California Aa Case Study

There is a connection between socio-economics and health.79 Therefore, it’s expected when a states decided to expand Medicaid for more low-income residents, and then that population of people tend to be sicker than the rest of the population (Gershon & Sullivan, 2014). These reasons for expanding Medicaid will transfer those individual’s off the exchange policy into Medicaid, especially those within 100%-133% FPL range. Medicaid expansion could cause the exchange risk pools to become healthier, which means a healthier-risk pool that may be a financial boom for insurance companies that have participated in the exchange. Insurers that participate in the exchange are subject under law, to loss of medical ratio’s; which prevents them from retaining more than a certain level of profit (Gershon & Sullivan, 2014). In cost savings, with a healthier- risk pool possibly can be passed down for other consumer’s to use.

The concept of providing basic healthcare services to individuals in need has undergone an agonizing transition, from a luxury once only afforded by the affluent to a basic human right granted to citizens of every economic station, and the recently enacted Affordable Care Act (ACA) was designed to finalize this ethical evolution. Reflecting perhaps the bitter political enmity currently consuming the nation's once cherished democratic process, Republican legislatures in states throughout the union have bristled at the ACA's primary provisions, threatening all manner of procedural protestation as they attempt to delay and derail the bill's eventual implementation. One of the most intriguing aspects of the sprawling, thousand page law, however, has been the stipulation that individual states will be given a choice to either accept federal funding to expand their statewide Medicaid roster, or to forfeit all federal funding for that program in perpetuity. The role of government in monitoring and regulating the healthcare industry has been long debated, and the bitterly contested passage of President Obama's ACA, a law aimed at revising the country's health insurance system through the creating of a federal health insurance exchange to facilitate increased competition among insurers, has rekindled the debate over who holds the ultimate responsibility for regulating the care provided by hospitals, community clinics, and private practices.

Healthcare is often driven by consumers and insurance companies; there is strong pushes for insurance companies to start paying better through Patient Care Medical Homes (PCMH) or Accountable Care Organizations (ACO) rather than paying at a per-visit basis (Hamlin, 2015). With PCMH or ACOs payment is made on a continuum of care, encouraging the provider to be involved in all aspects affecting health of the patient (Derksen, & Whelan,

Melnick, G., & Fonkycj, K. (2013). Fair pricing law prompts most California hospitals to adopt policies to protect uninsured patients from high charges. Health Affairs, 32(6), 1101-1108. Retrieved from http://ezproxy.nu.edu/login?url=http://search.proquest.com/docview/1372932073?accountid=2532

The Patient Protection and Affordable Care Act (ACA) is the 2010 health reform act that could extend insurance coverage to as many as 32 million Americans, which also included policies that affect the quality of coverage insurers must offer (Knickman & Kovner, 2015). In addition to this, the ACA created a range of programs focused on furthering change in how medical care is organized and delivered, with a goal of reducing costs and improving quality and outcomes (Knickman & Kovner, 2015). However, these goals come at a cost. The purpose of this paper is to analyze the impact the ACA had on the population it affected in the United States as a nation, but specifically in the state of North Carolina; describe the impact of economics of providing care to patients from the organization’s point of view; examine how patients were affected by the ACA in terms of the cost, quality, and access to treatment; and explain the ethical implications of the ACA.

Closing out the meeting was John Connolly who serves as Associate Director of Insure the Uninsured. Connolly detailed the Covered California healthcare exchange as a commercial insurance provider. Connolly spent the majority of his time speaking addressing the improvements to coverage, and eligibility changes to applicable California residents. Making a repeated and substantial effort to state how the commercial insurance exchange would work, Connolly showed the various healthcare providers that would be available to certain individuals, and an estimation of the average cost per provider. The most significant aspect of Connolly’s presentation was his outline of the new health insurance plan tier levels, ranging from “Bronze” to “Platinum”. Bronze tier coverage represented the tier with the smallest amount of payment made by the plan and highest amount of payment made by the consumer, and Platinum tier coverage representing the highest amount of payment made by the plan and lowest amount paid by consumer.

The negative impacts of healthcare reform to health systems are significant in that health systems are preparing their resources on developing Accountable Care Organizations (ACO) for bundled payments and population-based reimbursement. In this economy the impact to health systems may require healthcare systems to figure out ways to continue to keep positive financial performance due to the cost-reduction of healthcare reform. For some time now, health systems have subsidized their losses from the Medicare and Medicaid systems by contracting with commercial payers for their premium rates. As a result of the healthcare reform, cost shifting will shrink. Another negative impact over the next few years will be the large shift in health plan enrollment. Less people will be covered by highly

It has been one year since the implementation of the Patient Protection and Affordable Care Act, also known as Obamacare. Despite countless Republican attempts to repeal all or part of the new law, it is still with us and shows no sure signs of disintegration. The rollout of the government’s health care exchanges experienced significant growing pains right from the beginning. Time has fixed many of these technical glitches, but has done little to quell the debate over the affordability and viability of the law.

‘Some counties don't have certain types of doctors” (Leonard 2). If an individual only has one insurer that supports that area, that insurer may not cover that doctor or hospital in that area, which can result to that individual driving far out of their area, just so they can see a doctor or get their medical treatment for a reasonable price. Individuals are also being limited with options because their insurers may see them as costly, and they could force the individual to go to under resourced hospitals (Goodnough 3). This shows that even if an individual does not live in a rural area and has plenty of options to choose from, they can still be limited in location because their medical treatment can be seen as too expensive, and the insurance company has to figure out a way to save money.

The Affordable Care Act was signed into law by President Barack Obama on March 23, 2010. The Affordable Care Act also nicknamed as “ObamaCare” faced huge amounts of adversity and challenges on its way to being ratified and upheld by the Supreme Court. Some of these arguments highlight the disadvantages of free social services, the escalating federal deficit, and the altering the healthcare industry’s landscape completely. Healthcare is generally defined as providing for the wellbeing of a personal through medical services. In America, all services come with a price, and healthcare has become an industry that is nearly only about the money and less about the patient. Needless to say, the quality of care that a patient receives is almost

Through the history of health care, the standard of care changed from protecting our patient from injury and illness to a systemic entity to make money for insurance companies. Access to services and clinical outcomes are dependent on what health insurance providers will “pay” for in a clinical or community setting; as a result, patient safety, care and satisfaction has been negatively impacted.

In 2010, following much controversy, the Affordable Care Act (ACA) was deemed constitutional by the Supreme Court and signed into law. (Aoughsten, Johnson, Kuruvilla, & Bionat, 2015). Though this law is still relatively new, the public is reeling for a report on its effects on healthcare so far. The ACA is projected to reduce the uninsured rate by approximately 26 million by the year 2017, but people hunger for the effects on costs, the quality of their care, and any implications on their current healthcare situation (Blumenthal & Collins, 2014). The ACA strives to improve the overall healthcare system and create a patient-centered structure (Yuh, Dall’Era, Penson, & Evans, 2015). These goals have shifted the idea of healthcare we have always had in the United States and allowed healthcare to be focused on the patient as a whole and not just the disease they have. The Affordable Care Act should be continued as the United States healthcare

The Patient Protection and Affordable Care Act (PPACA), also referred to as the "Affordable Care Act" or "ACA" or "Obama Care") is the major health care reform bill passed into law on March 23, 2010. The debates surrounding the PPACA have been volatile at times, and continue to be the most intense public examinations of any piece of legislation in our recent history. The affordable Care Act (Obamacare) is ripe for repeal. For the American public, there are ample reasons for dissatisfaction: higher costs; arbitrary and sometimes absurd rule-making; bureaucratization of an already overly bureaucratized sector of the economy; incompatibility with personal freedom and religious liberty; enormous spending and heavy taxation; and widely acknowledged design flaws, evident in the ACA’s hopelessly complex and unworkable subsidy schemes, boondoggle bailouts, and collapsing co-ops. Nonetheless, other ACA legal challenges were still facing the healthcare law. In December 2015, the Association of American Physicians and Surgeons (AAPS) submitted an amicus brief to the Supreme Court arguing against the constitutionality of the employer insurance mandate within the Affordable Care Act. The law contains a number of experiments designed to drive down health costs, such as Accountable Care Organizations. The whole idea is to move the system away from paying for volume and toward paying for value. We still don't know whether that will happen. But it's fair to say that reducing the cost of health care will make it easier to expand coverage. The nation’s gains in health care coverage and delivery system design over the last several years have made measurable differences in the lives of millions of Americans. There are many ways to achieve a high-performing health system. But it’s critical that the nation remain committed to this goal.

When the Affordable Healthcare Act passed in 2010, I like many others thought it was a good idea and would make health insurance attainable for the millions of Americans who were not insured. The Affordable Healthcare Act was supposed to lower premiums for households between 100% and 400% above the poverty line through tax credits, and support innovative methods designed to lower healthcare costs. Unfortunately, this is not the case 7 years into the ACA, and millions of Americans can no longer afford the insurance offered to them through the healthcare exchange and must make sacrifices to avoid the penalty. This rise in cost has not only impacted the consumers of the exchange, but has also impacted the majority of Americans who purchase

There are two principal conditions leading to physician shortages in rural communities according to Wright and colleagues. They are “demand-deficient”, meaning they have insufficient populations and resources to support a physician practice, they are “ambiance-challenged,” meaning they are isolated, lack quality services and amenities, and/or are in geographically unattractive settings, or a combination of the two sets of conditions. Inner-city physician shortages are a more recently recognized issue. They are affected by the same conditions, though the specifics are different (Wright, Andrilla, and Hart 2001).