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Essay on The Impact of the Affordable Care Act on the Health Care Industry
The impact of the Affordable Care Act on healthcare
Affordable Care Act affects demand, supply, and price
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The cost of industry has a significant impact on health care so much so that while health institutions attempt to save money with cutbacks they see little reward and few gain in return. With technological advances, reduced staff numbers, and further push for greater efficiency the health care industry should see a great amount in savings which then should be pasted on to patients unfortunately this is not the reality. With all of the rising health costs and increased demand, health organizations are being forced to absorb more costs associated to patient care. A majority of the savings that come from cutbacks are being used to make up for those losses so that the institution can stay afloat. The struggle to stay afloat is very evident in organizations …show more content…
Unlike other industries, in health care larger doesn’t mean cheaper. It was recently reported by David Wenner, “Unfortunately, studies have shown that medical care often becomes more expensive after hospitals merge. That has also been the case after hospitals absorb doctors’ offices and other medical services” (Wenner, 2013). This is a surprise to many as we are trained to assume that with more resources one can provide more services and with more services being provided the costs associated can be reduced but this is simply not the case for health care. This fact should not be taken in a way that pushed the industry away from growth but from growing in a different way and being aware of the repercussions of merging. The Affordable Care Act is leaving health providers with an ultimatum, either they provide the quality and value of care expected or be penalized, which is leaving smaller organizations to integrate with others so that they can continue to provide care. Merging is costly and complicated as is integrating but it is through integration that the entire industry is being pushed to reduce mistakes and inefficiencies. There has been evidence from studies done by the Robert Woods Johnson Foundation that after hospitals merged costs grew by 20 percent on average (Wenner, 2013). This is an alarming number if one considers the additional increase in hospital mergers happening across the country, “In 2012, there were 105 mergers, up from 50 in 2009” (Wenner, 2013). Whether organizations continue to partner and grow into “super systems” and the effects of such are unknown but either way everyone will be
Bigger hospitals increasing market share Loss of Medicaid and Medicare reimbursement Decline in revenue Loss of patients
A recent phenomenon in the health services is the burgeoning of outpatient healthcare centers. Particularly vigorous growth has been observed in centers that perform diagnostic tests and simple surgeries and procedures like colonoscopies. At the current state, outpatient care centers outnumber hospitals in Pennsylvania. Furthermore, these centers now perform one of every four surgical and diagnostic procedures in the state (Levy 2006). However, the trend applies nationwide, and other states could easily follow suit. Many critics have commented on the negative and positive aspects of this trend. What remains to be determined are the long term effects (on health and the economy) of this paradigm shift, in terms of the wellness of the community as well as economically. Proponents of the movement have pointed to the lower overhead for these clinics trickling down to lower costs for patients. However, critics skeptically question whether the real benefits are for the patients or simply as a mechanism to stuff physicians' wallets. When considered as firms in the marketplace, it is evident that these two groups, both servicing the health needs of the community, have vastly different balance sheets and income statements. This transfers over to a difference in operational functionality, profitability, and cost structure. Furthermore, the disparity of financial motivations that is visible in the varying profit margins is of concern to the community. All of these are important considerations to be made when considering the economic implications of this new phenomenon.
Shay, P. D., & Mick, S. S. (2013). Post-Acute Care and Vertical Integration After the Patient Protection and Affordable Care Act. Journal Of Healthcare Management, 58(1), 15-27.
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
Based on the case study provided: Hospital A, Porter Regional Medical Centre (Hosp. A) & Hospital B Banner Regional Medical Centre and Turner Geriatric Centre (Hosp. B) merged to form a consolidated entity named “Portsmith Regional Medical Centre” (PRMC). Both Hospital A and B were fully accredited hospital, with “state-of- art diagnostic technology” which included MRI and CAT scanners, 24-hour physician staffed emergency centers. Both Hospital A and Hospital B are located in a small community of 60,000 people in southeastern part of Idaho.
Traurig, G., (2008/2009). Turmoil in the healthcare industry: what about the patients? The Americas Restructuring and Involvency Guide. Retrieved from http://www. americasrestructuring.com/08_SF/p100-106
The United States health care system is one of the most expensive systems in the world yet it is known as being unorganized and chaotic in comparison to other countries (Barton, 2010). This factor is attributed to numerous characteristics that define what the U.S. system is comprised of. Two of the major indications are imperfect market conditions and the demand for new technology (Barton, 2010). The health care system has been described as a free market in
Yong, Pierre L., Robert Samuel Saunders, and LeighAnne Olsen. The Healthcare Imperative: Lowering Costs and Improving Outcomes : Workshop Series Summary. Washington, D.C.: National Academies, 2010. Print.
With medical errors increasing the length of stay and cost of care, hospitals are facing even smaller margins. Struggling to turn a profit they only way hospitals can grow is to improve the quality of care and reduce errors. It was not until recent legislation that hospitals were being reimbursed for poor quality of care leading to longer patient stays or further hospital-acquired infections. The recent health care reform legislation, the Patient Protection and Accountable Care Act, has stopped hospitals from receiving reimbursement for readmissions due to error or nosocomial infections. Not only does this act prevent reimbursement for poor quality care, but also hospitals that deliver lower standards of care will not be able to participate in the Medicare and Medicaid programs (Andel et al.,
By the year 2020, there is expected to be over 54 million senior citizens age 65 years or older. Despite medical technology and advanced medications, seniors older than age 65 have four times the number of hospitalizations days as compared to younger age groups (Curtain, 2007). Health care demands are increasing due to the aging United States population, and the present-day Medicare system is not capable of funding this. Health insurance emphasis is now on efficiency, profits, customer satisfaction, ability to pay, and competition (Curtin, 2007). Social and political aspects are major influencers of our health care. The shift of focus from patient care to a business model has caused hospitals to maintain a tight budget, often affecting nursing staff ratios. Lean staffing ratios is associated with an increase in malpractice suits due to adverse events (Curtin, 2007).
The balance between quality patient care and medical necessity is a top priority and the main concern of many of the healthcare organizations today. Due to the rising cost of healthcare, there has been a change in the focus of reimbursement strategies that are affecting the delivery of patient care. This shift from a fee-for-service towards a value-based system creates a challenge that has shifted many providers’ focus more directly on their revenue. As a result, organizations are forced to take a hard look at the cost of services they are providing patients and then determining if the services and level of care are appropriate for the prescribed patient care.
Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.
Competitive advantage matters greatly to those responsible for the management of healthcare institutions. Together with rapidly escalating healthcare costs, increasingly complex medical technologies, and growing regulatory and legal pressures, healthcare organizations face a critical need to improve the quality of care at reduced costs (Cu...
I agree with you, operating in a highly regulated industry, the healthcare organizations need to consider several factors when it comes to forming an alliance or entering into a merger deal with other healthcare provider. As you mentioned, healthcare practice (patient care) is the one of the most important factor to consider because the ultimate goal of any healthcare organization is the quality patient care, so when organizations decide to merge the must consider how their new operation will contribute to patient care. You have provided very good reasons for the necessity of healthcare mergers. Merger can help organization cut the costs and share technology which can lead to improved patient
Thank you for your insightful evaluation and responses to the questions presented this week. As you stated, health care rationing often takes many shapes and forms. Organ allocation is an excellent example of current health care rationing. In fact, Rossoff (2014), who is a professor of pediatrics and medicine at Duke University Medical Center and the director of clinical ethics at Duke University Hospital, also noted organ allocation as a current form of health care rationing in his book titled Rationing is Not a Four-letter Word: Setting Limits on Health Care.