Robert Kocher, MD; Ezekiel J. Emanuel, MD; Nancy-Ann M. DeParle, JD
Kocher R, Emanuel EJ, DeParle NM. The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges. Ann Intern Med. 2010;153:536-539. doi: 10.7326/0003-4819-153-8-201010190-00274
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Published: Ann Intern Med. 2010;153(8):536-539.
The Affordable Care Act is a once-in-a-generation change to the U.S. health system. It guarantees access to health care for all Americans, creates new incentives to change clinical practice to foster better coordination and quality, gives physicians more information to make them better clinicians and patients more information to make them more value-conscious consumers, and changes the payment system to reward value. The Act and the health information technology provisions in the American Recovery and Reinvestment Act remove many barriers to delivering high-quality care, such as unnecessary administrative complexity, inaccessible clinical data, and insufficient access to primary care and allied health providers.
We hope that physicians will embrace the opportunities created by the Affordable Care Act that will enable them to provide better care for their patients and lead the U.S. health system in a more positive direction. To fully realize the benefits of the Affordable Care Act for their practices and their patients, physicians will design their offices for seamless care, employing new practice models and using technology to integrate patient information with professional society guidelines to keep patients with chronic conditions healthy and out of the hospital. Under the Affordable Care Act, physicians who effectively collaborate with other providers to improve patient outcomes, the value of medical services, and patient experiences will thrive and be the leaders of the health care system.
Focusing care around exceptional patient experience and shared clinical outcome goals.
Expanding the use of electronic health records with capacity for drug reconciliation, guidelines, alerts, and other decision support.
Redesigning care to include a team of nonphysician providers, such as nurse practitioners, physician's assistants, care coordinators, and dietitians.
Establishing, with physician colleagues, patient care teams to take part in bundled payments and incentive programs, such as accountable care organizations and patient-centered medical homes.
Proactively managing preventive care—reaching out to patients to assure they get recommended tests and follow-up interventions.
Collaborating with hospitals to dramatically reduce readmissions and hospital-acquired infections.
Engaging in shared decision-making discussions regarding treatment goals and approaches.
Redesigning medical office processes to capture savings from administrative simplification.
Developing approaches to engage and monitor patients outside of the office (e.g., electronically, home visits, other team members).
Incorporating patient-centered outcomes research to tailor care appropriate for specific patient populations.
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Hospital Medicine, Healthcare Delivery and Policy, High Value Care, Prevention/Screening.
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