The 2010 healthcare reform law, commonly known as Obamacare, topped the politics and policy category and ranked No. 3 overall, garnering 399 votes from Modern Healthcare readers. Placing second in politics and policy—No. 6 overall—was the Health Insurance Portability and Accountability Act, coming up on its 20th anniversary in August.
Both Obamacare and HIPAA have had broad effects on the healthcare industry, said Chip Kahn, CEO of the Federation of American Hospitals. They “created tremendous change on the delivery side through Medicare and Medicaid as well as the new plans that are available to people,” he said. “Every hospitalization is touched by health reform.”
HIPAA has remained relevant for nearly two decades because of its breadth and the advent of health information technology, which it sought to regulate at a time when computers were mostly used in the healthcare industry for claims processing and revenue-cycle management. HIPAA was designed as a framework, with Congress coming back later to craft details.
“But (it) never did,” said Kahn, who worked on the legislation as a top Republican aide on Capitol Hill. “It was too complex and difficult.”
As a result, government agencies implemented rules such as the recent switch to ICD-10 diagnostic and procedural codes. “It touches patients day to day, every day,” Kahn said. “For every transaction, there is something that crosses that rule.”
In healthcare delivery,the category winner was the eradication of smallpox, ranked fourth overall with 320 votes.
After nearly two centuries of public health efforts that started when English physician Dr. Edward Jenner began promoting vaccination in the 1700s, smallpox was officially declared dead by the World Health Organization in 1980. The elimination of smallpox in the U.S. had been largely achieved in the 19th century, but as recently as the 1950s, tens of millions of people elsewhere in the world were infected with the virus each year.Dr. William Foege, who headed the Centers for Disease Control and Prevention from 1977 to 1983, began battling smallpox as a consultant to a Lutheran health mission in eastern Nigeria in 1966 and continued the fight at the CDC in the last endemic areas—India, Bangladesh, and finally, Somalia in 1977.
“We're now going on about half a century without a single case,” said Foege, now a consultant to the Carter Center and the Bill & Melinda Gates Foundation.
Identifying the first case of acquired immune deficiency syndrome, or AIDS, placed second in the healthcare delivery category and fifth overall. The mysterious outbreak was first reported in the CDC's Morbidity and Mortality Weekly Report in July 1981.