We are excited to have Robert Enderle, Principal Analyst of Enderle Group, as a guest on the DocuSign blog, sharing his views on The Affordable Care Act and how it is shifting focus to manage costs.

There are two parts to the Affordable Care act, the part that gets the publicity and the part that should. If you’re on the left, the part getting publicity is how folks can’t afford health care. If you’re on the right, it’s all about a bunch of freeloading slackers getting free stuff. But what’s been lost and is really important is the fact that the income healthcare payers receive for care will be dropping sharply.  When coupled with the Act itself, this means healthcare providers will be expected to provide more care but they will likely be getting far less money for individual treatments. This will only accelerate as both parties in Congress focus on belt tightening.

80/20 Rule: Insurance Providers Aren’t Alone

This isn’t just providers, but it rolls up to Medical Insurance companies who are required to spend 80% of their income on actual medical procedures. That doesn’t leave a lot for operations let alone any profit for operating a business. This means like the healthcare providers, insurance providers in this segment will also be laser focused on massive cost cutting.

Both Care Providers and Insurance Companies Will Need Strategic Plans

To get there, they will need to develop a number of strategic plans. First, if they are not already, they will need to get a very accurate view of their competitive advantage. This will not be a case where the meek will inherit the customers. In the battles to come, firms will be measured both on their financial efficiency and on their ability to fund care completely and timely. If they fail on the first they are likely to go bankrupt, and if they fail on the second their government funding will likely be cut. Given an ever more social world where customers frequently share their experiences with anyone and everyone listening, they are likely to loose their customer base, as well. Making sure the firm is an example of best practices in controlling costs and assuring care will also assure the company’s success and survival in what is likely to be a very stressful time.

Part of the goal of the program is to achieve Affordable Care – and that either means with these firms or over their dead bodies. Most would likely prefer the former to the latter.


One of the key areas that should be on the short list to be fixed is the administrative process that surrounds the massive amount of paper documentation this industry generates. It amazes me that this industry is still largely driven by paper rather than faster, more secure and cost effective digital forms. Consider the expense, lack of security and inability to track paper, as well as the number of mistakes often made during data entry and transcription. What an avoidable waste.

It would appear that moving to a digital format would not only sharply reduce administrative costs, but should reduce expensive (from the standpoint of malpractice litigation) mistakes, as well. Because digital documents are cheaper to move, more effectively managed during approval processes, and easily accessed and signed from any Internet connected device, one would think they would already be ubiquitous in healthcare. By going digital, companies can cut millions in avoidable costs.

Wrapping Up:  Listen In On Our Expert Panel

On March 28th I will be moderating a panel of experts that include Kirsten Schaub Senior Account Executive from DocuSign who will share some best practices she has seen across DocuSign’s eSignature clients and Julie Dunham from Wellmark Blue Cross and Blue Shield who will talk about the practices that assured that her organization could respond to and flourish after this massive change.

Learn more during our free webinar Affordable Care Act:  Sustainable Achievement of Compliance