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RALEIGH – Economists say the fallout for hospitals, insurance providers and pharmaceutical companies after the health reform bill takes effect could be mixed.

N.C. State economist Mike Walden says while health care reform will likely benefit hospitals and the pharmaceutical industry, it's hard to tell with insurance providers. The insurance industry should benefit from as many as 30 million new customers.

"But the new legislation did two things,” Walden said. “First of all, you cannot deny coverage with pre-existing conditions, and secondly, it took away any cap on total payments for a customer. So, I think we don't know yet, how the insurers are going to come out."

Walden said medical device makers could suffer through the health care policy changes. New and higher fees for their products could lead to a decrease in demand.

"It comes down to access, cost, and quality," WakeMed President and CEO Dr. Bill Atkinson said.

He said health care reform means more people will have access to quality care. He calls the legislation a good start, while others in the industry are taking a more cautious approach.

"I think we're going to have to wait and see what this is going to do for the health care industry and for our patients quite frankly,” said Carolinas Healthcare System Vice President Martha Ann McConnell. “We're really excited about the access and the increased access, but at the same time we want to make sure it's a sustainable model for our patients."

"I think this is about meeting somewhere in the middle,” Atkinson. “Do what's right for the people in this country."

Despite all the debate over the cost of healthcare reform, Atkinson says the changes could turn out to be a big economic boost in North Carolina.

"There's an emphasis, a big emphasis on something that's very important in North Carolina, and that's information technology, and a big emphasis from the government on moving towards a uniform standard on how we collect and disseminate information in a secure manner," Atkinson said. "And for patients, it can make a difference on whether you live or die."