The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges
ABSTRACT The Affordable Care Act is a once-in-a-generation change to the U.S. health system. It guarantees access to health care for all Americans, creates new incentives to change clinical practice to foster better coordination and quality, gives physicians more information to make them better clinicians and patients more information to make them more value-conscious consumers, and changes the payment system to reward value. The Act and the health information technology provisions in the American Recovery and Reinvestment Act remove many barriers to delivering high-quality care, such as unnecessary administrative complexity, inaccessible clinical data, and insufficient access to primary care and allied health providers. We hope that physicians will embrace the opportunities created by the Affordable Care Act that will enable them to provide better care for their patients and lead the U.S. health system in a more positive direction. To fully realize the benefits of the Affordable Care Act for their practices and their patients, physicians will design their offices for seamless care, employing new practice models and using technology to integrate patient information with professional society guidelines to keep patients with chronic conditions healthy and out of the hospital. Under the Affordable Care Act, physicians who effectively collaborate with other providers to improve patient outcomes, the value of medical services, and patient experiences will thrive and be the leaders of the health care system.
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ABSTRACT: Nonphysician medical providers may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate by supporting best practices through the promotion of guidelines/protocols and playing active roles in patient engagement and organizational quality-improvement efforts. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315387/The Permanente journal 01/2015; 19(1):90-3. DOI:10.7812/TPP/14-095
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ABSTRACT: The Affordable Care Act (ACA) aims to expand coverage to the uninsured, improve quality, and contain costs. The goal of this study was to ascertain how plastic surgeons perceive the ACA. An electronic questionnaire was e-mailed to members of the American Society of Plastic Surgeons between May and June 2014. The survey was anonymous and voluntary and included questions to assess understanding and opinions of the ACA. The survey was sent to 3070 members of the American Society of Plastic Surgeons, and the response rate was 17%. Sixty-eight percent agree or strongly agree that they understand the basic concepts of the ACA. The majority of respondents disagree (38% strongly disagree, 31% disagree) with the notion that the ACA will positively affect their practice, and 51% agree with the statement, "I do not support the ACA, and I believe it did too much." Two thirds (66%) believe that the ACA deserves a grade of D or F. When answers were analyzed across demographics, 42% of respondents with "Academic" practice background identify with the statement, "I support the ACA but I think it needs more work," compared to 15% of those who selected "Solo Practice" (p <0.001). The ACA will affect all specialties, including plastic surgery. The results of this survey suggest that many plastic surgeons believe that they have a baseline understanding of current health-care reform. The majority of surveyed surgeons do not support the Act. It is imperative that plastic surgeons possess the knowledge of the ACA; its changes, both current and impending, will likely affect patient mix, coverage of procedures, and reimbursement.01/2015; 3(1):e293. DOI:10.1097/GOX.0000000000000265
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ABSTRACT: Purpose: The purpose of this study is to measure the implementation and effects of a multi-site coordinated care approach that delivered diabetes self-management education (DSME) and diabetes self-management support (DSMS) for disadvantaged patients within four patient-centered medical homes (PCMH). Methods: A total of 173 patients (69.9% African American, 26.0% Caucasian, and 4.1% other) experienced elements of the intervention, which featured DSME and coordinated care. Key informant interviews with PCMH site staff were used to capture, code, and characterize activities related to implementation and sustainability of the intervention. Outcome measures collected at baseline and at 6 months included clinical health indicators: A1C, body mass index (BMI), blood pressure, and lipids; as well as the AADE7 BehaviorsTM. Results: A statistically significant decrease occurred in A1C and BMI within 6 months for participants within one PCMH. This improvement among clinical health outcomes was associated with the frequency of services provided (eg, DSME, patient support). Conclusion: Integrating and delivering DSME and DSMS within coordinated care settings have the potential to improve PCMH practice and associated clinical health outcomes for populations experiencing health disparities.The Diabetes Educator 03/2015; 41(3). DOI:10.117/0145715577638 · 1.92 Impact Factor