For some time now, he said, the hospital has been implementing measures aimed at streamlining care. And no matter what happens after the November election, that is the direction that El Camino will continue to move, Pifer said.
"As health care providers, we — as much as anybody — recognize the problems in the way that we do health care in the United States," he said. "I think we've always felt that it needs to be a lot simpler."
As it stands now, Pifer said, the country's health care system is "very fragmented." Patients are constantly moving from one provider to another, there is no uniform system for sharing patient information, and there are a multitude of payment systems, he explained. All of these factors add up to a system that is chaotic, confusing and more expensive than it needs to be.
The Affordable Care Act will help to strip away much of that confusion, Pifer said, although he acknowledged it is no panacea.
"The law is not perfect, but it pushes the country in the direction that it needs to go," he said.
For starters, the law works against what he called "perverse incentives." Currently, doctors are rewarded financially the longer a patient is in a clinic or hospital; they are paid for each test conducted and each procedure performed.
The Affordable Care Act pushes physicians to keep their patients out of their offices by offering monetary incentives for efficient care and earning high marks on patient satisfaction surveys — essentially for keeping people well, not curing them once they are sick.
The hospital's recently completed strategic plan emphasizes this preventative model of care, Pifer said.
A key component in keeping people well will come in the form of better record keeping. That means maintaining records in an electronic system for easy reference as well as keeping track of at-risk patients after they've been discharged.
The presumed Republican presidential candidate, Mitt Romney, has said he will make the repeal of "Obamacare" his No. 1 priority should he defeat the incumbent in this fall's presidential election. But until then, the hospital is moving forward as if the Affordable Care Act will continue to roll out.
The next big challenge will come as the vast majority of formerly uninsured people are able to obtain health insurance.
"We were all preparing for the individual mandate to be overturned," Pifer said, referring to the most controversial portion of the president's bill — the one that requires all Americans to purchase health insurance. But the provision was upheld, and as it is rolled out, Pifer is expecting the hospital to see a large influx of patients.
All of this is manageable, Pifer said, and the hospital is working hard on solutions. "Our health care system is completely capable of providing the best health care in the world," he said. "We've got to coordinate care better. We've got to manage people across the continuum in better ways."
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