Potential impacts of the Affordable Care Act on the clinical practice of hepatology


  • Jayant A. Talwalkar

    Corresponding author
    1. Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
    2. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
    3. William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN
    • Address reprint requests to: Jayant A. Talwalkar, M.D., M.P.H., Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: talwalkar.jayant@mayo.edu; fax: 507-284-0538.

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  • Potential conflict of interest: Nothing to report


The Patient Protection and Affordable Care Act (ACA), along with the Health Care and Education Reconciliation Act, was signed into law and upheld by the Supreme Court earlier this year. The ACA contains a variety of reforms that, if implemented, will significantly affect current models of healthcare delivery for patients with acute and chronic hepatobiliary diseases. One of the Act's central reforms is the creation of accountable care organizations (ACOs) whose mission will be to integrate different levels of care to improve the quality of services delivered and outcomes among populations while maintaining, or preferably reducing, the overall costs of care. Currently, there are clinical practice areas within hepatology, such as liver transplantation, that already have many of the desired features attributed to ACOs. The ACA is sure to affect all fields of medicine, including the practice of clinical hepatology. This article describes the components of the ACA that have the greatest potential to influence the clinical practice of hepatology. Conclusion: Ultimately, it will be the responsibility of our profession to identify optimal healthcare delivery models for providing high-value, patient-centered care. (Hepatology 2014;59:1681–1687)