The Affordable Care Act's Payment Reforms and the Future of Hospitals
Authors: Andrew M. Ryan, Alvin I. Mushlin
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions20 May 2014The Affordable Care Act's Payment Reforms and the Future of HospitalsAndrew M. Ryan, PhD and Alvin I. Mushlin, MD, ScMAndrew M. Ryan, PhDFrom Weill Cornell Medical College, New York, New York.Search for more papers by this author and Alvin I. Mushlin, MD, ScMFrom Weill Cornell Medical College, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Patient Protection and Affordable Care Act (ACA) both giveth to and taketh away from hospitals. On the one hand, the ACA will benefit hospitals by expanding the base of insured patients. On the other, decreased payment rates and new incentives and penalties to improve efficiency could threaten hospitals’ bottom line. Together, these policy changes raise fundamental questions about the future of hospitals and their role in health care delivery.If history is any guide, hospitals will adapt to the ACA and maintain their prominent role in U.S. health care. For every policy change designed to incentivize efficiency and reduce ...References1. Fuchs VR. Major trends in the U.S. health economy since 1950. N Engl J Med. 2012;366:973-7. [PMID: 22417250] CrossrefMedlineGoogle Scholar2. Hartman M, Martin A, McDonnell P, Catlin A; National Health Expenditure Accounts Team. National health spending in 2007: slower drug spending contributes to lowest rate of overall growth since 1998. Health Aff (Millwood). 2009;28:246-61. [PMID: 19124877] CrossrefMedlineGoogle Scholar3. Sloan FA. Regulation and the rising cost of hospital care. Rev Econ Stat. 1981;63:479-87. CrossrefGoogle Scholar4. Ginsburg P. Evaluation of the ESP Program on hospitals: an analysis with aggregate data.. In: Zubkoff M, eds. 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New laws and rising costs create a surge of supersizing hospitals. The New York Times. 13 August 2013:B1. Google Scholar10. Berenson RA, Burton RA. Accountable care organizations in Medicare and the private sector: a status update. Washington, DC: The Urban Institute; 2011. Accessed at www.urban.org/uploadedpdf/412438-Accountable-Care-Organizations-in-Medicare-and-the-Private-Sector.pdf on 7 April 2014. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Weill Cornell Medical College, New York, New York.Grant Support: Dr. Ryan is supported by a grant from the Agency for Healthcare Research and Quality (K01 HS018546-01).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2033.Corresponding Author: Andrew M. Ryan, PhD, Department of Healthcare Policy and Research, Weill Cornell Medical College, 402 East 67th Street, New York, NY 10065; e-mail, [email protected]cornell.edu.Current Author Addresses: Drs. Ryan and Mushlin: Department of Healthcare Policy and Research, Weill Cornell Medical College, 402 East 67th Street, New York, NY 10065.Author Contributions: Conception and design: A. Ryan, A. Mushlin.Analysis and interpretation of the data: A. Ryan, A. Mushlin.Drafting of the article: A. Ryan, A. Mushlin.Critical revision of the article for important intellectual content: A. Ryan, A. Mushlin.Final approval of the article: A. Ryan, A. Mushlin.Obtaining of funding: A. Ryan.Collection and assembly of data: A. Ryan. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByProvision of STD Services in Community Settings After the Loss and Return of State Funding to Support Service Provision: Observations From Select Providers in Massachusetts, 2010 and 2013Return-on-Investment (ROI) Analyses of an Inpatient Lay Health Worker Model on 30-Day Readmission Rates in a Rural Community HospitalVariations in payment patterns for surgical care in the centers for Medicare and Medicaid Services 20 May 2014Volume 160, Issue 10Page: 729-730KeywordsForecastingHealth careHealth care policyHealth services researchInpatientsMedicareMotivationOutpatient clinics ePublished: 20 May 2014 Issue Published: 20 May 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...