US Health Care Policy and Reform: implications for cardiac electrophysiology

  • Mintu P. Turakhia
  • Aditya J. Ullal


In response to unsustainably rising costs, variable quality and access to health care, and the projected insolvency of vital safety net insurance programs, the federal government has proposed important health policy and regulatory changes in the USA. The US Supreme Court’s decision to uphold most of the major provisions of the Affordable Care Act will lead to some of the most sweeping government reforms on entitlements since the creation of Medicare. Furthermore, implementation of new organizational, reimbursement, and health care delivery models will strongly affect the practice of cardiac electrophysiology. In this brief review, we will provide background and context to the problem of rising health care costs and describe salient reforms and their projected impacts on the field and practice of cardiac electrophysiology.


Health expenditures Medicare Reimbursement mechanisms Health care organization and administration Health care reform Health policy 



Affordable Care Act (short for Patient Protection and Affordable Care Act)


Atrial fibrillation


Acute myocardial infarction


Coronary artery disease


Cardiac resynchronization therapy


Department of Justice




Gross domestic product


“Get with the Guidelines”


Heart failure


Implantable cardioverter-defibrillator


Value-based purchasing



This work is supported by a Veterans Health Services Research & Development Career Development award (CDA09027-1), an American Heart Association National Scientist Development grant (09SDG2250647), and a VA Health Services and Development MERIT award (IIR 09–092), and the Palo Alto Institute for Research and Education. The content and opinions expressed are solely the responsibility of the authors and do not necessarily represent the views or policies of the Department of Veterans Affairs.

Conflict of interest

Dr. Turakhia has the following disclosures: Medtronic, Inc., iRhythm, Inc., and Janssen Pharmaceuticals (research funding); Biotronik, Boston Scientific, St Jude Medical (honoraria for educational lectures); Precision Health Economics, St Jude Medical, Cyberheart (consulting); and Metrica Health, Inc. (equity).


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Veterans Affairs Palo Alto Health Care SystemPalo AltoUSA
  2. 2.Stanford University School of Medicine, Division of Cardiovascular Medicine, Department of MedicineStanfordUSA
  3. 3.University of CaliforniaBerkeleyUSA

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