Commentary on Part I: Objectives of the ACA

Abstract

Even before the November 2012 elections abruptly terminated the electoral challenge to the ACA, President Obama’s signature policy accomplishment had already set in motion transformative changes to the nation’s healthcare system. The ACA takes a systemic approach to reform by tackling issues of access, cost, quality of care, and payment reform simultaneously. The law incorporates truly revolutionary changes to the care delivery and reimbursement systems. The ACA builds in mechanisms that should drive continuous healthcare innovation, including the Center for Medicare and Medicaid Innovation and Patient Centered Outcomes Research Institute. Finally, the ACA preserves the predominant role in the healthcare system of private providers and insurers, while assigning the federal government more of a catalytic role in driving change. While there are numerous uncertainties about the effectiveness of healthcare reform moving forward, the ACA is now reality and the market has already anticipated some of its impact in moving the system from fee-for-service to global payment models that reward quality, coordination, and efficiency of care.