How health-care reform is changing our health care system, in charts

The Affordable Care Act is mostly known for its mandate to expand health insurance to 30 million more Americans within a decade. But much of the law’s 905 pages are dedicated to an effort that’s arguably more ambitious: the overhaul of the U.S. business model for medicine. These charts look at how we pay for health care now, how that's gone wrong and what the health-care law attempts to change about that.

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"The rapid growth of health expenditures is one of the most important economic trends in the United States in the post–World War II era," health care economist Victor Fuchs wrote recently in the New England Journal of Medicine. In 1950, 4.6 percent of the American economy was devoted to health care. Today, that number stands at 17.9 percent, or $2.6 trillion. Fuchs attributes much of that growth to the rise of medical technology and "increased specialization that comes along with it."

/ New England Journal of Medicine

As the demographics of the United States change, so does the way we pay for health care. With baby boomers aging onto Medicare, the federal government has found itself footing an increasingly large share of Americans' medical bills. By 2021, the Advisory Board Company estimates that most hospital patients will be Medicare patients.

/ The Advisory Board Company

More Americans shifting onto public programs creates a challenge for health-care providers. Medicare and Medicaid reimbursements have traditionally not covered hospitals' costs in caring for patients. "There was a patient-mix shift happening that, unless hospitals changed, they were going to be losing money in about five years," says Chas Roades, chief research officer at consulting firm The Advisory Board.

/ The American Hospital Association

As the Obama administration looked to expand health insurance, it was confronted with a huge problem: skyrocketing health-care costs. Insurance premiums had jumped 168 percent between 1999 and 2011. If it was going to extend health insurance to millions of Americans, it needed to make sure it would be affordable.

/ Kaiser Family Foundation

Many health-care economists think that the way we pay for medicine has a lot to do with why it's so expensive. Most private and public insurance pay doctors for the volume of medicine they provide, known as "fee-for-service." That, economists argue, pushes doctors to provide as much care as possible regardless of whether it's effective.

/ MedPac; The Bureau of Labor Statistics

With an eye towards making health insurance more affordable, the health-care overhaul includes 15 provisions that change the way health-care providers get paid. The idea is to move the system away from paying for volume, and instead reward doctors for the value of the care they provide.

/ The Advisory Board Company

Payment reform became "massively and unstoppably important" in drafting the Affordable Care Act, says former White House advisor Bob Kocher. It's key to expanding health insurance to 30 million more Americans while not speeding up the rate of health-care-cost growth.

/ Center for Medicare and Medicaid Services

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