The Affordable Care Act (ACA), often called Obamacare, accomplished two main goals:

  1. It provides affordable healthcare insurance to more Americans, and
  2. It introduced healthcare delivery system reform, with the Triple Aim of quality improvement, better healthcare access and payment reform.

As of 2011, just prior to passage of the ACA:

  • The United States ranked highest on the list of the 20 Organization for Economic Co-operation and Development (OECD) countries for health care expenditures, but last for coverage. OECD countries are those with above median total GDP and GDP per capita for at least one of the past ten years.
  • Life expectancy at birth in the U.S is lower than comparable OECD countries–just under 79 years, compared to an average of about 82 years for comparable countries.

So far, the ACA has managed to provide more health care coverage to Americans:

  • The uninsured rate dropped to 12.9% in the fourth quarter of 2014, down significantly from 17.1% in the fourth quarter of 2013.

Considerable work still needs to be done to improve the cost, access and quality of the health care Americans receive:

  • In terms of infant mortality, the United States ranks 169 of the 224 countries surveyed.
  • A survey of older people in 11 countries finds that U.S. adults are sicker than their counterparts abroad, as well as the most likely to have problems paying their medical bills and getting needed healthcare.
  • U.S. adults also reported difficulty getting healthcare access in a timely fashion and using emergency departments for issues that a primary care physician could treat.
  • Approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions.
  • In inpatient settings, research indicates that adverse drug events (ADEs) are among the largest contributors to hospital-related complications. It has been estimated that ADEs comprise one-third of hospital adverse events, affect approximately 2 million hospital stays annually, and prolong hospital length of stay by approximately 1.7 to 4.6 days.

Since the passage of the ACA, great strides have been made in improving insurance coverage nationwide, but more work must be done to improve the cost and quality of healthcare. True healthcare reform requires that doctors and other medical professionals work together to improve healthcare delivery for patients.

This is what we, at the Council of Accountable Physician Practices, and our partners are striving to do.

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