Of all that might be said about the Patient Protection and Affordable Care Act (ACA)—one of the most important and most challenged pieces of legislation in our nation’s history—why emphasize that it is an experiment? First, any major policy innovation is an experiment. There will be hypotheses and expectations, but until implemented and tested, we cannot be certain of the results—so we need to collect data on the impact of innovations so that the nation learns from the challenges of doing such experiments. In addition to being an experiment itself, the ACA has strengthened the role of research in improving the quality, effectiveness, and value of health care. By creating the Centers for Medicare and Medicaid (CMS) Innovation Center and the Patient-Centered Outcomes Research Institute (PCORI), the ACA has put research at the center of American healthcare improvement. Now, with the many improvements the ACA makes in American healthcare financing and delivery, and the important research it supports, there is the opportunity that all health policymakers and researchers long for, and on which the public depends, to have real impact on health.
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