The 2010 Affordable Care Act (ACA) has enabled more people in the US to get affordable medical insurance than ever before. People with household incomes between 100% and 400% of the federal poverty level now have access to better healthcare at reduced costs. Adults with income below 138% of the federal poverty level now receive expanded Medicaid coverage. The ACA also supports innovative medical care delivery methods designed to lower the costs of health care. In this interview, ACCESS Health’s Jean Galiana speaks about programs made possible by the ACA with Dr. Kristofer L. Smith, Senior Vice President in the Office of Population Health Management and the Medical Director for Northwell Health Solutions.

Smith discusses how the transition from fee for service to value based care has given rise to better opportunities for geriatric practices and healthcare in the home. He and his colleagues at Northwell Health, the largest integrated delivery system in New York State, use a home based primary care model to provide care at reduced costs for vulnerable elderly living in the community . Their mission is to provide patient and family centered care, ensure high quality advanced care planning, maintain or improve the patient’s functional capacity, reduce unwanted and unnecessary care, increase the days a patient spends at home, and, ultimately, facilitate death with dignity at home.

The programs developed at Northwell Health Solutions demonstrate how to reduce costs and increase the quality of healthcare through changes enacted by the Affordable Care Act.