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Quality of Care

Quick Facts

  • The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance.
  • An estimated 80% of heart disease, stroke, and type-2 diabetes, and 40% of cancers, could be prevented if Americans stopped smoking, adopted healthy diets, and became more physically active.
  • The Affordable Care Act provides long-term funding for patient-centered outcomes research, which should give physicians and patients the clinical and research information they need to make better informed and personalized decisions.
  • Primary care providers will receive a 10% Medicare bonus payment for primary care services provided, and Medicaid reimbursement levels will be increased to match Medicare levels for primary care physicians.

 

Problem

For too long, our healthcare system has failed to provide Americans with the quality of care they deserve at a price they can afford. The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. Across 37 performance indicators, the United States achieved an overall score of 65 out of a possible 100. The U.S. also lags in adoption of national policies that promote primary care, quality improvement, and information technology. We have far too many unplanned readmissions, medication errors, and hospital-acquired infections.

We also fall far short of delivering effective primary and secondary prevention for patients with chronic conditions who account for a majority of health care costs. Chronic disease accounts for 70% of all deaths (more than 1.7 million people). An estimated 80% of heart disease, stroke, and type-2 diabetes, and 40% of cancers, could be prevented if Americans stopped smoking, adopted healthy diets, and became more physically active.

The United States lags behind other nations in the use of error-reducing techniques, such as health information technology. Up to 98,000 Americans die each year as a result of medical errors, more than motor vehicle accidents, breast cancer, and AIDS. Additionally, ethnic and racial minorities are often less likely to receive recommended care, as are people with lower income or lower educational status. They are also more likely to be uninsured, more likely to leave the emergency room without being seen, and more likely to experience poor communication with their physicians.

Opportunity

The American Recovery and Reinvestment Act provides about $25 billion in incentives for physicians and hospitals to use electronic health records. Achieving the full extent of benefits necessitates streamlining office practices to enhance patient tracking, teamwork, and patient outcome orientation. The Affordable Care Act (ACA) provides long-term funding for patient-centered outcomes research, which should give physicians and patients the clinical and research information they need to make better informed and personalized decisions.

The ACA also makes a significant investment in Prevention, Wellness, Primary Care and Public Health.

  • Provides $15 billion to support prevention and wellness activities.
  • Eliminates co-pays or other cost sharing on most preventive services (as determined by the US Preventive Services Task Force -USPSTF) for Medicare patients and through all insurance plans available in the Health Insurance Exchange.
  • Provides coverage under Medicare, with no copayment or deductible, for an annual wellness visit.
  • Primary care providers will receive a 10% Medicare bonus payment for primary care services provided. General surgeons practicing in underserved areas will also receive 10% Medicare bonus payments.
  • Medicaid reimbursement levels will be increased to match Medicare levels for primary care physicians in 2013-2015.
  • Invests $11 billion over the next five years in Community Health Centers

The new health reform law includes $50 million in funding for the Secretary of Health and Human Services (HHS) to expand the new demonstration initiative that will help states and health care systems to test models for medical malpractice reform. The new pilots must meet the core principles and goals of putting patient safety first and working to reduce preventable injuries; fostering better communication between doctors and their patients; ensuring that patients are fairly and quickly compensated for medical injuries, while also reducing the incidence of frivolous lawsuits; and reducing liability premiums.

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