LAUSR

Key Points Question How were ambulatory quality, patient experience, utilization, and cost associated with implementation of the Patient Protection and Affordable Care Act (ACA)? Findings In this nationally representative cross-sectional study of 123 171 individuals, the ACA was associated with more high-value diagnostic and preventive testing, improved patient experience and access, and decreased out-of-pocket expenditures for lower income US individuals. The ACA was not associated with changes to most quality measures, utilization, or the total cost of care. Meaning These findings suggest that policy makers and health system leaders seeking to further improve value should combine insurance expansion with additional policy initiatives to see broader improvements in care.