ABSTRACT
The impact of the Affordable Care Act (ACA) was much like the impact of the creation of Medicare and Health Maintenance Organizations, and the law was an attempt to transform healthcare delivery in the United States. One of the primary ACA objectives is related to development of alternative payment models. ACA provisions included establishment of a National Health Care Workforce Commission, increased support for workforce training, cultural competency training, enhanced payments, expansion of health centers, and piloting of new care models. ACA provisions have also provided Medicare bonus payments to primary care physicians and eliminated differences in payments between Medicaid and Medicare for primary care services. Although the intent of the ACA legislation was to reduce the cost and improve the quality of healthcare for all Americans, Centers for Medicare and Medicaid Services payment policies have historically resulted in cost-shifting to private payers.
