Official goals and challenges of U.S. health care reform – A hope for better care, delivery, and costs – Part I

Health Care Reform NewsThe reforms to healthcare delivery being made by the Affordable Care Act are making an historic attempt to bring its costs under control by improving the quality and efficacy of the system.

According to an official fact sheet, among the key reforms being made in this effort are as follows:

Rewards for quality

  1.  Hospitals – this includes the first Hospital Value-Based Purchasing Program of its size, which will give funding to more than 3,500 hospitals across the country based on how much they have improved and whether or not they have met various standards of performance.
  2. Physicians – the Centers for Medicare and Medicaid Services (CMS) intend to maintain and improve the Physician Quality Reporting System into the 2012 Physician Fee Schedule as a part of its efforts to better patient care provided through physicians by way of incentives to encourage individuals to report quality measurement information to the CMS.
  3. Home Health Agencies – more than $15 million in shared savings is being given to more than 100 Home Health Agencies that are taking part in the Medicare Home Health Pay for Performance program for improving care but with less expense.
  4. Dialysis Facilities – A new Quality Incentive Program for the for End-Stage Renal Disease (ESRD) will be directly linking payments from the CMS to the performance of the facility with the goal of lowering cost while providing superior care to the almost 500,000 enrollees.
  5. Medicare Advantage Plans – The CMS has boosted the bonus system through the Affordable Care Act in order to drive improvement incentives for care quality to the beneficiaries of Medicare.

Protecting the safety of patients and encouraging superior care

  1.  Accountable Care Organizations (ACOs) – the formation of voluntary ACOs allow healthcare providers to work in conjunction with other industry professionals and facilities to provide better care coordination across various health settings.
  2. Partnerships for Patients – a cross-country three-year initiative to help to minimize the instance of preventable complications and injuries among patients.
  3. Growth of Electronic Health Records (EHR) – building electronic health records may simplify patient medical status assessment by doctors, hospitals, and other healthcare providers, to ensure appropriate care while reducing the instance of redundant expensive procedures.
  4. Quality Improvement Organization (QIO) Program – A national QIO network will be made up of organizations that exist within each state with the intention of quickly spreading systemic healthcare change on a large scale.

So much information to sift through has made many wary about the up in coming changes within the health care system. It is only natural to wonder how this will exactly affect consumers. Within this three part series the goal is map out, a plan and clear vision, of what is suppose to happen along the way. Next, we will explore how waste and fraud will be addressed within the new system.


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