So much has changed since the Affordable Care Act was signed into law six years ago this month, but some things have remained the same.

That was the sentiment Thursday from Bob Ihrie, senior vice president of compensation and benefits at Lowe’s Companies. “From [a] strategy [perspective] nothing has changed,” he said, speaking at the National Business Group on Health’s Business Health Agenda conference in Washington, DC. “Obviously the environment around us has changed.”

Speaking of many employers’ push toward high deductible health plans, he said plan sponsors have implemented a lot of changes in reaction to the ACA’s excise tax.

“I think the government was surprised at how quickly employers moved to adapt, and how content most employers are in avoiding having to pay the tax if we can,” Ihrie said. “We know we can’t avoid it but we can delay further.”

But there are two pieces of the legislation that haven’t gotten as much attention – delivery system reform and improved population health – said Kathleen Sebelius, former U.S. secretary of Health and Human Services.

[Image credit: Bloomberg]
Kathleen Sebelius
[Image credit: Bloomberg]

“It’s early but there’re some encouraging signs around improvement around smoking and obesity,” she said. But “we have a long way to go on trying to address those two conditions which underlay virtually every chronic condition that has Americans living shorter lives.”

With regard to delivery system reform, there’s a lot going on in collaboration with the private sector, Sebelius added, which has been way ahead of the federal government and has been driven by data analytics.

Emphasizing it several times throughout the morning, the former secretary noted the importance of the ACA in taking data, analyzing it and using the analysis to get people to the right care at the right time.

Through these underappreciated parts of the law, comparing and contrasting employee healthcare across the country has become more exact.

“There is now a massive amount of data that has been put into the public sphere for employers to take advantage of,” Sebelius said, noting prior to electronic health records, much of the data was shared through anecdotes or written records.

E-records are now in place all over the country, she noted. “That sets a different platform to help measure. I think that was a critical part. Because you can’t move to a pay-for-quality [system] unless you know what’s going on.”

“The value of data is enormous,” Ihrie said. There is a glimmer of hope that the U.S. can one day get to value-based care, he added. As an example, he said Lowe’s works with a center of excellence on knee and hip replacement surgeries. And because of advances in population health ventures alongside data sharing, the company was able to avoid 14 unneeded surgeries.

But, Sebelius cautioned organizations with less-than-robust e-health collecting programs. Electronic records aren’t just data dumping, but require a protocol of collecting data that can be measured and used meaningfully, she said.

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