The ACA: Changing the Conversation

January 14, 2016

Although aspects of the health care industry are widely debated, no one challenges the notion that changing the delivery of care is a positive movement.

The Affordable Care Act (ACA) may have its shortcomings, as it doesn’t adequately address components of the system that continue to drive up cost. However, the legislation continues to serve as a catalyst for change.

Empowering the individual

While the complexity of insurance can be overwhelming, we are now seeing an industry that once spoke in acronyms and jargon simplify the conversation in an effort to appeal to a whole new segment—the consumer.

Education campaigns, community outreach, savvy technology and more personalized customer service are all results of the ACA. That is because the consumer demands it.

Gone are the days when a brochure would suffice. Consumers want to be communicated to in a way that is simple and that will help them make good decisions quickly.

An industry that was once elusive is now more transparent, which is in response to the new “retail” culture that has been born. While health care is still catching up to the likes of other industries in terms of service and technology—we are on a clear path, moving swiftly ahead.

As a result, over the past few years the way we operate has been transformed.

A new normal

There has been a clear shift towards accountable care, which has prompted more meaningful collaboration between insurers and providers—changing the way we do business.

The traditional conversation was focused on a fee-for-service approach. Now we see an industry moving towards reimbursement tied to quality and performance.

Insurers and providers are coming together to identify shared goals, with the member at the center of it all. Patient-centered care is the new normal, and it’s what is driving the fundamental changes needed in order to effectively transform the delivery of care.

We’re in it together

Understanding the concept and value of patient-centered care further empowers individuals when they are making important decisions about their health care needs. This applies not only to purchasing an insurance plan, but also when choosing a provider or specialist. For example, choosing an in-network provider can directly help reduce excess spending related to out-of-network fees. It all ties back to empowering the individuals with information and knowledge that will help them make informed decisions.


The consumer’s active role in the marketplace has warranted change. In the years to come, we can expect that insurers and providers will continue to cultivate ideas and foster relationships in response to that change.


Individuals need to be actively engaged in effectively managing their health care for it all to work seamlessly. A lot of progress has been made, but this is just the beginning.



Written by: Judith L. Roman
President & CEO, AmeriHealth

As President & CEO of AmeriHealth New Jersey Judy Roman has set a very clear vision for the company — enable the people of New Jersey to improve their health and well-being while providing them access to affordable, quality care. In her role, Judy actively oversees AmeriHealth New Jersey’s business operations including Sales and Marketing, Provider Networking, Contracting and Reimbursement, Clinical Services, Finance, Medical Cost Analysis and Communications. With more than 30 years experience, Judy has watched the health care industry transform and has lead AmeriHealth New Jersey to do the same since she assumed the role of president and CEO in 2006. Read full bio here: //

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