Impact of Health Care Policy on Quality, Outcomes, and Equity in Cardiovascular Disease

Health policy is the collection of laws and regulations that dictates how health care is accessed, delivered, and financed. Evidence to date suggests that health insurance coverage is crucial for achieving optimal cardiovascular and overall health, and improvements to insurance markets as well as Medicaid expansion under the Affordable Care Act (ACA) have increased rates of coverage nationwide. The value-based and alternative payment models introduced in the ACA have mostly been suboptimally effective at improving outcomes or reducing costs, and some may have had unintended consequences for access and equity. Major inequities exist in care and outcomes for racial and ethnic minorities, people living in poverty, and those in rural areas, despite growing recognition of their magnitude. Further efforts are needed to build on successful policies such as insurance expansion, improve those that have been somewhat less successful such as payment reform, and drive toward better and more equitable health for all.