Quality and safety in medical care: what does the future hold?
BACKGROUND
The rapid changes in health care policy, embracing quality and safety mandates, have culminated in programs and initiatives under the Patient Protection and Affordable Care Act.


OBJECTIVE
To review the context of, and anticipated quality and patient safety mandates for, delivery systems, incentives under health care reform, and models for future accountability for outcomes of care.


METHODS
Assessment of the provisions of Patient Protection and Affordable Care Act, other reform efforts, and reform initiatives focusing on future quality and safety provisions for health care providers.


RESULTS
Health care reform and other efforts focus on consumerism in the context of price. Quality and safety efforts will be structured using financial incentives, best-practices research, and new delivery models that focus on reaching benchmarks while reducing costs. In addition, patient experience will be a key component of reimbursement, and a move toward "retail" approaches directed at the individual patient may supplant traditional "wholesale" efforts at attracting employers.


CONCLUSIONS
Quality and safety have always been of prime importance in medicine. However, in the future, under health care reform and associated initiatives, a shift in the paradigm of medicine will integrate quality and safety measurement with financial incentives and a new emphasis on consumerism.
Institute of Health Law Studies, California Western School of Law, 350 Cedar St, San Diego, CA 92101, USA. baliang@alum.mit.edu
Bryan A
BA
Liang
Tim
T
Mackey
D003695:Delivery of Health Care / Q000639:trends*; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D058991:Patient Protection and Affordable Care Act; D061214:Patient Safety; D011787:Quality of Health Care / Q000639:trends*; D014481:United States