Many of the elements of the Affordable Care Act (ACA) went into effect in 2014, and with the establishment of many new rules and regulations, there will continue to be significant changes to the United States health care system. It is not clear what impact these changes will have on medical and public health preparedness programs around the country. Although there has been tremendous progress since 2005 and Hurricane Katrina, there is still a long way to go to ensure the health security of the Country. There is a commonly held notion that preparedness is separate and distinct from everyday operations, and that it only affects emergency departments. But time and time again, catastrophic events challenge the entire health care system, from acute care and emergency medical services down to the public health and community clinic level, and the lack of preparedness of one part of the system places preventable stress on other components. The implementation of the ACA provides the opportunity to consider how to incorporate preparedness into all aspects of the health care system.

The Impacts of the Affordable Care Act on Preparedness Resources and Programs is the summary of a workshop convened by the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events in November 2013 to discuss how changes to the health system as a result of the ACA might impact medical and public health preparedness programs across the nation. This report discusses challenges and benefits of the Affordable Care Act to disaster preparedness and response efforts around the country and considers how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities.

Contents

• THE NATIONAL ACADEMIES
• WORKSHOP PLANNING COMMITTEE
• FORUM ON MEDICAL AND PUBLIC HEALTH PREPAREDNESS FOR CATASTROPHIC EVENTS
• Reviewers
• 1. Introduction
  • WORKSHOP OBJECTIVES
  • BACKGROUND AND OVERVIEW
  • ORGANIZATION OF THE REPORT
  • TOPICS HIGHLIGHTED DURING PRESENTATIONS AND DISCUSSIONS
• 2. How the ACA Will Change the Health Care Delivery System
  • COVERAGE EXPANSION
  • FINANCING AND DELIVERY REFORM
• 3. Preparedness Impacts of the Changes to Health Care System Financing and Delivery Infrastructure
  • INTEGRATED CARE AND OPPORTUNITIES FOR PREPAREDNESS
  • PREPARING TO MEET THE NEEDS OF THE MOST VULNERABLE
  • DISTRIBUTED NETWORKS OF CARE
  • FINANCING PREPAREDNESS
• 4. The Evolving Health Workforce
  • WORKFORCE IMPLICATIONS OF NEW CARE SETTINGS
  • CHANGES IN HOSPITAL OPERATIONS IMPACTING WORKFORCE
  • OPPORTUNITIES FOR NEW PROVIDER ROLES IN HEALTH CARE AND PREPAREDNESS
  • TRAINING
• 5. Needs and Logistics of Data Sharing and Health Information Technology
  • UNDERSTANDING THE NEEDS OF THE POPULATION: TURNING DATA INTO INFORMATION
  • STANDARDS AND INTEROPERABILITY
• 6. Potential Opportunities to Enhance Preparedness Through Health Information Exchanges and Predictive Analytics
  • HEALTH INFORMATION EXCHANGES
  • PREDICTIVE ANALYTICS IN PUBLIC HEALTH PREPAREDNESS
• 7. Leveraging the Affordable Care Act and Information Technology to Innovate
  • PCCI: LAYERING TECHNOLOGIES FOR INFORMATION EXCHANGE, ANALYTICS, AND CONTINUITY OF CARE
  • INTEGRATING TELEMEDICINE INTO DISASTER PLANS
  • INCORPORATING HEALTH INFORMATION TECHNOLOGY INTO EVERYDAY USE
• 8. The Continuing Role for Public Health Preparedness and Response
  • INSURANCE: NOT A REPLACEMENT FOR PUBLIC HEALTH
  • EXPANDING PUBLIC HEALTH CAPACITY AND REACH THROUGH PUBLIC–PRIVATE COLLABORATIONS
  • LOOKING FORWARD
• APPENDIXES
  • A References
  • B Acronyms
  • C Statement of Task
  • D Agenda
  • E Biographical Sketches of Invited Speakers and Panelists
  • F Key Features of the Affordable Care Act by Year

Rapporteurs: Megan Reeve, Theresa Wizemann, Bradley Eckert, and Bruce Altevogt.

This activity was supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians; American Hospital Association; Association of State and Territorial Health Officials; Centers for Disease Control and Prevention (Contract No. 200-2011-38807, TO #19); Department of Defense (Contract No. HT0011-11-P-0186); Department of Defense, Uniformed Services University of the Health Sciences (Contract No. HT9404-12-1-0022); Department of Health and Human Services' National Institutes of Health: National Institute of Allergy and Infectious Diseases, National Institute of Environmental Sciences, National Library of Medicine (Contract No. HHSN26300007 [Under Base 1 #HHSN263201200074I]); Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response (Contract No. HHSO100201000021P); Department of Homeland Security's Federal Emergency Management Agency (Contract No. HSFE20-13-P-0212); Department of Homeland Security, Office of Health Affairs (Contract No. HSHQDC-13-J-00384 [Under Base 1 #HSHQDC-11-D-00009]); Department of Transportation's National Highway Traffic Safety Administration (Contract No. DTNH22-10H-00287); Department of Veterans Affairs (Contract No. 101-G09041); Emergency Nurses Association; Food and Drug Administration (Contract No. HHSF22301027T [Under Base Contract DHHS-8598]); Infectious Diseases Society of America; Martin, Blanck & Associates; Mayo Clinic; Merck Research Laboratories (Contract No. 2391); National Association of Chain Drug Stores; National Association of County and City Health Officials; National Association of Emergency Medical Technicians; Pharmaceutical Research and Manufacturers of America; Target Corporation; Trauma Center Association of America; and United Health Foundation. 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:

IOM (Institute of Medicine). 2014. The impacts of the Affordable Care Act on preparedness resources and programs: Workshop summary. Washington, DC: The National Academies Press.

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.