The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation.
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October 2014
Special Article|
October 01 2014
Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist
Tina L. Cheng, MD;
aDepartment of Pediatrics, Johns Hopkins School of Medicine, and
bDepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;
Address correspondence to Tina L. Cheng, MD, MPH, Johns Hopkins University General Pediatrics and Adolescent Medicine, 200 North Wolfe St, Suite 2055, Baltimore, MD 21287. E-mail: [email protected]
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Paul H. Wise, MD;
Paul H. Wise, MD
cDepartment of Pediatrics, and
dCenter for Policy, Outcomes, and Prevention, Stanford University, Palo Alto, California; and
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Neal Halfon, MD
Neal Halfon, MD
eDepartment of Pediatrics, David Geffen School of Medicine,
fDepartment of Health Policy and Management, Fielding School of Public Health,
gDepartment of Public Policy, Luskin School of Public Affairs, and
hCenter for Healthier Children, Families, and Communities, University of California, Los Angeles, Los Angeles, California
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Address correspondence to Tina L. Cheng, MD, MPH, Johns Hopkins University General Pediatrics and Adolescent Medicine, 200 North Wolfe St, Suite 2055, Baltimore, MD 21287. E-mail: [email protected]
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2014) 134 (4): 794–802.
Article history
Accepted:
July 25 2014
Citation
Tina L. Cheng, Paul H. Wise, Neal Halfon; Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist. Pediatrics October 2014; 134 (4): 794–802. 10.1542/peds.2014-0881
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