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PPACA's Impact on Quality of Care Isn't Getting Its Due

Cheryl Clark, for HealthLeaders Media, July 12, 2012

I haven't seen anyone mention that the law calls for an expansion of performance transparency in these government websites: Hospital Compare, Physician Compare and Nursing Home Compare.

Here's a specific example: Several sections of the act shore up, with financial support, the ability of local municipalities and hospitals to provide accountable and appropriate trauma and emergency room care through coordinated region-wide systems that don't exist in many parts of the country. In far too many regions of the country still today, patients aren't taken to the most appropriate hospital when they get in trouble; they're taken to the nearest.

Implementing these kinds of systems in areas that don't have them would almost certainly provide a very big bang for the buck in lives saved. That is an extreme example of improved quality of care.

It seems that almost every day, some high-ranking member of the Obama administration's Health and Human Services Department holds a news briefing to boast of another way the ACA has helped patients by improving coverage and benefits, either by lowering premiums or share of cost, or providing free access to preventive services.

During the most recent news briefing Tuesday, for example, HHS Secretary Kathleen Sebelius spoke of how the ACA has enabled more than 16 million people with Medicare obtain "at least one preventive service at no cost."

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8 comments on "PPACA's Impact on Quality of Care Isn't Getting Its Due"


Todd (7/19/2012 at 9:19 AM)
The legislation surrounding improving quality is a nonstarter. Hospitals will simply further cost-shift to employers to pay for their penalties associated with readmission and other expenses. Competition with other hospitals, especially international facilities to attract patients will improve care long-term, not some absurd government mandate. Government never does anything well.

Alton Brantley (7/13/2012 at 3:09 PM)
As Mark points out, the Supreme Court was asked to determine 2 things: First, could Congress impose the individual mandate, and second, could HHS withhold Medicaid funding if states do not participate in PPACA. Their ruling was solely on these two questions of law, not on any issue of healthcare. For the first issue, SCOTUS ruled that the mandate is a tax (filed by tax return, leveed against taxable income and approved deductions, and collected by IRS). Second, Congress has by the Constitution the right to levy taxes. But they denied that it fell under the Commerce clause. So the health insurance tax stands. For the second issue, SCOTUS ruled that failure to participate in the Medicaid expansion could not be penalized by withdrawal of current Medicaid support. (States rights vs Federal enumerated powers).

MkWs (7/13/2012 at 12:29 PM)
Hi Cheryl, These are things to hide because the public doesn't want to take the time to understand anything that doesn't fit in two paragraphs, political careers are no longer made on success but opposition, only policy wonks and clinical and research people understand the ins and outs of the topic of quality and how woefully inadequate it is, and finally because anyone who suggests our tech-driven, high-touch, expensive, and well-salaried system is already anything but the world's best and is in need of improvement suddenly finds themselves in a room full of deaf ears. How about that for a few reasons? Wish it weren't so but I believe that aptly describes the environment for today's discussions on PPACA and the state of US health care today. Thank you for writing the article and bringing attention to a question that has been on my mind as well since mid-2009. Mark Wesson