An evaluation of how the patient protection and affordable care act advances the national quality strategy, national prevention strategy and healthy people goals to reduce disparities in care of people with disabilities

As a result of the Patient Protection and Affordable Care Act (PPACA), the National Quality Strategy (NQS) was created with an emphasis on better quality care, healthy people, communities, and affordable care. The National Prevention Strategy (NPS) Framework, released in 2011, proposed a change in emphasis from sickness to wellness. The NPS focus on community environments, preventive services, empowered people, and the elimination of health disparities is supportive of Healthy People 2020 (HP2020) goals to achieve health equity and eliminate disparities for a more equitable society. The purpose of our study was to evaluate and reconcile the NQS, NPS Framework and HP2020 Goals to reduce disparities for the disabled. We assessed whether specific provisions of the PPACA have the potential to support initiatives outlined in the NQS, NPS and the HP2020 target of 10% improvement in prevention and reduction of chronic diseases for the disabled. High-risk pools for pre-existing conditions and insurance rescission bans should reduce disparities among the disabled. Patient-centered care, medical homes, and a reallocation of resources to home and community based services should improve the level of and coordination of services. Specific provisions intended for other vulnerable groups, e.g., women, minorities and older Americans, should also improve health care and outcomes for the disabled. However, the implementation of state level exchanges and budgetary decisions may have unintended consequences for lower-income groups. Overall, the PPACA supports the NQS, NPS and HP2020 goals, with increased attention on prevention and increased access to care for the disabled.