title: The Affordable Care Act's payment and delivery system reforms: a progress report at five years.
abstract: In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in how health care is delivered and paid for in the United States. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms and, where possible, documents their initial impact at the ACA's five-year mark. While it is still far too early to offer any kind of definitive assessment of the law's transformation-seeking reforms, it is clear that the ACA has spurred activity in both the public and private sectors, and is contributing to momentum in states and localities across the U.S. to improve the value obtained for our health care dollars.
authors.affiliation: Health Care Delivery System Reform, The Commonwealth Fund. mka@cmwf.org
authors.forename: Melinda
authors.initials: M
authors.lastname: Abrams
authors.forename: Rachel
authors.initials: R
authors.lastname: Nuzum
authors.forename: Mark
authors.initials: M
authors.lastname: Zezza
authors.forename: Jamie
authors.initials: J
authors.lastname: Ryan
authors.forename: Jordan
authors.initials: J
authors.lastname: Kiszla
authors.forename: Stuart
authors.initials: S
authors.lastname: Guterman
mesh_terms: D060866:Accountable Care Organizations / Q000331:legislation & jurisprudence; D019985:Benchmarking / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000331:legislation & jurisprudence* / Q000379:methods; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000191:economics; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D018802:Patient-Centered Care / Q000191:economics / Q000331:legislation & jurisprudence; D011320:Primary Health Care; D011785:Quality Assurance, Health Care; D014481:United States