title: The Affordable Care Act: a case study for understanding and applying complexity concepts to health care reform.
abstract: OBJECTIVE
  The current health system in the United States is the result of a history of patchwork policy decisions and cultural assumptions that have led to persistent contradictions in practice, gaps in coverage, unsustainable costs, and inconsistent outcomes. In working toward a more efficient health system, understanding and applying complexity science concepts will allow for policy that better promotes desired outcomes and minimizes the effects of unintended consequences.
  
  
  METHODS
  This paper will consider three applied complexity science concepts in the context of the Patient Protection and Affordable Care Act (PPACA): developing a shared vision around reimbursement for value, creating an environment for emergence through simple rules, and embracing transformational leadership at all levels.
  
  
  CONCLUSIONS
  Transforming the US health system, or any other health system, will be neither easy nor quick. Applying complexity concepts to health reform efforts, however, will facilitate long-term change in all levels, leading to health systems that are more effective, efficient, and equitable.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: D Justin
authors.initials: DJ
authors.lastname: Larkin
authors.affiliation: Department of Health Sciences, Brigham Young University, Provo, UT, USA.|Department of Emergency Medicine, Intermountain Healthcare, Provo, UT, USA.
authors.forename: R Chad
authors.initials: RC
authors.lastname: Swanson
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Spencer
authors.initials: S
authors.lastname: Fuller
authors.affiliation: Healthcare Delivery and Policy Program, Arizona State University, Tempe, AZ, USA.|Mayo Clinic, Rochester, MN, USA.
authors.forename: Denis A
authors.initials: DA
authors.lastname: Cortese
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D007857:Leadership; D058991:Patient Protection and Affordable Care Act; D012052:Reimbursement, Incentive; D014481:United States
keywords: complexity science; health care policy; health care reform