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Boise -- Patients across Idaho are now using insurance plans from the state-based exchange, Your Health Idaho, and hospitals are transitioning to a new system of health care.

Despite controversy, the Affordable Care Act is here, and now we're beginning to see how it's affecting your care.

KTVB sat down with doctors and patients at both St. Luke's Boise Medical Center and Saint Alphonsus Regional Medical Center to find out more about the changes.


Its been a long time since doctors made house calls, butnurse Jill Konrad is doing just that.

She's a transitional coach, who meets patients in the hospital, then checks up on them once they're out.Her main job is to make sure patients like 83-year-old Joyce Magee understand their medication, and their condition.

Magee had been in the hospital several times in several months for heart failure. But,she hasn't been back since she met Konrad.

It just gave me better confidence in what I was doing because I was truly a mess when I came home from the hospital, said Magee.

Konrad's position is new, as part of the Affordable Care Act's goal of reducing emergency room visits and re-admissions.So far, she thinks it's working.

They just hit the ER and then back into the hospital so therefore if I educate them and help them through the process they can manage their condition at home or through their primary care physician, said Konrad.

Magee says she's grateful for the help she's getting and she feels better.

Just by being there has, she just really has helped, I don't think I would feel as good today if it weren't for the program, said Magee.


Dr. David Gough with Saint Alphonsus saysfocusing on patients like Magee is key.

Hospitals really need to rethink their strategy for survival in this transformation of health care, the focus will not be so much hospital centered but patient centered, said Dr. Gough.

Dr. Gough says when patients now stay at Saint Al's, they'll see a new continuum of care, with medical staff focused on seeing patients before an issue develops.

I think patients can expect to see better access to primary care that will be a major component of the ACA success, said Dr. Gough.

Another big change -- hospitals themselves must be held accountable for the quality of care.
Once a patient has checked out, insurance companies won't pay the hospital for the service unless they've proved that the patient has successfully recovered.

The whole reimbursement is undergoing transformation too, not just how care is delivered but how it's paid for, and there will be value based reimbursement for the work that we do, and that's appropriate that's how it should be, said Dr. Gough.


At St. Luke's, the big change revolves around technology.

It's a platform the hospital has been pushing for years, in order to comply with the level of care that ACA demands.

Mike Vaughn is a patient who uses his phone and his computer to keep up to date on his medical needs.

It's a big change because the level of communication is a whole lot better, it's a lot easier to communicate, said Vaughn.

He schedules appointments, checks his test results, and keeps up to date on his medications -- all with one app called Mychart. It's an app that's directly linked to all his physicians, and assoon as they enter his medical records, they're released right back to him.

Nurse practitioner Dana Peachey says the technology has helped both medical staff and patients.

I think there are less frustrations on the patients part, calling in, waiting for someone to call back, they know that they can check their email, check their Mychart, said Peachey.

Dr. Marc Chasin says it's a huge undertaking. He says theinstallation of the technology system alone has taken years and cost $200 million.

We have over 500 clinicians actively engaging patient care on the same record so there is no longer re-duplication, same questions being asked, you can see the patient's care records no matter where you go, said Dr. Chasin.

All the changes are toward one main goal of revamping the health system in order to keep all patients healthier.

We want to change the paradigm so that the patient is an equal participant in their care and feels empowered to weigh in as an active participant, said Dr. Chasin.

Both hospitals say its still early to see exactly how the changes will affect care. But, they say despite the hard work it's taking to make the transition happen, their doctors and medical staff seem to be in support of making the Affordable Care Act work for them and their patients.

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