1. Michael Rendon
Professor Tanner
Literature Review Map
Texas Tech University
Abstract
Interdisciplinary Problem: Affordable Care Act
Name of Discipline #1: Medicine
Health Care Reforms: Disruptors Need Not Apply (Bush, Jonathan. Source:Forbes. 6/16/2014,
Vol. 193 Issue 8, p28-28. 1p.) Retrieved From: http://eds.b.ebscohost.com.lib-
e2.lib.ttu.edu/ehost/detail?sid=480c7dfe-b8f7-4fb2-
91d2f7c24fc60383%40sessionmgr112&vid=1&hid=115&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db
=bth&AN=96269132
The problem addressed in the article is that Accountable Care Organizations or ACOs, which are
designed to be a way in which physicians can better coordinate and be more accountable for care
management are a hassle and very inefficient.
The research method is qualitative.
The key concept identified by the author is that the ACO as it stands right now is more disruptive than
beneficial.
The results of these strict ACO’s is that most health care physicians are simply leaving their independent
practice for hospitals and large health systems to avoid the regulations imposed by ACO’s.
Key sources are Patient Protection and Affordable Care Act and the Offices of Physicians.
Investing in Health Care: What Happens When Physicians Invest and Why the Recent
Changes in the Patient Protection and Affordable Care Act Fail to Protect Patients from Their
Physicians’ Self-Interest (Zisk, Nancy L. Source: Seattle University Law Review 36. 2012-2013,
Vol. 36, P.189-208) Retrieved From:
http://www.heinonline.org.libe2.lib.ttu.edu/HOL/Page?handle=hein.journals/sealr36&id=197&collectio
n=journals&index=#202
The problem addressed in the article is that physicians must disclose their ownership interests in
diagnostic tools and provide alternative resources for these means, however the current disclosure
requirement put a weight on the patients shoulders, which forces the patient to stay with physicians and
help these physicians achieve their own personal financial goals.
The research method is qualitative.

2. Michael Rendon
Professor Tanner
Literature Review Map
Texas Tech University
The key concept is that physicians are able to make money based on recommendations and their own
investments. It may not seem problematic, but it becomes problematic to the relationship between the
physicians and patient when the patient decides on an alternative option.
The conclusion that Zisk proposes is that physicians should adopt a flat bill so that the patient is not
forced into the tough decision discussed.
Key Sources include The Stark Law in Retrospect, Patient Protection and Affordable Care
Act.
An Introduction to Health Policy (Sethi, Manish K.; Obremskey, Alexandra; Latuska, Richard.
2013, P. 235-249)
This book is a key work because it entails information up until the recent Affordable Health Care act. It
also entails information regarding the current policy and ways to improve on it as well as possible future
implications. This sets out the health plan in its entirety and discusses problems pertaining to, or
solutions implied by this new law. Reinventing American Health Care (Emanuel, Ezekiel. March 4,2014)
This book discusses the health care system from the early stages to present day. Furthermore, it goes in
depth on where your expenses are going with physician services accounting for up to 20% of health care
expenditures. They discuss that the majority of patients needs however are services that do not require
specialty training, so you see conflict there. Another key thing it addresses is that in 2008 just under all
physicians worked in groups of 5 or fewer. Fast forward to present day where there is more than 50% of
physicians working with hospitals, or not independently.
Journals:
Promoting Prevention through the Affordable Care Act (Koh, Howard K.; Sebelius, Kathleen
G.)
Patient Protection and Affordable Care Act of 2010: a primer for NeuroInterventionalists Professional
Organizations: asae-The Center for Association Leadership- The Power of AANA- American Nurses
Association-Health Care Reform
In Brief:
These resources are important because they take a look at various aspects such as the physician/patient
relationship, physician self-interests, and the physicians becoming less independent. The first aspect
being the physician/patient relationship matters because the perceived need to contribute to the
physician’s self-interest makes the patient think they are in better hands and will get better care. The
physician self-interest should be taken out of play, they should either have a flat rate, or not be able to

3. Michael Rendon
Professor Tanner
Literature Review Map
Texas Tech University
invest in the equipment that gives them kickbacks through use. The physicians becoming less
independent through stricter regulations means that we could be at a stage where we will start to see
big business dominate all fields.
Discipline #2: Economics
The Impacts of the Affordable Care Act: How Reasonable Are the Projections? (Gruber,
Jonathan. National Bureau of Economics Research. 2011.) Retrieved
From:http://www.nber.org/papers/w17168
The problem addressed are the impacts that the ACA is expected to have.
The research method was that of a mixed method where there was both qualitative and
quantitative.
The key concept identified in this article, is that we can only predict what will happen in the future.
Other than that we need to just wait and see how much implementation they actually enforce. The
results are unsure as we are still in the beginning phase of the effects that the plan has on our costs.
However, the authors’ conclusion is that we have multiple possible solutions that are proposed to
reduce health care costs.Therefor he concludes that it is unlikely that we will significantly reduce costs,
but rather are on a path to controlling them.
Key References: America’s Health Insurance Plans, 2007. “Individual Health Insurance
2006–2007: A Comprehensive Survey of Premiums, Availability and Benefits.” America’s Health
Insurance Plans, Washington, DC,
http://www.ahipresearch.org/pdfs/Individual_Market_Survey_December_2007.pdf.Congressional
Budget Office, 2010a. The Long-Term Budget Outlook. Congressional Budget Office, Washington, DC.
Estimated Financial Effects of the “Patient Protection and Affordable Care Act,” as passed by the Senate
on December 24, 2009 (Foster, Richard S. Department of Health and Human Services. 2010.) Retrieved
From
http://books.google.com/books?hl=en&lr=&id=6HbmkiKFVLYC&oi=fnd&pg=PA1&dq=affordable+care+a
ct+on+economy&ots=5JbLPai0DE&sig=qz-
Y6rpkYCQBfMIfLnvs7k608s#v=onepage&q=affordable%20care%20act%20on%20economy&f=false
The problem addressed is that the Affordable Care Act will positively effect the economy if we are
willing to invest in this system.

4. Michael Rendon
Professor Tanner
Literature Review Map
Texas Tech University
The research method seems to be more of quantitative breaking down the numbers. The key concept is
that the total amount of Medicare and tax savings would offset the cost of national coverage provisions
resulting in a reduction in the Federal deficit.
The projected results would be an astounding 34 million more people being covered by insurance by
2019.
Key References: Office of the Actuary, Medicare and Medicaid Services. GDP projections from
http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2008.pdf
The Health and Wealth of a Nation: Employer-based Health Insurance and the Affordable Care Act
(Maxwell, Nan L. 2012)
This is a key book because it highlights some of the effects that will be imposed on big businesses and
small businesses. The big businesses will see an increase in expenses in order to either cover the worker
better or face financial punishment. As for the small businesses, premiums are increasing which makes it
less likely for a small business to offer adequate insurance to their employee which could impact their
businesses ability to succeed. Without adequate funds and adequate help, the small businesses could
have a more difficult time competing.
Healthcare, Insurance, And You: The Savvy Consumer’s Guide (Zamosky, Lisa. 2013.)
This book is important because it discusses that although we have one of the best healthcare systems
around we spend on average about 3,000.00 more per year on our individual insurance than the top two
next best systems in the world. It also states that even though we pay a higher price, we don’t often go
to the doctor as frequently as citizens from other countries. The book also states that there will be no
deductible, co-payment, or co-insurance, which may mean higher premiums. And the last and most
important figure I got from the book is that healthcare spending accounts for 18% of the annual United
States economy, or 2.7 trillion. However, the law attempts to do quality based payment as opposed to
fee for service which could have a tremendous impact.
Journals:
The Journal of Medical Practice Management (Rak S; Coffin J)
New England Journal of Medicine: Legislating Against use of cost-effectiveness information (Neumann,
PJ; Weinstein, MC. 2010)
Professional Organizations:
Health Care Reform Educational Institute
American Society of Health Economists

5. Michael Rendon
Professor Tanner
Literature Review Map
Texas Tech University
In Brief: All of these articles, journals and books will be useful to examining the actual impacts of the
ACA in the future. We have estimates and proposed theories based on these useful resources, but these
are only a guideline to help understand what actually happens and make comparisons. They made
known some things that I did not know, like no deductibles, co- pay and the like. Although I read
somewhere else that this will lead to increased premiums. Nobody really knows where this bill will put
us with health spending, but at least they are attempting to do something about the system, and based
upon these projections and past numbers we will have a good basis to judge the effectiveness.
References
Health Care Reforms: Disruptors Need Not Apply (Bush, Jonathan. Source:Forbes. 6/16/2014,
Vol. 193 Issue 8, p28-28. 1p.) Retrieved From:
http://eds.b.ebscohost.com.libe2.lib.ttu.edu/ehost/detail?sid=480c7dfe-b8f7-4fb2-
91d2f7c24fc60383%40sessionmgr112&vid=1&hid=115&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db
=bth&AN=96269132
Investing in Health Care: What Happens When Physicians Invest and Why the Recent
Changes in the Patient Protection and Affordable Care Act Fail to Protect Patients from Their
Physicians’ Self-Interest (Zisk, Nancy L. Source: Seattle University Law Review 36. 2012-2013,
Vol. 36, P.189-208)
Retrieved From:
http://www.heinonline.org.libe2.lib.ttu.edu/HOL/Page?handle=hein.journals/sealr36&id=197&collectio
n=journals&index=#202
An Introduction to Health Policy (Sethi, Manish K.; Obremskey, Alexandra; Latuska, Richard.
2013, P. 235-249)
Reinventing American Health Care (Emanuel, Ezekiel. March 4,2014)
Promoting Prevention through the Affordable Care Act (Koh, Howard K.; Sebelius, Kathleen
G.)
Patient Protection and Affordable Care Act of 2010: a primer for NeuroInterventionalists

6. Michael Rendon
Professor Tanner
Literature Review Map
Texas Tech University
http://m.proquest.safaribooksonline.com/hd/content?xmlId=9781430249535/9781430249535_ch01_x
html#id=9781430249535sec19_xhtml