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The Affordable Care Act: a case study for understanding and applying complexity concepts to health care reform
D Justin Larkin1, R Chad Swanson2,3, Spencer Fuller4
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Rationale, Aims And Objectives:
The current health system in the United States is the result of a history of patchwork policy decisions and cultural assumptions that have led to persistent contradictions in practice, gaps in coverage, unsustainable costs, and inconsistent outcomes. In working toward a more efficient health system, understanding and applying complexity science concepts will allow for policy that better promotes desired outcomes and minimizes the effects of unintended consequences.
Methods:
This paper will consider three applied complexity science concepts in the context of the Patient Protection and Affordable Care Act (PPACA): developing a shared vision around reimbursement for value, creating an environment for emergence through simple rules, and embracing transformational leadership at all levels.
Results And Conclusions:
Transforming the US health system, or any other health system, will be neither easy nor quick. Applying complexity concepts to health reform efforts, however, will facilitate long-term change in all levels, leading to health systems that are more effective, efficient, and equitable.
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