Published October 22, 2013
As the Patient Protection and Affordable Care Act (ACA) begins to reshape the American health care system, the University at Buffalo is working to ensure that current and future health care professionals are ready to take on new challenges.
“The ACA will absolutely change — and I would say, improve — the way we care for our patients,” says Nancy Nielsen, MD ’76, PhD, inaugural senior associate dean for health policy in the School of Medicine and Biomedical Sciences.
“Our students need to be well prepared to function in this environment and lead the changes that can improve medical care.”
Today’s medical students are looking forward to that future, she adds.
“When I addressed UB’s first- and second-year medical students, they were very attuned to the changes that are coming and they’re excited about giving patients better, more efficient care.”
Nielsen lists four major changes that the act will influence or necessitate.
“The world of medicine is becoming more patient-centered and efficient, and the ACA is going to reinforce and support those improvements,” she says.
For example, the ACA emphasizes evidence-based medicine.
“Our medical students learn very early how to critically evaluate the medical literature and use the best scientific evidence to guide their approach to patient care,” Nielsen says.
In addition, the act created pilot programs that invest heavily in primary care practices that provide robust, easily accessible care, she notes. Commercial health plans have mirrored that investment in Western New York and around the country.
“If we are to have a sustainable health care system, physicians and patients need to be more aware of the costs and benefits of the things we order,” she says.
There is a drive to educate physicians to fully appreciate what things cost and the economic and medical impacts of tests and procedures they order, she adds.
The nationwide movement “Choosing Wisely,” for example, is currently providing information on procedures and tests that should not be done routinely.
“Physicians will be practicing and delivering care as members of teams, and there may be some new members on those teams,” she says.
“The ACA will further promote the move toward interprofessional education, where students in all the health sciences learn to work together.”
UB and other schools are already moving in this direction, she notes.
Under the act, health care will improve as more people are able to afford health insurance.
“We know that being uninsured is hazardous to your health,” she says. “Insured patients seek care in doctor’s offices, not just emergency rooms.”
Despite controversy over the new legislation, Nielsen is upbeat about its potential.
“This is a very exciting time,” she says. “We are the last developed country in the world to figure out how to insure our citizens, and this is long overdue.”
“This is not a new government ‘program,’ ” she adds. “It’s just a new way, a ‘marketplace,’ where insurers compete for business and consumers choose plans that are best for themselves and their families.”
The new system “will be a big improvement for those who have no insurance, or who have been buying policies on the individual market,” she notes.
The U.S. government estimates that six out of 10 Americans who seek insurance through the exchanges will ultimately pay less than $100 a month for individual coverage.
In her current position as of fall 2013, Nielsen is helping UB take a proactive leadership role in transforming health care delivery.
She will teach health policy to students, consult with UBMD clinicians, and collaborate with faculty and curriculum committee members to disseminate knowledge about evolving health care policy.
Most recently, Nielsen was a senior adviser at the Center for Medicare and Medicaid Innovation in Washington, D.C. This unit of the U.S. Department of Health and Human Services is testing innovative approaches to improving health care delivery, payment and quality.
Nielsen previously led UB’s Office of Medical Education. She is a past president of the American Medical Association.