Right Care at the Right Time = Right Outcome
Some Americans are receiving too much care (unnecessary tests, visits to the doctor, etc.), while others aren’t receiving enough care. The healthcare law wants to help make sure patients are getting the right amount of care at the right time with the right outcome.
There are 3 main categories of provisions in the new law:
- Increasing prevention & wellness
- Innovative patient care programs
- Incentives to improve the quality of care
Increasing Prevention & Wellness
The Affordable Care Act has already made several changes to increase early prevention and wellness, and has more changes planned for 2013.
- 2010: Patients gained access to more preventive programs and vaccines at no cost.
- 2011: Medicare beneficiaries were granted free annual wellness visits, no cost screenings for diabetes, high blood pressure, heart disease, cervical cancer, mammograms, bone density tests, flu vaccines, and more.
- 2013: States that choose to expand prevention programs for Medicaid will receive funding from the federal government.
Innovative Patient Care Programs
The healthcare law established programs and centers of innovation to take steps to increase prevention measures, and improve the quality of care while lowering the cost.
- 2010: The law established a $15 billion fund to invest in proven prevention and public health programs that can keep Americans healthy – from smoking cessation to combating obesity.
- Jan 1, 2011: The Center for Medicare and Medicaid Innovation was established to start testing new ways of delivering care that improve quality and lower costs.
- 2011: The Community Care Transition Program was created. This new program helps high-risk hospitalized Medicare patients avoid readmissions by coordinating care.
Incentives to Improve Quality of Care
So, the Affordable Care Act has taken steps to:
- Research new, innovative ways to deliver quality care
- Increase access to free preventive services/screenings
Now, the healthcare law wants to make sure all of this care you’re receiving is coordinated.
Too often, patients receive duplicate services because their care isn’t coordinated or they miss out on critical services, such as a foot exam for diabetics because one doctor thought the another would take care of it.
To accomplish this, in 2012 Accountable Care Organizations or ACOs were established. An ACO is a group of doctors and other providers (hospitals, clinics, etc.) who come together to give patients high quality, multi-specialty care. These organizations strive to provide better coordinated, seamless care for patients. Learn more about ACOs.
Started in Oct. 2012, a Hospital Value Based Purchasing Program began for traditional Medicare. Hospitals are given financial incentives to improve quality, especially when it comes to heart attacks, heart failure, pneumonia, surgical care, healthcare-acquired infections (like getting a MRSA, an antibody resistant staph infection) during a hospital stay), and the patients’ perception of care.
In a few years, starting Jan.1, 2015, doctor’s reimbursement will be directly tied to quality measures. The higher the quality (outcomes), the higher the payment.
We hope this series on cost, access, and then today’s post about quality has helped you learn a little bit more about the Affordable Care Act. What other questions do you have about ObamaCare that we can address?