Abstract
The incredible complexity of the United States health care system can be connected to three simple outcomes: access, affordability, and quality. We should measure our progress against these three measures. While historic progress on access was made through implementation of the Affordable Care Act, the next area of focus for more results across all three measures is delivery system reform.
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References
1.
R. A. Cohen
,
M. E. Martinez
, and
E. P. Zammitti
Division of Health Interview Statistics, National Center for Health Statistics , Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January – March 2018 , August 2018 , available at <https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201808.pdf> (last accessed December 5, 2018 ).
2.The Economic Record of the Obama Administration: Reforming the Health Care System , The White House , December 2016 , available at <https://obamawhitehouse.archives.gov/sites/default/files/page/files/20161213_cea_record_healh_care_reform.pdf> (last accessed October 10, 2018 ), 27 -36 .
3.
Cohen, Martinez, and Zammitti, supra note 1.
4.“Status of State Action on the Medicaid Expansion Decision,” Kaiser Family Foundation , January 16 , 2018 , available at <https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D> (last accessed October 10, 2018 ).
5.
M. Buettgens
, The Implications of Medicaid Expansion in the Remaining States: 2018 Update , The Robert Wood Johnson and Urban Institute , May 2018 , available at <https://www.urban.org/sites/default/files/publication/98467/the_implications_of_medicaid_expansion_2001838_2.pdf> (last accessed on October 10, 2018 ).
6.“Key Facts about the Uninsured Population,” Kaiser Family Foundation , November 29 , 2017 , available at <https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/#footnote-237026-13> (last accessed on October 11, 2018 ).
7.
R. Garfield
,
A. Damico
,
J. Foutz
,
G. Claxton
, and
L. Levitt
“Estimates of Eligibility for ACA Coverage Among the Uninsured in 2016,” Kaiser Family Foundation , October 25 , 2017 , available at <https://www.kff.org/uninsured/issue-brief/estimates-of-eligibility-for-aca-coverage-among-the-uninsuredin-2016-october-2017-update/> (last accessed October 11, 2018 ).
8.
A. Looney
and
K. Martin
“One in Five 2014 Marketplace Consumers was a Small Business Owner or Self-Employed,” U.S. Department of the Treasury , January 12 , 2017 , available at <https://www.treasury.gov/connect/blog/Pages/Onein-Five-2014-Marketplace-Consumers-was-a-Small-Business-Owner-or-Self-Employed.aspx> (last accessed October 11, 2018 ).
9.
A. Finkelstein
,
N. Hendren
, and
M. Shepard
Subsidizing Health Insurance for Low-Income Adults: Evidence from Massachusetts , The National Bureau of Economic Research, Working Paper No. 23668 , August 2017 , available at <https://scholar.harvard.edu/files/hendren/files/commcare.pdf> (last accessed on March 21, 2018 ).
10.“Employer Health Benefits: 2017 Annual Survey,” The Kaiser Family Foundation and Health Research & Educational Trust , available at <http://files.kff.org/attachment/Report-Employer-Health-Benefits-Annual-Survey-2018> (last accessed December 5, 2018 ).
11.
A. Chappel
,
S. Sheingold
, and
N. Nguyen
Health Care Spending Growth and Federal Policy , U.S. Department of Health and Human Services, Office of the Assistant Secretary of Policy and Evaluation , March 22 , 2016 , available at <https://aspe.hhs.gov/system/files/pdf/190471/SpendingGrowth.pdf> (last accessed October 11, 2018 ).
12.The Economic Record of the Obama Administration: Reforming the Health Care System , The White House , December 2016 , 3-4 , available at <https://web.archive.org/web/20170118031033/https://www.whitehouse.gov/sites/default/files/page/files/20161213_cea_record_healh_care_reform.pdf> (last accessed October 11, 2018 ).
13.“National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015: Interim Data from National Efforts to Make Health Care Safer,” Agency for Healthcare Research and Quality , December 2016 , available at <https://www.ahrq.gov/professionals/quality-patient-safety/pfp/2015-interim.html> (last accessed on October 11, 2018 ).
14.ASPE Issue Brief , Essential Health Benefits: Individual Market Coverage , Assistant Secretary for Planning and Evaluation U.S. Department of Healt hand Human Services (December 16 , 2011 ), available at <https://aspe.hhs.gov/basic-report/essential-health-benefits-individual-market-coverage>(last visited December 5, 2018 ).
15.“NHE Fact Sheet,” Centers for Medicare and Medicaid Services , available at <https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nation-alhealthexpenddata/nhe-fact-sheet.html> (last accessed October 11, 2018 ), last updated February 2018.
16.
M. Miliard
, “HHS gets to value-based reimbursement goal ahead of schedule,” Healthcare IT News , March 3 , 2016 , available at <www.healthcareitnews.com/news/hhs-gets-value-based-reimbursement-goal-ahead-schedule> (last accessed October 11, 2018 ).
17.
S. L. Fryhofer
,
M. Seshamani
,
K. B. DeSalvo
, and
P. H. Conway
“Progress and Path Forward on Delivery System Reform,” NEJM Catalyst , available at <https://catalyst.nejm.org/delivery-system-reform-progress-path/> (last accessed October 11, 2018 ).
18.Id .
19.HHS Retrospective Regulatory Review Update : May 2012 , available at <https://www.hhs.gov/sites/default/files/open/retrospective-review/regulatory-introductory-statement201205.pdf> (last accessed on October 11, 2018 )
20.
S. L. Fryhofer
,
M. Seshamani
,
K. B. DeSalvo
, and
P. H. Conway
“Progress and Path Forward on Delivery System Reform,” NEJM Catalyst , available at <https://catalyst.nejm.org/delivery-system-reform-progress-path/> (last accessed on October 11, 2018 ).
21.
A. Slavitt
and
P. Conway
“A Healthier Medicare: Focusing on Primary Care, Mental Health, and Diabetes Prevention,” The Official Blog for the Centers for Medicare and Medicaid Services , November 11 , 2016 , available at <http://way-back.archive-it.org/2744/20170118125253/https:/blog.cms.gov/2016/11/02/a-healthier-medicare-focusing-on-primary-care-mental-health-and-diabetes-prevention/> (last accessed October 11, 2018 ).
22.
Gov.
J. W. Hickenlooper
, Gov.
J. Kasich
, Gov.
B. Walker
, Gov.
T. Wolf
, and Gov.
B. Sandoval
A Bipartisan Blueprint for Improving Our Nation’s Health System Performance , February 23 , 2018 , available at <https://www.colorado.gov/governor/sites/default/files/bipartisan_governors_blueprint_022218final.pdf> (last accessed October 11, 2018 ).
23.“Hatch, Wyden Applaud Committee Passage of CHRONIC Care Act,” United States Senate Committee on Finance , May 18 , 2017 , available at <https://www.finance.senate.gov/chairmans-news/hatch-wyden-applaud-committee-passage-of-chronic-care-act> (last accessed October 11, 2018 ).