Hcs 235 Week Health Care Utilization Paper

1067 Words5 Pages
Health Care Utilization Paper
HCS/235: Health Care Delivery in the U.S. Health Care Reform
The Patient Protection and Affordable Care Act of 2010 (PPACA) was designed to decrease health care costs and require health care access to all U.S. citizens. The Act has the potential for reducing the cost of health care in the United States; however, with many risks which could possibly strain the health care system, increase debt, and decrease the quality of care many are concerned.
Access to Care
The PPACA was enacted in 2010; however, the Act was not completely implemented right away. The health care reform has been dispersing provisions as the years progressed. Provisions such as simply investing in new resources to fight against
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Utilization Utilization management has taken a key role in the health reform act because it evaluates the need, appropriateness, and the efficiency of the health care services which will be used by the covered individual. Health insurance plans are pressured to find ways to reduce plan costs and improve the quality of care provided to their members. Utilization management efforts have reduced inappropriate services and high medical costs just by taking some time to review pre-authorizations instead of providing clinically inappropriate, out-of-network services which prevents the accurate care for patient and increases cost for plans. Today’s decision-making and support of utilizations for members are performed in real-time. Real-time utilization achieves the decrease of unnecessary expenses and improves member’s health. Use of unnecessary services increases the cost for plans and limits them on the amount of services they can provide to members who are in dire need of them.
Universal Health Care Achieving the goal of providing health care benefits for all U.S. citizens is a goal that is not new in our health care system and still lingers to be resolved by government officials. The health reform act’s provisions are stated to achieve these goals. The Medicaid

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