Will the Affordable Care Act Move Patient-Centeredness to Center Stage?

It has been almost a decade since the Institute of Medicine (IOM) designated "patient-centeredness" as one of six goals for a 21st century health care system; the Patient Protection and Affordable Care Act (ACA) has mandated the use of measures of the quality of care, public reporting, and performance payments that reflect this ambitious aim.

The ACA repeatedly refers to patient-centeredness, patient satisfaction, patient experience of care, patient engagement, and shared decision-making in its provisions. Even when the law only uses the more general term "quality measures," patient-centered assessments are being required when these provisions are turned into regulations for specific programs such as with Medicare’s Value-Based Purchasing Program.

This paper from the Urban Institute, on behalf of the Robert Wood Johnson Foundation, discusses how the Affordable Care Act (ACA) places new emphasis on measuring patients’ experiences of care and using that information to improve care. The paper traces the way in which listening to the patient’s voice has grown from an ethical demand of the patient rights movement into a series of specific, measurable behaviors characterized by use of patient experience surveys. The paper also examines patient engagement, patient experience of care, and overall patient centeredness within the context of the ACA and its mandates.

And finally, the paper outlines the growing evidence of benefits from better communication between providers and patients, and involving patients more closely in their care, including greater adherence to medical advice, fewer complaints, fewer malpractice claims and improvement in patient health.