The Affordable Care Act: a case study for understanding and applying complexity concepts to health care reform

J Eval Clin Pract. 2016 Feb;22(1):133-140. doi: 10.1111/jep.12271. Epub 2014 Nov 4.

Abstract

Rationale, aims and objectives: The current health system in the United States is the result of a history of patchwork policy decisions and cultural assumptions that have led to persistent contradictions in practice, gaps in coverage, unsustainable costs, and inconsistent outcomes. In working toward a more efficient health system, understanding and applying complexity science concepts will allow for policy that better promotes desired outcomes and minimizes the effects of unintended consequences.

Methods: This paper will consider three applied complexity science concepts in the context of the Patient Protection and Affordable Care Act (PPACA): developing a shared vision around reimbursement for value, creating an environment for emergence through simple rules, and embracing transformational leadership at all levels.

Results and conclusions: Transforming the US health system, or any other health system, will be neither easy nor quick. Applying complexity concepts to health reform efforts, however, will facilitate long-term change in all levels, leading to health systems that are more effective, efficient, and equitable.

Keywords: complexity science; health care policy; health care reform.

MeSH terms

  • Delivery of Health Care / organization & administration
  • Health Care Reform*
  • Health Policy
  • Humans
  • Leadership
  • Patient Protection and Affordable Care Act*
  • Reimbursement, Incentive
  • United States