Does the Accountable Care Act Aim to Promote Quality, Health, and Control Costs or Has It Missed the Mark? ;Comment on “Health System Reform in the United States”

Document Type : Commentary

Author

School of Health and Human Services, University of Baltimore, Baltimore, USA

Abstract

McDonough’s perspective on healthcare reform in the US provides a clear, coherent analysis of the mix of access and delivery reforms in the Affordable Care Act (ACA) aka Obamacare. As noted by McDonough, this major reform bill is designed to expand access for health coverage that includes both prevention and treatment benefits among uninsured Americans. Additionally, this legislation includes several financial strategies (e.g. incentives and penalties) to improve care coordination and quality in the hospital and outpatient settings while also reducing healthcare spending and costs. This commentary is intended to discuss this mix of access and delivery reform in terms of its potential to achieve the Triple Aim: population health, quality, and costs. Final remarks will include the role of the US federal government to reform the American private health industry together with that of an informed consumer.

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1.  The Henry J. Kaiser Family Foundation [Internet]. Menlo Park (CA): The Henry J. Kaiser Family Foundation; c2013. Data note: Summary of the Affordable Care Act; 2013 April 23 [cited 2014 Feb 11]; [about 13 screens]. Available from: http://kff.org/health-reform/fact-sheet/summary-of-new-health-reform-law/
2.  Press release: More partnerships between doctors and hospitals strengthen  coordinated  care  for  Medicare  beneficiaries  (Centers for Medicare and Medicaid) [Internet]. 2013 Dec 23 [cited 2014 Feb 12]; Available from: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-Releases/2013-Press-ReleasesItems/2013-12-23.html
3.  Auerbach D, Liu H, Hussey P, Lau C, Mehrotra A. Accountable care organization formation is associated with integrated systems but not high medical spending. Health Aff (Millwood) 2013; 32: 1781–8. doi: 10.1377/hlthaff.2013.0372
4.  Shi L, Singh D. Delivering Health Care in the US. 5th ed. Burlington, MA: Jones & Bartlett Learning; 2011.
5.  Health insurance marketplace: February enrollment report For the period: October 1, 2013 – February 1, 2014 (Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation) [Internet]. 2014 February 12 [cited 2014 Feb 13]; Available from: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Feb2014/ib_2014feb_enrollment.pdf
6.  Mannion R. Take the money and run: the challenges of designing and  evaluating  financial  incentives  in  healthcare;  comment  on “paying for performance in healthcare organisations”. Int J Health Policy Manag 2014; 95–96. doi:        10.15171/ijhpm.2014.22
7.  Field R. Mother of invention: how the government created freemarket health care. Oxford: Oxford University Press; 2014. doi: 10.1093/acprof:oso/9780199746750.001.0001
8.  Lyles A. The importance of context to the generalizability of international research: the other health care reform. Clin Therapeutics 2010; 32: 2442–3. doi: http://dx.doi.org/10.1016/j.clinthera.2011.01.002
9.  Starr P. Remedy and reaction: the peculiar American struggle over health care reform. New Haven: Yale University Press; 2011.
10.  Cheng TM. Early results of China’s historic health reforms: the view from Minister Chen Zhu.Health Aff (Millwood)2012; 31: 2536–44. doi: 10.1377/hlthaff.2012.1017
11.  Weaver C. Millions trapped in health-law coverage gap; earning too little for health-law subsidies but ineligible for benefits under existing medicaid programs. The Wall Street Journal [serial on the internet]. 2014 Feb 10. Available from: http://online.wsj.com/news/articles/SB10001424052702304851104579363621009670740
12.  Collins SR, Rasmussen PW, Doty MM, Garber T, Blumenthal D. Americans’ Experiences in the Health Insurance Marketplaces: results from the first three months. Issue Brief (Commonw Fund) 2014; 1: 1–26.
13.  The Henry J. Kaiser Family Foundation [Internet]. Menlo Park (CA): Kaiser Family Foundation; c2014. Kaiser Health Tracking Poll: January 2014; 2014 Jan 30 [cited 2014 Feb 11]; [about 11 screens].  Available  from:  http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-january-2014