully managed for the best outcome.

The Affordable Care Act is expected to allow countless seniors to live longer, healthier lives.  The ACA brings lower drug costs, more free preventative health screenings and an annual consultation with a physician to create a personal health plan.  And, it should also mean an end to obscene increases in medical costs.  Senior advocate organizations have strongly supported the health care bill, and virtually all the major health care and health insurance associations have given it their full support.

New rules allowing for administrative simplification are gradually being rolled out and accepted as part of new health care law.  These changes are expected to save providers and health systems about $4.6 billion over the next 10 years.  How?  By eliminating the red tape.  Directed by Health and Human Services Secretary Kathleen Sebelius, a universally used administrative process is essential in providing cost-effective, patient-care focused treatment plans that lead to more time with the patient, less time filling out forms, and more positive patient outcomes.