Healthcare Reform 101

Introduction Although hotly debated in this country for many years, reform of the healthcare system has been long-anticipated and needed, and many would argue is still a long way from being effectively achieved. On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This was slightly more than one year after beginning his first term in office. PPACA is also referred to by the terms Affordable Care Act (ACA), Obamacare or, simply, health care reform. This legislation, with its lofty goals, effective reforms and significant flaws, represents the most significant overhaul of this country's healthcare system since the passage of Medicare and Medicaid in 1965 under President Lyndon Johnson. A quality-focused and outcomes-based model is believed to be the only way to achieve real, sustainable savings. It is believed that we need to move from episodic care to coordinated care management and therefore, the ACA's overarching goal was to improve patient access, improve patient experience and quality outcomes and decrease cost.

The need for the reforming of our healthcare system can be represented by the following symptoms. Our current system is evidenced by fragmentation in care delivery, which can result in a poor quality patient experience, inefficient operations, suboptimal clinical outcomes and increased cost. There is significant waste in the system resulting from duplication of efforts, poorly defined processes and loss of information.

While the United States may have the best-trained medical personnel and the highest level of technology, the cold reality…

ABBREVIATIONS: ACA – Accountable Care Act; CBO – Congressional Budget Office; CHIP – Children's Health Insurance Program; FDA – Food and Drug Administration; PPACA – Patient Protection and Accountable Care Act.