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A balanced scorecard analysis.
The Affordable Care Act was signed into law in March 2010. After four years, how is it working?
The goal of the ACA is to implement an American "system" of healthcare in which all of its elements work together to achieve the long-term goals of affordability, quality and access. A useful way to look at large systems such as the ACA is the balanced scorecard methodology. This technique was developed in the early 1990s by Robert S. Kaplan, PhD, and David P. Norton, PhD, and is used by many healthcare organizations today.
A key element of this methodology is to logically link initiatives together in order to achieve desired strategic objectives. These initiatives are usually grouped into four perspectives: learning and growing, operations, customers, and finance. Initiatives in each perspective are connected by a strategy map that details how each initiative supports the strategic objectives of the organization. This methodology can be used to create a strategy that shows how a selected set of important initiatives (policy changes) in the ACA are being used to meet its strategic objectives of reducing costs, improving quality and increasing access (see chart on page 70).
Learning and Growing
Organizations that effectively use strategy maps start with a learning and growing perspective. What skills, support and information does the organization need to provide to its employees for them to be effective? The ACA addresses this challenge in three areas: primary care capability, health insurance knowledge diffusion and new information on the most effective care methods.
Primary care capability has been strained in many parts of the country due to a number of factors, but a significant issue has been compensation levels for primary care practitioners. The ACA provides additional funding...