Delivery System Reform: Making Health Care Work Better for Everyone

Content From: U.S. Dept. of Health and Human Services BlogPublished: March 23, 20165 min read



ACA 20 MillionStrong

Summary: The Affordable Care Act gives us the tools to build a health care system that puts patients at the center.


In the six years since President Obama signed the Affordable Care Act, we’ve made important progress to bring more access to quality, affordable health care. Today, 20 million more Americans have insurance because of the ACA, bringing our uninsured rate to an all-time low. Since the ACA was enacted, health care prices have been rising at the slowest rate in five decades. And with new protections and benefits, everyone’s insurance provides preventive services at no extra cost, can’t cap coverage, and isn’t allowed to discriminate based on pre-existing conditions.

This progress has changed people’s lives, but it’s important to remember that the ACA has always been about more than affordable, quality coverage. It gives us the tools to build a health care system that puts patients at the center. Some people call this effort Delivery System Reform, but you could also just call it “making health care work better.”Watch this video to learn more:As the video explains, we’re doing three things to make this better system a reality.

  1. Changing how we pay doctors and health care systems, so they can focus on quality not quantity.
  2. Improving care, by encouraging better coordination and focusing on wellness and prevention.
  3. Unlocking health care data and putting it to work.

We’ve made progress on this effort, and we are already starting to see the results of this work. Here are some of the initiatives happening today that are helping us create a system that provides better care, smarter spending, and healthier people.

Smarter Spending
  • HHS set a goal of tying 30 percent of traditional, or fee-for-service, Medicare provider payments to quality through alternative payment models, such as Accountable Care Organizations (ACOs). We’ve already met the 30 percent goal. Go here for a quick overview of the Department’s alternative payment models.
  • We recently announced a new test to find smarter ways to pay for drugs and improve quality in prescribing practices through drugs administered in doctor’s offices.
Improving Care
  • Partnership for Patients is a public-private partnership of doctors, nurses, hospitals, employers, patients and their advocates, and the federal and state governments to make care safer and improve the transition of care from one care setting to another, so that all hospital readmissions would be reduced.
  • The Independence at Home Demonstration tests whether delivering primary care at home leads to better health outcomes for elderly patients with multiple chronic conditions, while actually reducing Medicare costs. The demonstration participants saved an average of $3,070 per participating beneficiary during the first year, while delivering high quality care at home.
  • The Medicaid Innovation Accelerator Program is designed to build state capacity, improve care coordination in Medicaid, and provide support to states targeted to substance use disorders; complex health needs; long-term services and supports; and physical and mental health.
  • Strong Start and Strong Start II are designed to determine if enhanced services in maternity care homes, group prenatal care, and birth centers for women enrolled in Medicaid or CHIP can reduce the rate of preterm births, improve the health outcomes of pregnant women and newborns and decrease the cost of medical care during pregnancy, delivery and over the first year of life.
Unlocking Health Care Data
  • HHS brought together companies that provide 90 percent of electronic health records used by hospitals, health care systems with facilities in 46 states, and over a dozen professional associations and stakeholder groups on three core commitments that will help to make sure that health information works better for consumers and doctors.
  • HHS has announced app challenges to make it easier for consumers to gather their health information from multiple systems and make health information more accessible and user-friendly for physicians.
  • Physician Compare and Hospital Compare are websites that HHS has created to help consumers make informed choices about the health care they receive from Medicare physicians and other health care professionals. This includes 4,000 Medicare-certified hospitals across the country.
    • The Medicare Drug Spending Dashboard provides information on prescription drugs Medicare spending to provide additional information, increase transparency and address the affordability of prescription drugs.