Some health system changes will move forward, regardless of the Supreme Court ruling

News outlets report that a "quiet revolution" in how care is delivered is already taking place across the country that closely tracks many of the changes advanced by the health law.

The Fiscal Times:  High Court Can't Stop Some Key Health Care Reforms
The Supreme Court may rule some or all of the Affordable Care Act unconstitutional today, but its decision will have little impact on the quiet revolution that is already transforming how many of the nation's hospital and physician networks deliver care – changes that parallel the reforms contained in the law. Even conservative states leading the legal challenge to Obamacare are moving toward implementing bundled payments, "medical homes" and accountable care organizations. Many have already moved beyond the law's pilot project phase to institute system-wide changes (Goozner, 6/28).

National Journal: Health Care Ruling Won't Stop All Of Industry's Changes
Whatever the Supreme Court does on Thursday, there's no time machine for the health care system. Legally, a ruling reversing or eviscerating the Affordable Care Act could bring the country back to 2009. But practically, there's no going back. In the two years since the health care legislation became law, big players in the industry have begun reshaping their business practices, changing their structures, and altering the rules of play in ways that will be difficult to reverse. Hospitals have begun buying up medical practices and their smaller competitors. Insurance companies have been moving toward new payment paradigms and promising to preserve new consumer protections. State governments have overhauled their Medicaid enrollment systems and insurance oversight. The health care ruling will be consequential in numerous ways, but there is much that the law has set in motion that is likely to outlive it (Sanger-Katz, 6/27).

Marketplace:  Health Industry Faces Big Decisions With Supreme Court Ruling
It's hard to find an example of the Supreme Court tossing out a law, where more had already been done to implement it. If even part of health care reform is tossed out, insurers and regulators face a huge task deciding what to undo, and how. Sara Collins researches health care reform with the Commonwealth Fund (Horwich, 6/27).

Meanwhile, investors are bracing for the decision -

Market Watch: Look For Nuances In Health Stocks After Ruling
As the clock ticks down to the U.S. Supreme Court's ruling on the health-care overhaul bill, investors wait and wonder how significant a shift there will be once the justices hand down their verdict. The general consensus has been that insurers and hospitals should be braced for a storm of selling or buying, depending on whether the high court strikes down all or portions of the landmark 2010 legislation, or upholds it entirely when it is expected to hand down its ruling Thursday morning (Britt, 6/27).

Chicago Sun-Times: Investors Watch For Health Care Ruling
Investors are almost as interested in what the Supreme Court does with health care reform Thursday as patients and doctors. Depending on what the high court decides regarding the legality of the Patient Protection and Affordable Care Act, the fate of the nation's health care system is in balance, potentially upending again how the key players are paid. The statute, often called Obamacare, passed in 2009 and stands to change the industry, so the decision is critical to investors in health care stocks. "It's a sweeping piece of legislation that has a broad impact on how (health care) industries are structured," says Matthew Coffina, health care analyst at Morningstar (Krantz, 6/28).

In other related news -

Philadelphia Inquirer: Supreme Court Predictions And Opinions On Disclosing Payments To Doctors
The Physician Payments Sunshine Act is part of the Patient Protection and Affordable Care Act, all of which hangs in the balance Thursday morning when the U.S. Supreme Court will likely rule on the constitutionality of all or parts of the package. … The Sunshine Act requires pharmaceutical and medical device companies to report payments made to doctors and teaching hospitals. It is designed to give patients and others more information and shed light on potential conflicts of interest. The question is whether a doctor paid by a company is more inclined to prescribe that company's drug over a competitor's drug or no drug because of his or her financial relationship with the first company, regardless of the effect on the patient (Sell, 6/27).