The various delivery-system reform provisions of the Patient Protection and Affordable Care Act (H.R.3590) and the Health Care Education and Reconciliation Act (H.R.4872) – together known as theAffordable Care Act (ACA) – strive to achieve the “Three Part Aim”: improving the experience of care for individuals, improving the health of populations, and lowering per capita costs. In order to achieve those goals, the existing payment models and health care delivery system need to be reformed.
Despite general public perception,, the healthcare system of the United States does not deliver the best care it can (see Health Care Facts on this website). Yet, it is the most expensive healthcare system in the world. The ACA aims to move the healthcare system away from its current episodic, fee-for-service payment approach and towards a coordinated model that is focused on delivering high-quality, low-cost care across the continuum of care. The fee-for-service method of paying for healthcare can create incentives for providers to deliver more care, but not necessarily better care. Developing a payment system that rewards quality outcomes and stewardship of healthcare resources is necessary for America to rein in its costs and improve the overall quality of the healthcare system. In addition to changing the method through which providers are paid for healthcare, it is also necessary to reform the way in which that care is delivered, i.e., reforming the delivery system by creating high-performing organizations of physicians and hospitals that use systems of care and information technology to prevent illness, improve access to care, improve safety, and coordinate services—in other words, to become accountable for the quality and cost of American health care.