This ninth edition of Health Care USA: Understanding Its Organization and Delivery marks the end of an era and the beginning of a new one. In the early 1990s, I was invited to create a series of books on epidemiology, public health, and health care. For the volume on health care, I engaged my esteemed colleague and good friend Professor Harry Sultz, who, in turn, invited Professor Kristina Young to join him as coauthor. Having had unique and complementary experiences, they produced the first edition of this book in 1996, and it became a best seller. Throughout his professional career, Professor Sultz was inspirational to his colleagues and students alike. He approached each new edition of the book with excitement. He always kept the reader in mind as he wrote clearly and succinctly. For each edition, he included the most up-to-date advances in health care with the comments and analyses of a seasoned researcher and author. Woven through the many subjects covered in the book, the reader can sense the special contribution of Professor Sultz, an author who indeed has “been there.” In 2014, after the eighth edition was published, Professor Sultz decided to retire from his coauthorship of the text, but his thoughts and contributions will continue to be evident in the ninth and succeeding editions. This ninth edition, under the able lead authorship of Kristina Young and with her new, highly credentialed coauthor, Dr. Philip Kroth, will continue the tradition of being on the cutting edge of understanding the complex issues of health care and its delivery—a fitting tribute to Professor Harry Sultz. Now, almost 7 years since becoming law in 2010, the Patient Protection and Affordable Care Act (ACA) has survived an unprecedented number of Congressional challenges. Although the period since its implementation is very short in historical terms of system change, the ACA is beginning to yield results. Through the ACA, more than 20 million Americans have gained access to health insurance through state-based marketplace exchanges and Medicaid expansion. Valuebased payment reforms through patientcentered medical homes, accountable care organizations, and historic physician payment reforms are beginning to reign in cost growth and improve healthcare quality through increased transparency and accountability. It is certain that experimentation with new healthcare delivery models will continue to identify best practices as healthcare providers and organizations continue adapting to the ACA and marketplace changes.
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