The Blind Spot in the Patient Protection and Affordable Care Act's Cost-Control Policies
Authors: Erin C. Fuse Brown
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions1 December 2015The Blind Spot in the Patient Protection and Affordable Care Act's Cost-Control PoliciesErin C. Fuse Brown, JD, MPHErin C. Fuse Brown, JD, MPHFrom Georgia State University College of Law, Atlanta, Georgia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1386 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Patient Protection and Affordable Care Act (ACA) seems to be helping bend the health care cost curve. However, optimism about more modest spending growth could obscure the lurking problem of unrestrained health care prices that is largely unaddressed by the ACA (1).Health care cost containment consists of 2 parts: reducing overtreatment and constraining health care prices. With Medicare, the government sets the prices, so the cost control discussion focuses on reducing overuse through payment reforms, such as accountable care organizations (ACOs) or bundled payments. These reforms aim to reduce wasteful or unnecessarily costly care, which makes up nearly ...References1. Holahan J, McMorrow S. The Widespread Slowdown in Health Spending Growth: Implications for Future Spending Projections and the Cost of the Affordable Care Act. Washington, DC: Urban Institute; 2015. Accessed at http://webarchive.urban.org/publications/2000176.html on 9 June 2015. Google Scholar2. Wennberg JE, Fisher ES, Skinner JS. Geography and the debate over Medicare reform. Health Aff (Millwood). 2002;Suppl Web Exclusives:W96-114. [PMID: 12703563] CrossrefMedlineGoogle Scholar3. Ginsburg PB, Pawlson LG. Seeking lower prices where providers are consolidated: an examination of market and policy strategies. Health Aff (Millwood). 2014;33:1067-75. [PMID: 24841883] doi:10.1377/hlthaff.2013.0810 CrossrefMedlineGoogle Scholar4. Dafny L. Hospital industry consolidation—still more to come? N Engl J Med. 2014;370:198-9. [PMID: 24328443] doi:10.1056/NEJMp1313948 CrossrefMedlineGoogle Scholar5. Cutler DM, ScottMorton F. Hospitals, market share, and consolidation. JAMA. 2013;310:1964-70. [PMID: 24219952] doi:10.1001/jama.2013.281675 CrossrefMedlineGoogle Scholar6. White C. Contrary to cost-shift theory, lower Medicare hospital payment rates for inpatient care lead to lower private payment rates. Health Aff (Millwood). 2013;32:935-43. [PMID: 23650328] doi:10.1377/hlthaff.2012.0332 CrossrefMedlineGoogle Scholar7. Feldman R. The economics of provider payment reform: are accountable care organizations the answer?. J Health Polit Policy Law. 2015. [PMID: 26124297] CrossrefMedlineGoogle Scholar8. Vladeck BC. Paradigm lost: provider concentration and the failure of market theory. Health Aff (Millwood). 2014;33:1083-7. [PMID: 24841885] doi:10.1377/hlthaff.2014.0336 CrossrefMedlineGoogle Scholar9. Greaney TL. Regulators as market-makers: accountable care organizations and competition policy. Ariz State Law J. 2014;46:1-40. Google Scholar10. Murray R. Setting hospital rates to control costs and boost quality: the Maryland experience. Health Aff (Millwood). 2009;28:1395-405. [PMID: 19738257] doi:10.1377/hlthaff.28.5.1395 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Erin C. Fuse Brown, JD, MPHAffiliations: From Georgia State University College of Law, Atlanta, Georgia.Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1386.Corresponding Author: Erin C. Fuse Brown, JD, MPH, Assistant Professor of Law, Georgia State University College of Law, PO Box 4037, Atlanta, GA 30302-4037; e-mail, [email protected]edu.Author Contributions: Conception and design: E.C. Fuse Brown.Drafting of the article: E.C. Fuse Brown.Critical revision for important intellectual content: E.C. Fuse Brown.Final approval of the article: E.C. Fuse Brown.This article was published online first at www.annals.org on 22 September 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEnterprise target cost control algorithm based on hypercycle modelHealth Reform and Theories of Cost ControlMerger & Acquisition and Capital Expenditure in Health Care 1 December 2015Volume 163, Issue 11Page: 871-872KeywordsAccountable care organizationsHealth careHealth care policyHealth care providersHealth care sectorMedicareMotivationPatient Protection and Affordable Care ActTaxesTwins ePublished: 22 September 2015 Issue Published: 1 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...