Despite the largely unfavorable view of the Affordable Care Act and its potential impact on the U.S. healthcare system held by the majority of the public and many politicians, a blog published online in Health Affairs argued that healthcare leaders do not share such a pessimistic outlook. A survey found that 65 percent of executives believe the healthcare system will improve because of the new law.

Researchers from the University of Pennsylvania in Philadelphia surveyed 74 executives from U.S. hospitals and health systems, most of them working for large academic medical centers. Those intricately involved in the workings of healthcare, such as executives, offer a “more meaningful source for an appraisal of healthcare reform,” they explained in the Dec. 18 post.

In addition to their belief that the health system will be better off under the new law, nearly all the respondents (93 percent) believed their own facilities will improve and 91 percent said their facilities would see improvements in cost metrics by 2020. On average, they expected an 11.7 percent decrease in operating costs and predicted annual savings of 16 percent if Congress passed laws in favor of bundled payments rather than fee-for-service arrangements.

The respondents predicted the implementation of three major cost-cutting strategies—a decrease in hospitalizations, readmissions and emergency room visits. They also predicted lower costs for medical devices and drugs. In addition, measures such as EMRs and physician integration are helping reduce costs and improve quality.

Respondents who were not as optimistic said the main barrier to success is “persistent administrative complexities beyond the institution’s control.” They also disagreed with reimbursement incentives, with some questioning why there are no incentives for coordinated care, for example.

The authors noted, however, that these reasons for pessimism were inherent in the healthcare system long before the Affordable Care Act and that overall, healthcare leaders “expect that by 2020, their own institutions, and the system at large, will be better, both in terms of cost and quality.”