Under the then brand-new Center for Medicare and Medicaid Innovation – an ACA creation – CMS organized a partnership among more than 4,000 hospitals to reduce errors in care (like hospital-acquired infections, pressure sores, and surgical mishaps) and needless hospital readmissions. Over five years, this program averted 87,000 deaths, 2 million patient injuries, and nearly $20 billion in costs due to errors.
Under the ACA, over 500 new partnerships between Medicare and local groups of doctors and hospitals have formed – so-called “Accountable Care Organizations,” trying to give over 10 million Medicare beneficiaries better patient satisfaction, better outcomes, and lower costs.
The ACA and other laws require publicly available measurements of quality for hospitals, and they use payment to encourage adoption of electronic medical records, which are, at last, ubiquitous in hospitals and taking root in many office practices. In 2009, fewer than 20% of US physicians had electronic medical records; today, more than 80% do. Overall health care costs will be $2.6 trillion lower over the decade following enactment of the ACA than projected even while millions more people have insurance.
This is “delivery system reform” - changing the processes of care. It’s a much better way to reduce costs, through improving the quality of care, rather than shifting the burden to patients and families. Instead of waiting for trouble in chronically ill patients, for example, reaching out proactively into their homes, intercepting deterioration and averting the need for a hospital stay. Standardize best practices using checklists and reminder systems. Help telemedicine take off, giving doctors and patients easier ways to interact at lower cost than in traditional office visits.
