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

Cheryl Clark, for HealthLeaders Media , July 12, 2012

Like most of you, I've been reading everything I can to understand the varying views on the Supreme Court justices' decision to uphold the Patient Protection and Affordable Care Act.

Yes, I have no life.

But what I haven't seen much about—dare I say anything—is that in upholding most of the law, the court validates its many pages that improve and streamline provider quality and safety of care. Even if the individual mandate had been tossed aside, there are more than 40 sections of the law that critically affect how we measure and pay for, and improve, quality of care. 

By that I mean the healthcare that improves outcomes without harming patients in the process.

Quibble with the metrics or don't; they're pretty darn important. For it wouldn't matter much if we expanded access and made healthcare cheaper if the care that was provided was deficient, needless, inappropriate, or even harmful.

It is, after all, called the Patient Protection and Affordable Care Act.

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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




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