The Affordable Care Act—also known as national health reform—will transform the U.S. health care system in many ways. Some provisions, such as coverage for young adults, small-business tax credits, and new quality initiatives, are already in place. Other major reforms, including Medicaid expansion and new state health insurance exchanges for individuals and small businesses, will take effect in 2014. Yet even before health reform has been fully implemented, the health system has started—quite literally—to re-form itself. That’s partly because of the parts of the law that are already in effect. But many hospitals, physicians, employers, insurers, and states are also anticipating the changes ahead and preparing for them now, and discovering new ways to improve access and quality, and control rising health care costs as they do.
The result: experimentation—across the health care system. The new emphasis is on primary care, care coordination, and chronic disease management. With this shift in health care delivery comes new ideas for payment models and financial incentives that take a broader view of health management than the traditional fee-for-service structure. The aim is to allocate more resources to up-front preventive and primary care, as well as care coordination, reducing the need for costly acute and emergency care services down the road.
This report shines a light on emerging innovations, providing examples from different sectors across the country, to inform journalists and others of the different ways in which the system is reforming itself. It may also provide ideas for journalists who are interested in exploring the early effects of health reform and the implications for the future.