Changing landscape of the US health care system through the ACA

Discuss the changing landscape of the US health care system through the ACA and specific initiatives that have been funded, enacted and currently implemented to improve health care for all Americans

            Prior to 2010 when the ACA was passed, some of the American people had one type of healthcare insurance coverage. The elderly people were provided with insurance coverage by government through Medicare. Some poor people had their insurance coverage through Medicaid provided by the government as well. Many other people were covered through their jobs and some paid for their insurance coverage. However, there are still millions of American people left without any type of medical insurance coverage. Additionally, the American health care delivery system was more of curative than preventive. It was in effort to fix this healthcare system that resulted in the Affordable Care Act (ACA) of 2010. The ACA passed in 2010 and fully implemented in 2014, was intended to expand coverage and bring about a new era of health care access(Gaffney,  & McCormick,2017,p1447)

Center for Medicare and Medicaid Innovation (CMMI)

            With the implementation of affordable healthcare in which millions of uninsured Americans will have access to health care coverage, government anticipated a rise in health care cost. In effort to guide against this anticipated problem,  the ACA created and funded the Center for Medicare and Medicaid Innovation within Center for Medicare and Medicaid Services (CMS) allocating $10 billion over ten years to test innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care”(Baron, et al, 2018, p218). This agency is to design a payment model  that will reduce the health care cost without reducing the quality of health care delivery as well as improve patient satisfaction.


            The Medicare Access and CHIP Reauthorization Act (MACRA) which was enacted in April 2015 aimed at pushing forward the agenda of transforming the fee for service volume-based US healthcare delivery system into one that is value-driven”(Hirch, et al,2017, p3). This agency regulate the cost of providing care to Medicare beneficiaries. Instead of reimbursing the care providers for service they delivered, they will be rather be reimbursed based on the quality of care they delivered.

Patient centered Outcomes Research (PCOR)

            Patient centered Outcomes Research is another agency that has been funded, enacted, and currently implementing to improve the healthcare delivery. The PCOR is to ensure that the healthcare providers are providing high quality and efficient care to patient. According to Vaida,(2016) sincde its launch in 2010, it has spent $1.25 billion on research project and it has another $1.3 billion to spend on additional research.


Baron,, R., Berwick, D., Gilfillan, R., Lee, P., Perla,, R., & Pham,, H. (feb 2018). Government as innovation catalyst: lessons from the early center for Medicare And Medicaid Innovation Models. Health Affairs,37(2), 213-221. doi:DOI:10.1377/hlthaff.2017.1109

Gaffney, A., & McCormick, D. (apr 8, 2017). The Affordable Care Act: implications for health-care equity. The Lancet,389(10077), 1442-1452. doi:DOI:10.1016/S0140-6736(17)30786-9

Hirsch, J., Liu, R., Manchikanti, R., Nicola, G., & Rosenkrantz, A. (nov 2017). The episode, the PTAC, cost, and the neurointerventionalist. Journal of NeuroInterventional Surgery,9(11), 1-4. doi:DOI:10.1136/neurintsurg-2016-012885

Vaida, B. (apr 2016). Patient-Centered Outcomes Research: Early evidence from a burgeoning field. Health Affairs,35(4), 595-602. doi:DOI:10.1377/hlthaff.2016.0239