The Effects of Healthcare Reform on Prevention
It will be important for healthcare professionals in the field of preventive medicine to understand and inform the public about the potential effects of the Affordable Care Act on the delivery of preventive services. If successful, healthcare reform will expand access to insurance coverage, reduce financial barriers to care, and strengthen the quality of care delivery. As a result, we estimate that an additional 9.8 million patients will receive recommended preventive services. With the potential to insure more than 30 million additional people and enhance their access to and use of preventive care, coverage expansion provisions under the Affordable Care Act are critical and need to be fully implemented.
It will also be important for healthcare professionals to adopt the medical home model of care promoted under healthcare reform. Among insured patients, having a medical home greatly improves access to recommended preventive screenings.
Aside from the medical home demonstrations and initiatives created under the Affordable Care Act, several commercial health plans and several states are testing new payment approaches to support the medical home model of care. At the state level, 41 state Medicaid and CHIP programs are planning or implementing medical home pilots for low-income beneficiaries that test an enhanced or revised payment approach to promote the medical home model of care. As coverage expansions and medical home initiatives of the Affordable Care Act get under way, it will be important for preventive medicine professionals to support these reforms and help our nation achieve a high-performance healthcare system.
Acknowledgment
The authors thank Jonathan Gruber for his projections of changes in insurance coverage in the United States following the Affordable Care Act's coverage expansions, and Michelle M. Doty, Sara R. Collins, Ruth Robertson, and Tracy Garber for data and analytic support.
The mission of The Commonwealth Fund is to promote a high performance healthcare system. The Fund carries out this mandate by supporting independent research on healthcare issues and making grants to improve healthcare practice and policy. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff.
Anthony Shih, MD, MPH, is executive vice president for programs at The Commonwealth Fund, a national foundation that promotes a high-performance healthcare system for the United States by supporting and conducting independent research to improve healthcare policy and practice. In this role, Dr. Shih serves as a member of the Fund's executive management team and is responsible for all of The Commonwealth Fund's grants programs. Previously, Dr. Shih held various executive management positions at IPRO, one of the nation's leading independent, nonprofit healthcare quality improvement organizations, and he has worked in community-based mental healthcare.
Dr. Shih is board-certified in public health and preventive medicine and holds an MD from the New York University School of Medicine and an MPH from the Columbia University Mailman School of Public Health.
Julia A. Berenson, MSc, is the research associate to The Commonwealth Fund's executive vice president for programs. In this role, she provides written, analytical, and research support to the executive vice president for programs and program staff. Before joining the Fund, Ms. Berenson was a program associate at the Center for Health Care Strategies, where she worked on initiatives that enhance the organization, financing, and delivery of health systems aimed at improving the quality of care and reducing disparities among Medicaid beneficiaries. Previously, she was a research assistant at the London School of Economics, where she conducted research in global health focusing on infectious diseases and health disparities. Ms. Berenson received a master's degree in health policy, planning, and financing jointly awarded by the London School of Economics and the London School of Hygiene and Tropical Medicine.
Melinda Abrams, MS, is vice president at The Commonwealth Fund, where she directs the Patient-Centered Coordinated Care program, which seeks to improve the quality of primary care so that it is patient- and family-centered. Since coming to the Fund in 1997, Ms. Abrams has worked on the Fund's Task Force on Academic Health Centers, Commission on Women's Health, and the Child Development and Preventive Care programs. Ms. Abrams serves on several national committees, including the Board of Managers of TransforMED, Steering Committee for the Advanced Primary Care Demonstration at the Center for Medicare and Medicaid Innovation, various medical home expert panels for the Agency for Healthcare Research and Quality, and the Clinical Outcomes Workgroup for Patient-Aligned Care Teams at the Veterans Health Administration. In addition, Ms. Abrams is a peer reviewer for Health Affairs, American Journal of Managed Care, and the Annals of Family Medicine. Ms. Abrams holds a BA in history from Cornell University and an MS in health policy and management from Harvard School of Public Health.