Sophos, the renowned security firm, recently reported in its survey of data encryption: “The Sophos survey of IT decision makers in six countries reveals that there are some misconceptions about encryption, and some disconnects between what companies say they are concerned about – and what they’re doing about it.”

The article does not talk about misconceptions, but should!  Probably the biggest misconception is that your data is safe from hackers when you adopt an encryption technology.

In further analysis of the Sophos survey for Healthcare firms, Sara Heath writes:

Those organizations that do not encrypt their data – and even some that do – are seeing some gaps in data protection. Nearly one-quarter of customer information and customer financial information falls through the encryption cracks, leaving it liable to a data breach.

This is especially alarming when put into the context of the healthcare industry. Because patients are the customers in the healthcare industry, it is important that all of their PHI be fully protected via encryption to keep that valuable information from falling into malicious hands.

While encryption is great and everybody seems to be advocating it, does it really thwart a determined hacker?

Malicious hackers routinely steal information from private databases. It is a widespread fallacy that by encrypting the data in these databases, data will be safe. Regulators, compliance authorities and industry standards insist on encrypting sensitive information such as SSNs, credit card numbers, and health information.



However, unless the encryption is one-way – once encrypted, the data can no longer be recovered – encrypted data used by database-backed websites is usually as insecure as unencrypted data.

The encrypted data, to be usable, is obviously decrypted by some applications and processes within the system or on the network. Those applications and processes need to access the sensitive data, usually quite frequently, and have access to the decryption keys. The decryption keys are made available to these applications either by trusting their user-id, or their process filename, the computer’s IP address, or a similar factor.

To understand why data encryption might provide a false sense of comfort, let us make some rather formidable assumptions against our adversary, the hacker.

Let us assume that:
(a) the application logs are encrypted
(b) the application is encrypting its “heap” memory
(c) the application is enforcing data privacy in its interfaces to other components
(d) the decryption keys are stored in an ultra-secure (digital) vault

These assumptions are very hard to implement correctly. But let’s assume that they are true.

The fact that a hacker is able to access data, even if in encrypted form, in a database clearly indicates that the hacker has breached the various security perimeters and gained unauthorized access to an internal system. In normal course, the hacker should have not been able to access the raw database at all. Once the hacker is inside the network and has been able to access the database, it is a fair assumption that the hacker is able to assume the identity of the application or the web-server itself. In fact, once inside a system, it is not that hard for a hacker to just try and become the superuser of that system and then masquerade as a specific user.

Once that happens, all bets are off. If the hacker’s access to the database cannot be distinguished from the application’s access, encryption does not help at all. Once a hacker is inside your network and is able to access your encrypted data, it is usually only a matter of time before he figures out how to access the required keys, and then to decrypt the data.

Bruce Schneier, the famous crypto-expert, highlighted this way back in a blog article from 2010:

Let’s take a concrete example: credit card databases associated with websites. Those databases are not encrypted because it doesn’t make any sense. The whole point of storing credit card numbers on a website is so it’s accessible — so each time I buy something, I don’t have to type it in again. The website needs to dynamically query the database and retrieve the numbers, millions of times a day. If the database were encrypted, the website would need the key. But if the key were on the same network as the data, what would be the point of encrypting it? Access to the website equals access to the database in either case. Security is achieved by good access control on the website and database, not by encrypting the data.

We re-iterate the last sentence: Security is achieved by good access control on the website and database, not by encrypting the data.

To be sure, encryption is useful for carrying around sensitive information. But for data “at rest”, mere encryption offers but an illusion of safety.

With the Affordable Care Act, America has renewed focus on workplace wellness and employee well-being. The ACA discounts employers who foster workplace wellness, which in turn contributes to employee health and employer savings on health insurance. The concept is simple – employers encourage employees to participate in wellness programs, reduced tobacco use, etc. and in turn receive discounts on group health insurance.

Participation in Workplace Wellness programs differs from organization to organization. While some organizations might only require your vigilance in diet, exercise, and health habits, other organizations might dig deeper into your medical history, habits, and some very personal stuff. In fact, some organizations have subject employees to individualized targets on weight loss, tobacco use, blood pressure, and several other factors that impact their workplace wellness initiative.

Another issue related to workplace wellness is medical information privacy. At the outset of wellness programs, a lot of employers are collecting highly personal information from their employees. This exceptionally personal information, although kept safe and protected, might be illegally used by third parties or current employer to influence business decisions connected with the employee.

State Exchange

Some organizations are making optimum use of their workplace wellness initiatives. For instance, a lot of organizations are engaged in helping chronically ill workers connect with support groups, professionals, and motivational coaches who help in bettering their health habits. Under the workplace wellness initiative, employers and employees are working as partners, where one motivates other to stay healthy through various initiatives, and the other helps in running down the cost of healthcare in the organizations. This symbiotic relationship is at heart of the workplace wellness initiative, and in places where it’s actually working, it’s making a whole lot of difference.

At this moment, there is a solid argument going on between employer groups and the Obama administration. Employer groups are threatening to withdraw support from ACA if it hurts their business operations. At the same time, the administration is facing pressure from Equal Employment Opportunity Commission to fix this employee exploitation through wellness penalties under Obamacare. The EEOC is working to issue a set of guidelines which will clearly delineate what’s right and what’s wrong under the wellness initiative. These guidelines should bridge the gap between how employers are using wellness programs and how administration wants to see it used.

A repeal of the ACA has probably been a singular focus for the Republicans since 2010, ever since they launched their first attempt to replace the law with their alternative. After countless attempts to repeal and replace the Affordable Care Act, the GOP had to bow down to the ultimate success gathered by the law after a botched rollout last year. With formidable enrollment numbers and extended benefits through the law, it seemed nearly impossible for the GOP to take the law down in time.

However with a Republican-majority Senate, it looks like they have a strong opportunity to put their old plan in action and replace ACA with something endorsed by the party. The GOP taking a different approach to tearing ACA apart bit by bit – targeting the most unpopular provisions of the law and splitting them open with targeted legislation that could gather sufficient momentum. Here’s what could happen to Obamacare if a GOP Senate gets its way.

With this majority, the GOP plans to put in resolutions to repeal the entire law and, if that does not work, targeting the major taxes and penalties under Obamacare that are inacceptable to the party. The GOP still feels that it is necessary to break the law down as some provisions of ACA are mere unworkable expansions that will increase healthcare costs across the country, and will hurt employment, economy, and business growth.

The section of ACA receiving the strongest ire from Republicans is the employer mandate. The employer mandate requires businesses with more than 50 employees to provide health insurance coverage to employees, failing which they will be subject to penalties. The GOP feels that these aspects are hurting job growth in our economy, in turn hurting our people. Other than the workings of the employer mandate, the Republicans also want to target the gray area presented by the definition of ‘fulltime’ workers in ACA. Other than these primary aspects of the law, the Republicans will also focus on excise tax on medical devices, CAT scan machines, MRI machines, etc. The compensation for market losses to health insurers might also come in the line of fire.

The Republican efforts are drawing power from the business community’s constant lobbying efforts against employer requirements, penalties and taxes. Medical device manufacturers have continually spoken against excise duties, giving more firepower to Republicans. Amid this, some Democratic senators have also discussed supporting certain Republican measures. It looks like once the repeal efforts come to play, some negotiations might be possible between Republicans and Democrats, and the White House might not be able to veto every move of Republicans.

There are chances of a middle path being established on some attacks by Republicans, for instance, the tax penalties on employers who do not offer health coverage to employees might be replaced by incentives for employers who do. While the all out Obamacare repeal agenda will definitely be pushed off the floor, the seemingly minor alterations to the law might not be that easy to forgo.

As the ACA faces another Supreme Court case where the federal subsidies in states that did not opt for their own exchange are being reconsidered, this looming challenge might be a tough nut to crack. Unfortunately, a powerful act that has the potential of changing health insurance forever might succumb to mounting pressure from the opposition.

Since its enactment in 2010, the Affordable Care Act has come a long way in pursuit of its primary goal of a fully insured America. When the ACA was rolled out, it aimed to provide affordable health insurance to 32 million people by 2019. To realize that goal, the administration worked on a variety of initiatives, such as the setup of state and federal marketplaces that helped customers to shop for health insurance in a consumer centric marketplace format. The expansion of Medicaid was proposed to assist the momentum built by the ACA, and the health insurance industry was realigned to cut costs and suit the workings of the law.

In the last 5 years, ACA has had some hits and some misses in its journey. Today, we take a look at the top ten hits and misses in its 5-year journey.

1)  The Obama administration established the federally facilitated marketplace (aka healthcare.gov) that helped states without their own exchange offer subsidized health insurance to their citizens. For states that established their own state exchange, the Obama administration offered monetary support through grants that helped states pay for the exchanges. Although these exchanges struggled in the first 3 months, they delivered a solid enrollment figures when the first open enrollment ended in March 2014.

2)  As per the first enrollment, the administration was able to enroll 8 million even after suffering major setbacks in the first three months of enrollment. The majority of these enrollments were done over the phone or by paper apps.

3)  As many as 87 percent of the enrollees were able to control their health insurance costs through the exchange provided subsidies. These subsidies worked to minimize the cost of health insurance for people up to 400 percent of the federal poverty level, thus helping families cover for their health insurance. With removing the pre-existing condition, the ACA opened doors to people who had trouble finding insurance.

4)  By the end of the second open enrollment period in February 2015, the Obama administration managed to enroll 11 million people through the exchanges. Although a large chunk of these enrollments were people who had enrolled last year, deeper penetration of the law in the market was prevalent.

5)  It is expected that about 85 percent of the new enrollees will be eligible for the health insurance subsidies. Owing to the subsidies and the interest of healthy individuals in the law, the premium rise in the year 2015 was marginal.

6)  However, it seems that there will still be around 30 million uninsured Americans by 2019. If healthy individuals start dropping their health insurance, this number might go up, thus destabilizing the market and opening it for more challenges in terms of insurance pool balance.

7)  The ACA was built with concept of parallel expansion on Medicaid to cover some sections of the public. Since some states chose to not expand Medicaid, about 5 million people are stuck in a coverage gap, which prevents them from getting subsidies to cover their insurance costs from the exchanges nor are they eligible for Medicaid.

8)  Although health insurers are working with the law to provide affordable coverage, they have resorted to alternate measures to keep their profit margins. A lot of health plans have narrowed their networks and connected with low cost hospitals and physicians.

9)  Due to subsidies is such that people are choosing mid-tier silver plans, which ultimately cost a little higher but offer better cost assistance to consumers. However, the Silver plans expose the consumers to 30 percent of their healthcare costs, while 70 percent is covered by their plan, but most of these people cannot afford that remaining cost, and ultimately risk dropping their coverage and incurring significant medical debt.

10)  The shortage of primary care physicians is another challenge. The country is short of about 45,000 physicians, and most of the existing ones are no longer accepting new patients.

When Obamacare was being rolled out, people with pre-existing medical conditions were rejoicing. For the first time, people with pre-existing medical conditions had a chance to get affordable health insurance. People with a poor financial status had a chance to get government subsidies that pretty much offset the entire expense. It was thought that people dealing with substance abuse would also receive better treatment. In the same boat were people who were diagnosed with substance abuse. After nearly one year since the Obamacare rollout, let’s take a look at how the situation has changed for people undergoing substance abuse treatment.

A bird’s eye view of the situation reveals that the Obama administration’s plan to prevent substance abuse from becoming a discrimination ground is not going well. Health plans have already made use of the loopholes available around the mandate and have virtually made substance abuse out of reach for people with new health plans. This time, the health plans have placed extremely high deductibles for these people, and some have even removed substance abuse treatment from individual plans.

For substance abuse treatment, health plans have established deductibles as high as $25,000, which is out of reach for most people. After these deductibles, rehabilitation centers are not sure when the insurance coverage kicks in. And again, the coverage for people undergoing this lengthy treatment is usually two or three weeks, while the complete procedure can last up to three months, or 12 to 13 weeks. Another problem is the perspective of health insurance plans on the case of substance abuse. Insurance plans are viewing substance abuse as a pre-existing condition that cannot be treated easily and are shying away from the whole affair.

On the other hand, several insurance plans are trying to cut corners on this front by opting to cover only the cheapest treatment methods. Outpatient treatment programs for substance abuse, although not especially effective but cost one third of inpatient treatment, have been endorsed by insurance plans.

While it is still too early to pass a judgment on this, the overall picture does not look good. True, there are some insurance plans that are covering full substance abuse treatment. For residential treatment, 15 to 20 percent of participating health plans are willing to provide a large amount. Cigna and Aetna are a few of those 20 percent. These insurance plans are delivering the benefits of Obamacare preexisting condition mandate to people by covering a large chunk of their substance abuse treatment. But unfortunately, these insurance plans are too few.

Generally, the people who are availing substance abuse treatment under Obamacare are getting a raw deal, with only primitive methods assisting them in their recovery. The true benefits of Obamacare still haven’t reached the people who need them the most.

Healthcare has come a long way from giving a reactive response to standard, isolated incidents through subjective decision making. We have moved to a better form of care that functions on available personal information and medical history of a patient. This better form draws its efficacy from a very important variable – clinical data analysis. Although hospitals have figured operational and financial data in their working for decades, the use of universally usable clinical data to make more informed care choices is relatively new. Generally, this clinical data contains information about patients, such as diagnosis, treatments administered, medicines prescribed, procedures and lab tests conducted, and hospitalizations.

Generally, clinical data is driven by a variety of sources, including electronic health records, disease registries, patient surveys, and information exchanges among care providers. Effective analytics make this highly exhaustible data more useful and well aligned with the requirements of people who require actionable medical history for a patient. Here are 3 ways clinical data analytics is making healthcare better and reducing care costs.

1)  Clinical data analytics encourage preventive care over reactive care – reactive healthcare is costlier than preventive healthcare, and the existing trend shows that people tend to seek healthcare when there is a problem. Through clinical data analytics, preventive care can be practically implemented. With preventive care, hospitals can keep patients out of the costly emergency room care and reduce their healthcare costs. Predictive modeling, a part of clinical data analytics, is used by caregivers to determine the risk percentage to an individual’s health. Through these numbers, analytics can guide caregivers to provide precautionary care that can help cull the problem before it acutely infests the patient.

2)  Clinical data analytics provide evidence based treatment to patients – With more and more patients relying on electronic health records for sharing their information with caregivers, hospitals are now more equipped to make better care decisions for patients. Through relevant historical information about patients and their medical past, caregivers can mitigate the risk of post operation problems, such as surgical site infections, poor physical function, reaction to medicines and allergies. Traditionally, such problems have created unforeseen financial burden for hospitals and caregivers through unreimbursed costs, and have hampered patient satisfaction post operations. With clinical data analytics, such instances can be reduced to decrease costs and increase satisfaction.

3)  Clinical data analytics enable personalized care – Patients have frequently suffered the vicious cycle of changing doctors and getting stuck with the same set of tests, questions, and procedures over and over again. Usually, this type of care wastes time, money and effort, and does not bring any drastic improvement in patient’s health condition. With analytics, patients can drive a personalized care through an acute analysis of their clinical data that can bring suggestions for preventive care and wellness measures. Through the available data, doctors can generate a rounded view of the patient’s health and can drive better diagnosis and timely treatment. Other than reducing recurring costs of follow up care and hospital resources, caregivers can hope to provide a better care experience to patients by this personalization.  This personalization also improves chronic disease management programs for several patients. Through a better insight into patient history, caregivers are able to improve the efficacy of chronic disease management programs, such as how to administer self-care and how & when to take your medications.

Collectively, clinical data analytics can move the healthcare industry from a subjective, case by case approach to an objective, quantified approach that enables doctors to make better informed decisions. Through this objectivity, caregivers can reduce costs by reducing readmissions, emergency department visits, and wait times. Needless to say, the detailed insight through clinical data breakdown not only drives business by improving clinical outcomes but also affects higher patient satisfaction and improved care. Hospitals and caregivers have already begun investing in clinical data to provide better, well rounded care to their patients. As these hospitals improve healthcare by reducing costs, eliminating readmissions, and raising patient satisfaction, the industry will gather enough momentum to make a huge push for inculcating clinical data analytics in their base strategy.

A hacking incident (or rather, a five year long breach) at Community Health Systems, disclosed in August 2014, is supposed to have resulted in the leakage of 4.5 million health records.  Why on earth, one might be excused for asking, would someone steal health records?

Privacy

Let us first clarify the simpler matter that medical records are certainly worth protecting.  They contain private information about an individual.  Though most medical conditions say nothing about someone’s character or personality traits, there are still good reasons to want to keep one’s medical history private.  One may not want the world to know that one suffers from irritable bowel syndrome, or that one has suffered a few miscarriages, or even that one has had LASIK done to cure one’s eyesight.  You feel  comfortable in telling all to your doctor because you are assured that that information will be held in confidence.

Most people feel slightly embarrassed about having to explain an ailment to their doctors.   Imagine how much harder it would be for them if they knew that the doctor was going to put all that information in the public domain!

Other than privacy, is there any other reason to keep medical records secret?  Other than gossip and ridicule, what else does one have to fear?

Security

A lot, as it turns out.

The business of healthcare has become extremely complicated in the 20th and 21st centuries.  We have transitioned from a close relationship with the town or village doctor to a network of clinics, hospitals, providers, specialists, laboratories, pharmacies, medical device manufacturers and vendors, insurance carriers, government subsidies, medical tourism destinations, and so on.  It is all a rather dizzying array of complexity.

These entities exchange medical and payment information.  Usually, but not always, the payment is released by an insurance carrier.  In some cases, the payment might also be requested from an employer or the government.  It is quite difficult to impersonate someone to their employer, but most dealings with the government or with a large insurance provider are faceless.  All that matters in these interactions is whether one knows some important identifying numbers.

It is those numbers, and the history of one’s health conditions, which can enable hackers and thieves to fraudulently bill on your behalf.  Let us say a hacker knows that you are suffering from mild hearing loss.  The hacker might order a $20,000 hearing aid and bill your insurance carrier for it, and then sell it in the black market.  He might even be willing to make the co-payment.  Or, let’s assume a hacker figures out that you have Coronary Artery Disease (CAD), which might benefit from angioplasty.  What is to stop a hacker from creating the records of an imaginary angioplasty at, say, an “out-of-network” clinic (perhaps in another country) and bill your insurance carrier for hundreds of thousands of dollars?

To be sure, most medical histories do not lend themselves easily to lucrative exploitation.  Hence, it is very rare (unheard of, actually) that hackers will specifically target someone’s medical records.  Usually hackers attack a whole system and steal thousands or millions of records.  Then these are sold in bulk to specialized gangs which then sift through the information looking for opportunities.

“Ask for his ID!”

Shouldn’t it be required for the paying entities to authenticate the bill and the patient?  Well, they do.  But in today’s world, information is identify.  If you know enough about someone, you can, for all intents and purposes, become that person.  Their date of birth, their family history, their physical characteristics, even their biometric parameters (fingerprints, etc.) can be transmitted in such a way that there is no cause for suspicion that the transmitter is anyone other than who he says he is.

Banks and credit card companies have elaborate algorithms to detect when a transaction does not fit the pattern.  Unfortunately, health providers and insurance companies have not yet invested in such technologies.  And given the vast complexity of the human body, and the close relationship ill health has with suffering, it is doubtful if suspicion at a new symptom or a treatment is going to be welcomed by patients.  Such algorithms (at banks) fail, for example, when somebody suddenly has to travel to a location far from one’s normal place of business.

Healthcare is already riddled with too much paperwork.  And unlike financial transactions, health paperwork (e.g. diagnostic information) can be astoundingly varied and immune to simple algorithms.  To automatically scan all this complex data to detect fraudulent activity is not a simple project.

Therefore, the need is to protect the data in the first place.  If the data does not get into the wrong hands, hopefully we can prevent fraudulent billing.  Also, unlike financial information such as credit card numbers, stolen medical records continue to remain valid.  Its protection is therefore even more important.

As the Affordable Care Act goes into the waning days of its second open enrollment, the pressure is building on the U.S. healthcare system. More people have health insurance than ever, and this number is expected to continue to increase in the coming few months. In fact, for the 6.7 million people who purchased health insurance in the first enrollment period finding a primary care physician is getting difficult. Simply put, there are not enough primary care doctors to support the increasing number of people with health insurance.

As many as 81 percent of doctors reported that they are either working at full capacity or extended beyond their capacity. In addition, 44 percent of the doctors surveyed are considering cutting back on the number of patients they see in a month. Some doctors even talked about closing their doors to new patients, working part time or retiring altogether. The survey definitely reveals the additional pressure mounted on physicians with newly insured looking to find doctors.

Health plans, on the other hand, are more concerned about the rising competition in this new market, prompting them to cut the number of doctors in networks to curtail costs. This creates a roadblock of sorts for patients who are faced with either waiting for an extended period of time to get an appointment or incur additional out of pocket costs by seeing a doctor that is outside of the network.

With this primary care doctor shortage, the Obama Administration’s original purpose of connecting the uninsured to affordable, fully covered primary care is falling short. Nearly 20 percent of Americans are living in an area with a shortage of primary care physicians, and the supply of doctors isn’t enough to meet the demand. This supply-demand gap is expected to increase further, with nearly 66,000 additional doctors needed to fill this gap by 2016. Another major reason for this gap is that medical students are moving toward higher paying specialty areas instead of the primary care. Fortunately, until now, patients are receiving the care they need by driving farther out of their area, spending more time waiting for care, or settling for a nurse practitioner or an assistant instead of the doctor.

Naturally, this perennial challenge needs a resounding, permanent answer that can curtail this widening gap in primary care doctor supply-demand. One way is to ensure that more primary care physicians are available for the masses. The American Academy of Family Physicians has more than 115,000 member doctors, and it is constantly working to add new physicians, train nurse practitioners and assistants, and expanding their schedules by accepting patients in evening and weekends. Also, patients can utilize the second open enrollment to look for better health plans that give them a shot at easier access to doctors.

More than 1 million people enrolled through the Obamacare marketplaces in the first half of the second enrollment. This strong surge extends from a functional exchange marketplace and a strong belief in the potency of the law. However, there still are some aspects of the law that are confounding shoppers in their search for the health plan. For instance, people with chronic diseases are still being discriminated against in a subtle way, the very thing ACA was created to avoid right from the beginning. This discrimination comes through inadequate information and barriers to care that health plans are erecting for people with preexisting medical conditions.

However with a new CMS rule, things are about to change. The new CMS rule toughens the standards for health plans participating in the exchanges by requiring them to present all crucial information about their plans. The new requirement is targeted at making health plans more transparent, medications more accessible and healthcare barriers more ineffectual. Let’s take a look at the three improvements this new rule brings.

1)  More information about the plans – When people are shopping for health plans, they are frequently frustrated by the lack of easy access to most important information about the plans, including information about medications, doctors and hospitals. With the new rule, insurance firms will have to provide all this critical information, on separate website if needed, to give completely accurate drug information and provider network details. CMS might also take this a step further by requiring health plans to fill a standard template of information that exposes all the necessary loopholes in the information and requires health plans to provide all of that information in a single, handy format that can be read by machines for processing through consumer specific tools that assist decision making.

2)  Access to affordable medication – Other than lack of complete information about plan coverage, enrollees with chronic diseases are also perplexed with the problem of finding affordable medication. Currently, most health plans partake in the practice of designing a drug formulary that keeps specialty drugs required by people with chronic diseases at the highest cost sharing level. This practice is currently gathering more steam across health plans, with as many as 41 percent of the Silver plans doing this in 2015, as compared to only 27 percent in 2014. Under this new rule, the states will be required to review these changes to check if the health plans are providing affordable care as they should be. The Department of Health and Human Services will also be participating in this review. Under the rule, health insurers will also be prohibited from changing this drug level design in the middle of the year, thereby preventing health plans from denying coverage to people who purchased health insurance precisely to cover these drug costs.

3)  Extended support to patients who switch health plans – Currently, when patients change their health plans, they are faced with cost and health challenges as they are unable to continue their treatment routine and meet costs while searching for a new provider who will take over their health coverage. This new rule from CMS makes sure that when patients move from one plan to another, the new insurer covers all care and medication cost for 30 days, even if the prescription drugs do not fall under the plan’s drug formulary. This new concept, called ‘transition care’, is gaining ground, with the administration pushing for as long as 90 days of complete cover. For people with chronic conditions, these cost sharing mechanisms are an impediment to quality healthcare access, and the CMS wants to complete do away with it.

With this proposed rule, the Obama administration is sticking to its original commitment of making healthcare affordable for people with preexisting conditions. Although the rule is not finalized yet, it is set to make an ocean of difference in the quality of healthcare and associated costs for people with chronic conditions under ACA. The health plans might show some resistance to the passing of this rule, but once done, the rule will bolster the continued support Obamacare is receiving from people with chronic medical conditions.

Let’s admit it – the healthcare system in US has always been pretty. Typically, people with the most need of health insurance are the ones who are uninsured, and the ones with insurance tend to overload the system with unnecessary medical procedures. However, with Obamacare, things are looking brighter than before. The healthcare system is progressing in the right direction, and it looks like a bolstered approach of the ACA can fix a lot of gaps in the healthcare system. Here are the top three things that Obamacare is fixing in our healthcare system.

1) Balancing the Insurance Pool with New Enrollees – Before the rollout of the Affordable Care Act, health insurance remained out of reach for low and middle income families, who ultimately relied on emergency services for their health services. With the advent of the ACA, these families have received a strong boost that has helped them gain health insurance coverage. The Obamacare subsidies have connected these families to affordable coverage, and that is ultimately helping the healthcare system by removing the gap between those who have insurance but don’t need it, and those who need insurance but cannot afford it. Through this move, Obamacare has also eliminated the misuse of insurance policies for unneeded medical procedures and has directed that doctor bandwidth to care for patients who actually need healthcare. Instead of several overpaid specialists in the field of medicine, this pool balancing is also making primary care a pivotal field in medical science, finally getting students to move toward the field without thinking about remunerations.

2) Killing Medical Discrepancy and Resulting Mistakes – Medical mistakes are the third leading cause of deaths in the U.S. When a patient changes doctors, he is subject to repetition of tests and diagnosis. With Obamacare, a coordinated approach to patient care is now possible. When patients approach these services through their health plan, the patient can be addressed by in-network doctors, who are ultimately connected and share the diagnosis details. This, in turn, removes the chances of discrepancy in tests, diagnosis, and treatment, and can help the system by reducing deaths through medical mistakes. The concept of EHR increases this transparency. As of now, doctors are crippling the system by repeatedly prescribing high value tests that are reimbursed at high costs. With reduced discrepancy, the system can save millions of dollars by eliminating unnecessary, recurrent testing.

3) Incentivizing Better Health Habits and Wellness Programs – An additional benefit of the Affordable Care Act is the value attached to better health habits. The Affordable Care Act penalizes people who use tobacco through higher insurance premiums. On the other hand, for organizations that support wellness programs at workplace, the Affordable Care Act has a clause that provides them tax benefits for money contributed toward employee healthcare. The ACA believes that by spending on public health and wellness programs, the nation can remove the most common issues, which cause medical problems, ultimately relieving pressure from a struggling healthcare system. From a reactive care system, we can move to a preventive care system, and save a whole lot of money in the process. If the people start spending equally on exercise and diet, we can fix the reasons that affect 80 percent of our health.

The Affordable Care Act is already making strong progress in fixing the system through these facets of the law. However, there is still a lot more that can be done to bolster the system further. For instance, hospital and doctor pricing can be made more transparent, just like health insurance plans. Patients should take more control over care and work with their doctors to determine the right level of care. But we are making progress.