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The Unintended Consequences of the Affordable Health Care Act
Key provisions of the ACA toward reforming health care insurance
The impact of the Affordable Care Act on healthcare
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The presented article reviewed the impact that the Affordable Care Act (ACA) has had on the US healthcare system following it being signed by President Barack Obama on March 23, 2010. As described in the article, much of the full effect of the ACA is yet to be determined due to its existence being only five years. However, within this time frame the ACA has greatly modified two key factors of the healthcare system; the expansion in coverage of health insurance and a reform in the delivery system of healthcare. Reform in these two areas came largely in part due to the federal government providing subsidies which allowed for 87% of the 11.7 million qualifying Americans to receive coverage, and secondly because of individual states being allowed to expand their Medicaid programs (Blumenthal, Abrams & Nuzum, 2015). The effects of the ACA on this 87%, have been that many were pleased with their coverage and report being …show more content…
For those providers who have modified their practices to avoid penalties, reimbursement has been received based on newly presented guidelines under the ACA. The transition of reimbursing claims based on a “paid-for-value” matrix compared to the previous “paid-for-service” mindset has forced practitioners to modify their practices to reduce the amount of testing and other procedures that may not be considered medically necessary (Blumenthal, Abrams & Nuzum, 2015). To combat the confusion associated with this new mindset, the ACA has formally encouraged collaboration amongst providers through accountable care organizations which are designed to coordinate the various aspects of healthcare practices among multiple
Furthermore, uncertainty of new reimbursement models, diminishing reimbursement, and complicated compliance regulations are playing the role of a catalyst for streamlining the Chargemaster process in majority of healthcare organizations. A good example of these challenges was prompted by the Center for Medicare and Medicaid with the release of data and chargemasters from several healthcare facilities. The release of the chargemasters sends a wave shock across the healthcare industry as it depicts a huge price discrepancies among health care providers, and due to this exposure many healthcare organizations attempt to rectify their charges. The main purpose the CMS release the chargemasters was to encourage transparency in hospital’s billing
With the passage of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) has initiated reimbursement based off of patient satisfaction scores (Murphy, 2014). In fact, “CMS plans to base 30% of hospitals ' scores under the value-based purchasing initiative on patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey, or HCAHPS, which measures patient satisfaction” (Daly, 2011, p. 30). Consequently, a hospital’s HCAHPS score could influence 1% of a Medicare’s hospital reimbursement, which could cost between $500,000 and $850,000, depending on the organization (Murphy, 2014).
Due to the Patient Protection and Affordable Care Act signed into law on March 23rd, 2010; health care in the US is presently in a state of much needed transition. As of 2008, 46 Million residents (15% of the population) were uninsured and 60% of residents had coverage from private insurers. 55% of those covered by private insurers received it through their employer and 5% paid for it directly. Federal programs covered 24% of Americans; 13% under Medicare and10% under Medicaid. (Squires, 2010)
Healthcare in the U.S. has recently been affected by implementation of the Affordable Care Act (ACA) of 2010. The intent is to create a healthca...
The Affordable Care Act or “Obamacare” was designed to assure that all Americans regardless of health status have access to affordable health insurance. The Affordable Car Act was signed into law March 23, 2010. The primary goal of this act was to decrease barriers for obtaining health care coverage and allow Americans to access needed health care services (Affordable Care Act Summary, n.d). After the legislation is fully implemented in 2014, all Americans will be required to have health insurance through their employer, a public program such as Medicaid and/or Medicare or by purchasing insurance through the health insurance marketplace exchange (Affordable Care Act Summary, n.d). I will identify three parts of The Affordable Care Act that I believe are important. First, I will talk about the requirement that insurance companies are no longer able to deny coverage to individuals with pre-existing conditions. Secondly, I will explain why physician payments are being shifted to value over volume. Lastly, I will discuss Medicaid expansion and why some states are not expanding at all.
One of the most controversial topics in the United States in recent years has been the route which should be undertaken in overhauling the healthcare system for the millions of Americans who are currently uninsured. It is important to note that the goal of the Affordable Care Act is to make healthcare affordable; it provides low-cost, government-subsidized insurance options through the State Health Insurance Marketplace (Amadeo 1). Our current president, Barack Obama, made it one of his goals to bring healthcare to all Americans through the Patient Protection and Affordable Care Act of 2010. This plan, which has been termed “Obamacare”, has come under scrutiny from many Americans, but has also received a large amount of support in turn for a variety of reasons. Some of these reasons include a decrease in insurance discrimination on the basis of health or gender and affordable healthcare coverage for the millions of uninsured. The opposition to this act has cited increased costs and debt accumulation, a reduction in employer healthcare coverage options, as well as a penalization of those already using private healthcare insurance.
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
Health insurance, too many American citizens, is not an option. However, some citizens find it unnecessary. Working in the health care field, I witness the effects of uninsured patients on medical offices. Too often, I see a “self-pay” patient receive care from their doctor and then fail to pay for it. Altogether, their refusal to pay leaves the office at a loss of money and calls for patients to pay extra in covering for the cost of the care the uninsured patient received. One office visit does not seem like too big of an expense, but multiple patients failing to pay for the care they receive adds up. Imagine the hospital bills that patients fail to pay; health services in a hospital are double, sometimes triple, in price at a hospital. It is unfair that paying patients are responsible for covering these unpaid services. Luckily, the Affordable Care Act was passed on March 23, 2010, otherwise known as Obamacare. Obamacare is necessary in America because it calls for all citizens to be health insured, no worrying about pre-existing conditions, and free benefits for men and women’s health.
The current health care reimbursement system in the United State is not cost effective, and politicians, along with insurance companies, are searching for a new reimbursement model. A new health care arrangement, value based health care, seems to be gaining momentum with help from the biggest piece of health care legislation within the last decade; the Affordable Care Act is pushing the health care system to adopt this arrangement. However, the community of health care providers is attempting to slow the momentum of the value based health care, because they wish to maintain their autonomy under the current fee-for-service reimbursement system (FFS).
In March 2010, under the Obama administration, the United States enacted major health-care reform. The Affordable Care Act (ACA) of 2010 expands coverage to the majority of uninsured Americans, through: (a) subsidies aimed at lower-income individuals and families to purchase coverage, (b) a mandate that most Americans obtain insurance or face a penalty,
If the United States had unlimited funds, the appropriate response to such a high number of mentally ill Americans should naturally be to provide universal coverage that doesn’t discriminate between healthcare and mental healthcare. The United States doesn’t have unlimited funds to provide universal healthcare at this point, but the country does have the ability to stop coverage discrimination. A quarter of the 15.7 million Americans who received mental health care listed themselves as the main payer for the services, according to one survey that looked at those services from 2005 to 2009. 3 Separate research from the same agency found 45 percent of those not receiving mental health care listing cost as a barrier.3 President Obama and the advisors who helped construct The Affordable Care Act recognized the problem that confronts the mentally ill. Mental healthcare had to be more affordable and different measures had to be taken to help patients recover. Although The Affordable Care Act doesn’t provide mentally ill patients will universal coverage, the act has made substantial changes to the options available to them.
In 2015, the Centers for Medicaid and Medicare Services (CMS) released the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which implements the final rule which offers financial incentives for Medicare clinicians to deliver high-quality patient centered care.5 Essentially, taking the time to learn the patient’s goals and treatment preferences allows for the patient to walk away from the medical treatment or service feeling understood and cared for by the provider.4 Thus, resulting in a better, more comprehensive plan of care. Policy makers are hopeful that the new incentive-based payment system will accelerate improvement efforts.
The Affordable Care Act, passed by Congress and signed into law by President Obama in March 2010, offers middle class families more benefits in their healthcare. It ended insurance industry abuses, where it lowered health care costs, gave more choice to the clients, and enhanced the quality of life for All Americans (White House 2). The Patient’s Bill of Rights gave the control of healthcare to the client instead of the insurance company (White House 3). The insurance company no longer was able to deny the coverage request when the client was in need of it (White House 3).
The Patient Protection and Affordable Care Act (ACA) legislation passed in 2010 supported changes to private and public market places for patients, providers and health insurers most noticeably through expanded health insurance availability. A key piece of the legislation included a significant expansion to the Medicaid program to include all individuals with incomes below 138 percent of the Federal Poverty Level (FPL) (Hahn & Sheingold, 2013). Initially, if accepted within the state, the expansion is fully paid for by the federal government and progressively through 2020, 10 percent of the Medicaid spending is a responsibility for the state to fund. As part of continuing to receive any federal
My viewpoint of the Affordable Care Act has changed significantly over the course of the past eight weeks but primarily because I know more about it now than I did when I started this class. My viewpoint about what the future of health care holds has probably changed even more significantly than my viewpoint on the ACA. Prior to the onset of this class, I simply assumed that health care would hold steady at its current status with a few “minor” tweaks here and there. I did not realize how much affect technology had on health care, nor did I realize that health care as we know it today, is in such a sad state of disarray. Health care has remained a core issue faced by Americans for many years. Young & DeVoe (2012), estimate that the cost of health care in 2021 will equal 50% of the typical household income and if it is allowed to continue to rise; by 2033 it will surpass the average household income. With my new found interest in the ACA, I feel that I will be watching the news more closely and monitoring the future happenings to be more “in the know” of things, as they happen. I feel that my opinions will wax and wane based on future financial changes that occur and the effects that it has on health care.