Commentary: Preparing for Health Care Reform: Ten Recommendations for Academic Health Centers

Shomaker, T. Samuel MD, JD

doi: 10.1097/ACM.0b013e3182103443

Health care reform, the subject of intense national debate and discussion during the presidential campaign and the first year of the Obama presidency, is now reality. The Patient Protection and Affordable Care Act of 2010 (PPACA) became law in March 2010. Despite efforts by the new Republican majority in the House of Representatives of the 112th Congress to repeal the bill, some aspects of PPACA have already taken effect, and the majority of the remainder are scheduled to be implemented by 2014. PPACA will change the U.S. health care system in fundamental ways. Perhaps more than other entities in the U.S. health care system, academic health centers (AHCs) will bear the impact of the struggle to care for 32 million new, primarily low-income insurance beneficiaries. A large influx of new patients trying to access the health care system through AHCs will coincide with major changes in the financing of health care, the training of health professions students, and the conduct of biomedical research. Although many of the sweeping changes coming through PPACA will not happen until later in this decade, AHCs must begin planning for the future now if they are to prosper, or even survive, in the brave new world of health care reform. The author of this commentary first briefly analyzes some of the most important effects PPACA will have on AHCs and then makes recommendations for how AHCs can prepare to take advantage of the opportunities and mitigate the challenges inherent in implementing PPACA.

Dr. Shomaker is the Jean and Thomas McMullin Dean, College of Medicine, vice president for clinical affairs, and professor, Department of Anesthesiology, Texas A&M Health Science Center College of Medicine, Bryan, Texas.

Correspondence should be addressed to Dr. Shomaker, Texas A&M Health Science Center College of Medicine, Health Professions Educational Building, 8447 State Highway 47, Suite 3050, Bryan, TX 77807-3260; telephone: (979) 436-0205; fax: (979) 436-0092; e-mail:

First published online February 4, 2011

© 2011 Association of American Medical Colleges