Patient Protection And Affordable Care Act Discussion.
Patient Protection And Affordable Care Act Discussion.
The healthcare system of the United States continues to witness healthcare reforms for the purposes of making healthcare universally accessible, highly efficient and of high quality. One such reform is the enactment of the Patient Protection and Affordable Care Act. This Act was amended from the Health Education Reconciliation Act and signed into law by President Barack Obama on the 23rd of March 2010. Patient Protection And Affordable Care Act Discussion.It is one of the most comprehensive and largest overhaul of the health care system of the United States since the inception of Medicaid and Medicare.
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The focus of the Patient Protection and Affordable Care Act was: reducing the number of Americans who were uninsured, making health care and health insurance more affordable and improving the performance and outcome of the healthcare industry. Eight years since its enactment into law, this paper discusses how the Patient Protection and Affordable Care Act has improved the Healthcare Delivery system and how it is a liability to the healthcare industry. This knowledge is essential in providing insights to other healthcare providers and policymakers on the areas that may need amendments to make the healthcare delivery system more efficient, effective and universal.
How The Patient Protection and Affordable Care Act is an Improvement of Our Healthcare Delivery System
Universal Health Coverage For Uninsured Americans
Following the Implementation of the Patient Protection and Affordable Care Act, statistics reveal that more than 32 million Americans from middle and low socioeconomic status have been able to obtain health insurance coverage (Glied & Jackson, 2017). This population continues to grow rapidly with more young adults who were previously uninsured obtaining health insurance coverage. As suggested by Glied & Jackson (2017), this has been influenced by health insurance companies being prevented by the Act from making increases in the rates of insurance.Patient Protection And Affordable Care Act Discussion.
Citizens are presented with a wide range of health insurance coverage options to select from. For patients with a pre-existing or underlying chronic illness such as cancers, the Act forbids the denial of their insurance coverage. To add on, consumers can efficiently access preventive care services which include patient health education, immunization, and screening at no additional costs (Glied & Jackson, 2017). This has helped to transform the provision of healthcare from curative to preventive care with more improved outcomes.
Improvements in Primary Care
The Patient Protection and Affordable Care Act has enhanced a marked improvement in primary care services. While the Medicaid and Medicare enrollment fee for primary care physicians has been eliminated, they received increments in Medicaid payments. As a result, there has been a significant increase in the number of patients who visit primary care physicians for a wide range of healthcare services. According to the statistics provided by the Department of Health and Human Services, this number has tripled with newly insured adults and young adults accounting for more than a third of the visits more so Black Americans (McGough et al., 2017).
This particular increase has to date overwhelmed the healthcare delivery system. As a result, primary care organizations continue to look for ways to meet the health needs of the entire population such as; expanding the scope of training and practice of advanced nurse practitioners (McGough et al., 2017).
ACA elimination of lifetime and annual limits of coverage ensures that no costs are contained on an annual basis and patients can have as many primary care visits as possible. These costs are passed to Medicaid and later on to the taxpayer. With health insurance coverage expansion, American citizens who were previously uninsured are now able to access a wide range of primary care services and this has increased the demand for different services such as mental health and palliative care with improved health outcomes (McGough et al., 2017).
Improved Performance through Pay for Performance Incentives
The Patient Protection and Affordable Care Act outlines some of its initiatives which aim at improving efficiency, quality and the general value of healthcare. A perfect example is the pay for performance initiative whereby, the new systems of payment tend to reward health care organizations and doctors for improving the quality of care (Rosenbaum, 2013). This approach has become popular among policymakers in both the private and public sectors and the Affordable Care Act tends to maximize on the use of pay for performance incentives
This has encouraged healthcare organizations to research, experiment and identify programs and designs that are most effective in promoting quality health outcomes. The utilization of information technology through the electronic health records system is a perfect example (Rosenbaum, 2013). Therefore, healthcare providers and healthcare organizations are motivated to engage in evidence-based research to find innovative solutions that promote quality healthcare
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How the Patient Protection and Affordable Care Act is a Liability to Our Healthcare Delivery System
Increased Premiums and Fines
The Patient Protection and Affordable Care Act was meant to ensure that families from low socio-economic status are brought to the insurance market. These households could be given subsidies from the federal government to make sure that their health insurance plans were affordable. For families of high socio-economic status, the same subsidies were not availed. Besides, the Act requires that several healthcare services and health care benefits are covered. This means that health insurance plans are nonspecific rather than being personalized to meet the individual needs of consumers (Borelli, Bujanda & Maier, 2016). Since the Act includes health insurance coverage for groups and individuals at high risk, it was mandatory to implement an inclusion for healthy populations to balance both groups. The mandate is to obtain an insurance plan or to pay a fine of up to 2% of an individual’s income. The resultant effect has been a dramatic increase in premiums and fines especially for families of minority populations which continue to live beyond the poverty line. Patient Protection And Affordable Care Act Discussion.
With regards to pharmaceutical sales, medical devices and people with high income, potential tax increments have been witnessed on specific sources of income. Part of the funds that were used to fund this Act was taken from Medicaid payment savings and this resulted to a reduction in the number of doctors who accepted this plan (Borelli, Bujanda & Maier, 2016). In other words, the richest citizens of the US are being asked to fund the health care services of those who are poor.
Cancellation of Most Private Insurance Plans
The enactment of the Patient Protection and Affordable Care Act required that health consumers are provided with 10 essential healthcare services. Therefore, rather than changing health care plans, most insurers canceled them (Borelli, Bujanda & Maier, 2016). Most households lost their insurances which were affordable and were forced to replace with high-cost plans which included other health care services that most people did not need.
Conclusion
The enactment of the Patient Protection and Affordable Care Act has contributed tremendously to improvements in healthcare reforms in the United States. Some of the most visible improvements include high enrollment in primary care, universal health care and improved performance through pay for performance incentives. However, the Act has also been a liability in several ways such as: resulting in increments in fines and premiums and the cancellation of most private insurance plans. With this knowledge, it is possible for healthcare providers and policy makers to identify the existing gaps that hinder the provision of high quality and efficient care. Only then can possible amendments be made to ensure that the Act fully serves its purpose. Patient Protection And Affordable Care Act Discussion.
References
Borelli, M. C., Bujanda, M., & Maier, K. (2016). The Affordable Care Act Insurance Reforms:
Where Are We Now, and What’s Next? Clinical Diabetes : A Publication of the American Diabetes Association, 34(1), 58–64.
Glied, S., & Jackson, A. (2017). The Future of the Affordable Care Act and Insurance
Coverage. American Journal of Public Health, 107(4), 538–540.
McGough, P. M., Norris, T. E., Scott, J. D., & Burner, T. G. (2017). Meeting the Demands of the
Affordable Care Act: Improving Access to Primary Care. Population Health Management, 20(2), 87–89
Rosenbaum, S. (2013). The Patient Protection and Affordable Care Act: Implications for Public
Health Policy and Practice. Public Health Reports, 126(1), 130–135.Patient Protection And Affordable Care Act Discussion.
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