Healthcare Reform and Multilevel Interventions and Research: Big Changes Go Hand in Hand with Big Science by Kelly Devers, PhD

The purpose of this paper is to describe and discuss the implications of the Affordable Care Act, and other major pieces of legislation passed in 2009, for cancer care and related research. Continuing with these major areas and provisions, we illustrate and discuss how the implementation of these reforms occurs at multiple levels of the health system. General concepts must be translated into specific and often-complex, multilevel interventions that often vary based on states and local markets prior history, interpretation, and current capacities and constraints. Recommendations will be presented for how best to develop this multilevel infrastructure to ensure that the Big Changes underway are accompanied by a new, health services research Big Science approach.