The Affordable Care Act (ACA) was signed into law March 23, 2010, and aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance, and contain the rising costs of health care for individuals and the government. Since the passage of the ACA, CMS has turned its attention to awarding value of care over the volume of services provided to patients by encouraging innovation and quality care improvements. APTA is committed to keeping members abreast of any changes that may be made to the ACA, especially those changes that impact our members and their patients.
Understanding Health Care Reform
'Making Sense of Health Care Reform' Series
This series highlights some of the issues from health care reform that are of concern to physical therapy. Each document in the series provides background, an explanation of the issue, implications for practice, tips, and links to further resources.
Themes of Health Care Reform
APTA has divided the contents of the law into four major themes, which are listed below. The ACA increases access to health care through its expansion of health insurance coverage provisions as well as the creation of new insurance protections; creates new models of care beyond traditional fee for service; shifts payment focus to rewarding providers for the quality of their services; and increases auditing and screening processes to enhance the integrity of federal health care programs.
Expansion of Coverage
The ACA expands health insurance coverage through use of the Health Insurance Marketplaces and the expansion of the Medicaid program population. Additionally, the ACA creates protections for coverage, such as "guaranteed issue" and restrictions on certain coverage limits.
Collaborative Models of Care - Innovation in Programs
Collaborative care models include accountable care organizations (ACOs), bundled payment models, and patient-centered medical homes.
Payment Changes and Linking Payment to Quality
The ACA makes refinements to payment systems and links payment to quality of care. Access resources on private insurance payment changes and updates on the latest reimbursement issues and trends.
The ACA provided for funding increases to the program integrity efforts, such as auditing programs.
CMS Home Health CoP Surveyor Protocol (.pdf) (Revised January 2018)