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Related Experiment Videos

The Affordable Care Act: What's Next?

Mark McClellan1, Mark Japinga1

  • 1Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina 27708; email: mark.mcclellan@duke.edu , mark.japinga@duke.edu.

Annual Review of Medicine
|February 8, 2018
PubMed
Summary

Reforming healthcare to lower costs and improve quality is key for improving health insurance access. Strategies include high-risk pools, reinsurance, and payment reforms for better outcomes.

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Area of Science:

  • Health Policy
  • Healthcare Economics
  • Public Health

Background:

  • The Affordable Care Act (ACA) faces ongoing debate regarding its future, driven by high and increasing healthcare costs.
  • The individual health insurance market struggles with limited options and rising premiums for enrollees.

Purpose of the Study:

  • To identify feasible, bipartisan strategies for improving healthcare coverage and quality while reducing costs.
  • To explore reforms for the individual insurance market and state Medicaid programs.

Main Methods:

  • Analysis of policy proposals for healthcare reform.
  • Examination of market mechanisms like high-risk pools, reinsurance, and risk adjustment.
  • Review of potential federal reforms for state Medicaid programs.
Keywords:
Medicaidalternative payment modelshealth carehealth exchangeshealthcare reformpayment reform

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  • Assessment of payment reforms and innovative care delivery models.

    • Main Results:

    • A combination of high-risk pools, reinsurance, and risk adjustment can enhance coverage options and encourage innovation for high-risk individuals.
    • Federal reforms offering states more flexibility and outcome-based goals can improve Medicaid program effectiveness.
    • Payment reforms and evidence-based innovative care delivery models can advance coverage reform.

    Conclusions:

    • Reforming healthcare to achieve higher quality at a lower cost is essential for improving access to coverage.
    • Targeted market and program reforms, coupled with payment and delivery system innovations, are crucial for sustainable healthcare coverage solutions.