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United States Health Care Reform: Progress to Date and Next Steps

Overview of attention for article published in JAMA: Journal of the American Medical Association, July 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#1 of 20,580)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Readers on

mendeley
221 Mendeley
citeulike
4 CiteULike
Title
United States Health Care Reform: Progress to Date and Next Steps
Published in
JAMA: Journal of the American Medical Association, July 2016
DOI 10.1001/jama.2016.9797
Pubmed ID
Authors

Barack Obama, Obama, Barack, Obama B

Abstract

The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law's reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600-$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation's most complex challenges.

Twitter Demographics

The data shown below were collected from the profiles of 8,337 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 221 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 15 7%
France 2 <1%
Switzerland 1 <1%
United Kingdom 1 <1%
Brazil 1 <1%
Poland 1 <1%
Taiwan 1 <1%
Sri Lanka 1 <1%
Argentina 1 <1%
Other 2 <1%
Unknown 195 88%

Demographic breakdown

Readers by professional status Count As %
Student > Master 44 20%
Researcher 42 19%
Student > Ph. D. Student 35 16%
Student > Bachelor 20 9%
Student > Doctoral Student 20 9%
Other 60 27%
Readers by discipline Count As %
Medicine and Dentistry 56 25%
Nursing and Health Professions 26 12%
Social Sciences 20 9%
Psychology 19 9%
Engineering 15 7%
Other 85 38%

Attention Score in Context

This research output has an Altmetric Attention Score of 8546. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 October 2017.
All research outputs
#2
of 8,523,474 outputs
Outputs from JAMA: Journal of the American Medical Association
#1
of 20,580 outputs
Outputs of similar age
#1
of 262,527 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#1
of 429 outputs
Altmetric has tracked 8,523,474 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 20,580 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 37.7. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 262,527 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 429 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.