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Community action will make year-old law work

Wednesday marked the one-year anniversary of the Patient Protection and Affordable Care Act, which set into motion a new chapter in how health care is delivered in this country. Efforts to repeal and replace the legislation will keep the discussion and debate on the congressional agenda. While there may be changes to the law, the fact remains that reform must take place not only for the physical health of our community, but also for the economic viability of our region and the nation.

During the first year of this legislation, we've seen the expansion of coverage through a number of provisions, including expanding dependent coverage to age 26, a small business tax credit and filling the Medicare coverage gap. But there is much to be accomplished as we look ahead to 2014 and the start of health care exchanges. Through the exchange and other provisions, the law is intended to improve access to coverage, but the solutions to quality and cost containment will occur at the local level. The act doesn't contain prescriptive solutions to address the issue of cost and quality, but does include incentives for communities to develop their own responses.

Our region continues to make progress to improve the health of our community and we all have a role to play in creating a culture of health in Western New York. This requires a collective effort; one where we all have a responsibility. Employers, members and providers need to be aligned and incentivized with the same goal of better health, better quality and lower costs.

This effort will require employers to offer wellness programs that engage and reward employees who participate in healthy lifestyle changes and health risk management. It includes payers who reward physicians and hospitals for quality outcomes, not the volume of services provided. It involves active participation by community organizations and requires each one of us to take greater responsibility for our own health. And it depends on innovative collaborations among key stakeholders and the sharing of clinical information and adoption of health information technology and electronic medical records through organizations such as HEALTHeLINK. We're inspired by the results we've seen on all fronts.

While the law provides an important framework for health care reform, local community initiatives and partnerships are the pillars that support reform. Organizations like the P2 Collaborative of Western New York, the YMCA Buffalo Niagara and many others are working to empower the community to play a role in its health. Together, we can be a model for other communities to follow.

Health care reform has focused on the law, but locally, our focus is on what we continue to face -- rising costs, improving quality and access to health care -- and what we can do, together, to address these important issues. Our success is up to us.


Michael W. Cropp, M.D., is president and chief executive officer of Independent Health.

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