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Achieving Health Equity via the Affordable Care Act

Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities ; Board on Population Health and Public Health Practice ; Institute of Medicine ; National Academies of Sciences, Engineering, and Medicine .

Since its creation by the Institute of Medicine (IOM) in 2007, the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities has been fostering dialogue on racial and ethnic disparities in health and health care, examining the development of programs and strategies to reduce disparities, and encouraging the emergence of new leadership focused on health equity. For the past several years, a prominent topic of discussion within the roundtable has been the Patient Protection and Affordable Care Act (ACA). The ACA has multiple provisions specific to race, ethnicity, and language and other provisions with significant implications for racially and ethnically diverse populations.

In April 2013, the roundtable held a workshop to address many issues surrounding the ACA, including expansion of coverage, delivery systems, and access points, service delivery and payment reform, public-private partnerships, and challenges to the safety net. This report summarizes the presentations and discussions from the workshop.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• PLANNING COMMITTEE
• ROUNDTABLE ON THE PROMOTION OF HEALTH EQUITY AND THE ELIMINATION OF HEALTH DISPARITIES
• Reviewers
• Acronyms
• 1. Introduction and Themes of the Workshop
  • THE ACA IN CONNECTICUT
  • THEMES OF THE WORKSHOP
  • ORGANIZATION OF THE WORKSHOP SUMMARY
  • OVERVIEW OF THE ACA
  • THE EXPERIENCE IN CONNECTICUT
  • REACTION AND DISCUSSION
  • CONTINUOUS VERSUS NONCONTINUOUS COVERAGE
  • THE AFFORDABILITY OF INSURANCE
  • RETAINING THE SAFETY NET
  • CARE MODELS
  • AN UNPRECEDENTED OPPORTUNITY
  • STANDARDS FOR PATIENT-CENTERED MEDICAL HOMES
  • LEVERAGING OPPORTUNITY IN A CHANGING HEALTH CARE LANDSCAPE
  • DISCUSSION
  • ALIGNING RESOURCES AND NEEDS WITHIN THE SAFETY NET
  • DRIVING HEALTH EQUITY THROUGH PUBLIC POLICY
  • DISCUSSION
  • THE PCORI APPROACH TO PATIENT AND STAKEHOLDER ENGAGEMENT
  • THE ROLE FOR CONSUMER ENGAGEMENT
  • CHALLENGES FOR EXCHANGES IN REACHING DIVERSE COMMUNITIES
  • REACHING THE PEOPLE
  • DISCUSSION
  • Appendix A. Workshop Agenda
  • APPENDIX B. Speaker Biographical Sketches

  Rapporteurs: Karen M. Anderson and Steve Olson.

  This activity was supported by a contract and grants between the National Academy of Sciences and Aetna Foundation (12-03699); Connecticut Health Foundation; Kaiser Permanente Program Offices Community Benefit II at the East Bay Community Foundation (20121256); The Kresge Foundation (245367); Merck Sharp & Dohme Corp. (2414); Robert Wood Johnson Foundation (70286); and the U.S. Department of Health and Human Services/Health Resources and Services Administration (HHSH25034010T). The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

  Suggested citation:

  National Academies of Sciences, Engineering, and Medicine. 2015. Achieving health equity via the Affordable Care Act: Promises, provisions, and making reform a reality for diverse patients: Workshop summary. Washington, DC: The National Academies Press.