What is the Future of Health Care Reform?

Publish Date: January 6, 2017


Paul Keckley, Ph.D

Health care reform could take some interesting turns in 2017.

There are a handful of experts who have the historical knowledge and visionary insights to help the rest of us navigate our way through reforms in health care and one of the top recognized thought leaders in this arena is Paul Keckley, Ph.D.

As managing editor of The Keckley Report, a health care researcher and widely known industry expert, Keckley has long served as a trusted source for health reform insights for the perioperative community. We recently spoke with him about the changing and challenging times that are ahead of us this year and beyond.

AORN: This journey toward reformed health care thus far has led to major changes in care delivery, care payment and quality measurement—are patients safer and receiving better care today because of these reform efforts?

Keckley: Yes, definitely. Health reform began long before the Affordable Care Act (ACA) and included efforts to measure and make transparent measures of quality and safety. The ACA magnified these by linking performance to incentives or penalties. It’s likely these efforts will continue in the new administration.

AORN: Where do you see health care reform moving toward in the year ahead?

Keckley: Three forces will drive health reforms this year:

  • Constraints on spending since federal deficits are increasing in large measure due to Medicare costs
  • Consolidation across the industry as margins thin and organizations seek scale to survive, and
  • Re-shaping of Medicare in the context of the “replacement” of the ACA

In all likelihood, premium support in Medicare, expansion of value-based programs, and relaxation of insurance company restrictions will be the big stories.

AORN: Perioperative nurses have been actively involved in health care reform—how can nurses make a difference with upcoming reform changes?

Keckley: Nursing is integral to care delivery and coordination. Their roles will expand and their significance in the system will increase as traditional scope of practice barriers fall and new delivery models take hold. Perioperative care is linked to incentives and care coordination, so it will be the frontline for changes to the system.

AORN: What is the most important quality you see perioperative nurses embodying as they stay ahead to meet the demands of reform efforts?

Keckley: Perioperative nursing will play an increased role in managing patient expectations that influence their outcomes, and in managing the care teams that provide services before and after surgeries. The role will expand!

Keckley will be talking about the future of health care at AORN’s Executive Leadership Summit. AORN looks forward to his insightful talk at the perioperative community’s biggest annual gathering.