Health Care Vs Primary Care

In 2010, a Patient’s Bill of Rights was put into place to protect consumers from the worst abuses of the insurance industry, such as prohibiting denying coverage of children based on pre – existing conditions and regulating annual limits on insurance coverage. In 2011, those with Medicare were able to get key preventive services for free and they were given discounts on brand name drugs. In 2012, Accountable Care Organizations helped doctors and health care providers work together to deliver better care. Examples of this include reducing paperwork and administrative cost and encouraging integrated health systems. In 2013, open enrollment in the Health Insurance Marketplace began on October 1st. In 2014, all Americans were given access to affordable health insurance options. These options include, making care more affordable and increasing the small business tax credit. In 2015, physicians were paid on value not volume meaning that physicians that provide a higher value of care will receive higher payments than those who provide lower quality care. In simpler terms, the key features of the ACA are free preventive care, protecting against health care fraud, small business tax credits, health insurance marketplace, consumer assistance, Rx discounts for seniors, and prohibiting denying coverage based on pre – existing conditions (Assistant Secretary for Public Affairs,

Anderson, Amy. “The Impact of the Affordable Care Act on the Health Care Workforce.” The Heritage Foundation. N.p., n.d. Web. 14 July 2015. This paper is a through report on the impact of the ACA on the workers in healthcare, particularly on the ratio of worker to patients. It shows that the act will increase the physician shortage, particularly in already underserved areas and specialties. It will also greatly increase the stress on workers, due to the increase demand from each physician or nurse and the increased amount of regulatory paperwork required. Many healthcare providers are merging into larger business to cut costs; others are running cash-only or annual-fee models. The act attempts to transition to paying physicians for performance

Out of the government budget of 132.4 billion for health, $50.6 billion was spent on primary health care in 2011-2012 which is 38.2% of the budget ( AIHW 2014).Primary health care is team based care consisting of health professionals such as medical practitioners, nurses and midwives, and allied health professionals such as medical practitioners, psychologists and optometrists. There are principles put in place to ensure adequate and professional care is being provided by the primary health care system and it is the principles which are most of importance

The patient centered medical homes (“PCMH”) approach “focuses on keeping people well, managing chronic conditions like diabetes or asthma, and proactively meeting the needs of patients.” According to the Arkansas Department of Health, chronic diseases like cancer heart disease or diabetes affect approximately over fifty percent of adult Arkansans. Yet chronic diseases are often preventable. The high rate of chronic diseases can partly be attributed health insurance coverage—“when people don’t have health insurance they tend to avoid seeing doctors. People

Health care coverage for individuals and small businesses will become more affordable and accessible (House Committee, 2010). The bill erases deductibles and co-payments for preventive care. Due to the recession, many American families struggle to pay the co-payment at their doctor’s office. The Patient Protection and Affordable Care Act does offer money directly to the consumer by eliminating co-payments at the doctor’s office (House Committee, 2010). There will be incentives for doctors to practice in poor areas of the country. For example, a new doctor fresh out of medical school would receive additional federal funds to establish their business and hire qualified personnel (House Committee, 2010).

Although the ACA have made progress, many still question whether or not this new law is working. The law is too complicated for people to understanding their coverage. "The ACA is not perfect", "but at least" the U.S. has taken one step toward reducing the disparities between rich and poor and providing health coverage to everyone (Gruber, 2011). In this paper I will discuss the benefit of the ACA and the affect it will have on provider reimbursement.

While the Affordable Care Act was implemented in 2010, the most significant changes in the healthcare system began in 2013 with the expansion of Medicaid. According to the ACA’s official website, the law’s main goals are to create cost efficient health insurance and medical services, as well as expand Medicaid so that the stated programs will be available to more Americans. (“Affordable Care Act (ACA)”). To do so, the ACA imposed many requirements on both sides of the health care system. The ACA has expanded federal regulations on private insurance providers by requiring that these companies cannot deny coverage based on the health of the beneficiary. The ACA has also established a marketplace for health insurance to be purchased by small businesses and individuals. Finally, the most noteworthy reform is the requirement for all Americans to purchase minimum coverage, or pay a penalty. However, those who cannot afford coverage and have “an income below 138% of the Federal Poverty Level eligible for Medicaid” will be paid for by the government (“The Affordable Care Act in the US”).

Understanding the Affordable Care Act (ACA) can be problematic, the goal of the ACA is to address the fact that millions of Americans do not have health insurance, yet they are contributors to the health care market, consuming health care services for which they do not pay. While this may seem to be a great idea, many Americans are not really sure how they are affected by this Health Care Reform. The goal is to make health insurance affordable, secure, and reliable for all. The ACA is a minimum coverage provision, individuals are given health insurance by amending the tax code. There is an individual mandate which stipulates all non-exempt individuals must maintain a minimum level of insurance or pay a tax penalty. ACA extends Medicaid, states have to accept or they will not receive Federal funding. The act also includes an employer mandate to obtain health coverage for employees. The Affordable Care Act has changed the way health care is provided and the way individuals will participate (The Affordable Care Act Cases. (n.d.). Retrieved September 3, 2015)

The Affordable Care Act (ACA) was created by President Obama back in March 2010 to help reduce healthcare costs and improve healthcare quality for uninsured Americans. The ACA was implemented to reduce the cost that was growing with Medicare and Medicaid because they have increased over the years threatening the entire federal budget (Amadeo, 2017). People who are not working and are unable to cover their healthcare expenses usually end up on Medicaid which is paid for by the government. The others who are over the age of 65 are on Medicare and have their premiums supported by the federal government. However, people who make too much money or who are too young to qualify for either

The Affordable Care Act (ACA), also known as ObamaCare, is a healthcare reform law that focus on providing more Americans with access to affordable health insurance. “The ACA is expected to add 32 million people seeking primary and preventive service and treatment” (journalofnursingregulation.com). It was first enacted by President Barack Obama on March 23, 2010. The act has offered a number of people with benefits, set up a place they can purchase health insurance, expanded the use of Medicaid and Medicare to the disabled and senior citizens. The Act has forced many employers to offer coverage to their employees. Despite all of the positive attributes this act has provided, there is a flip side to it. Americans are required to have health

The ACA provides various benefits to Medicaid enrollees by expanding coverage to include mental health, prescription drugs, family planning services, hospice care for children, tobacco cessation, preventive and obesity related services. The main provision of the act is to reduce cost while improve the quality of care and the way it is delivered. The law prohibits insurance companies from dropping coverage for any reason, provide insurance even if there is a pre-existing condition. Provide coverage for preventive services and immunizations. Dependant coverage is extended up to age 26. The law established a cap on insurance company’s spending on non-medical costs and administrative expenditures. Insurance companies cannot charge more money based on an individual’s health status, gender or salary. The ACA reforms Medicare by closing the coverage gap also known as the “donut hole” by continuing coverage for prescription drugs.

The Affordable Care Act aims to help small businesses get health insurance for their workers. According to the US government, the Act should "help increase the number of primary care physicians, nurses, physician assistants and other health care professional.

When the Affordable Care Act was first enacted, the main purpose was to reduce the number of individuals in American who did not have health insurance. Based on the idea of the individual mandate, the Affordable Care Act required that all individuals obtain health insurance, thus creating programs and options for individuals who found it difficult to afford it (Kaiser Family Foundation 2013). Those who failed to obtain health insurance would essentially have to pay a penalty tax. Additionally, eventually businesses of a certain size would also have to offer insurance options to employees. To assist those who could not afford health insurance, the ACA also formed state-based American Health Benefit Exchanges, which would provide subsidies, cost-sharing credits, and assistance to individuals/families with income between 133-400% of the federal poverty level (FPL). (Kaiser Family Foundation 2013). Most importantly, those who fell at 133% of the FPL or below would be eligible for Medicaid, a federally funded health insurance program. Prior to the ACA, Medicaid was only offered to

The primary goal of the Affordable Care Act was to expand health care access to Americans and subsequently reduce the number of uninsured in the nation. From September 2013 to March 2015, there was a significant reduction in uninsured Americans from 17.6% to 10.1% (Anderson, Hempstead, Karpman, Kenney, Long, Shartzer, Wissoker, Zuckerman , 2015). This was achieved through the new laws affecting private insurance and the expansion of the government’s Medicaid program. The ACA started the process by extending tax credits to an estimated 4 million small businesses that would help them provide insurance for their workers in 2010 (Implementation, 2016). In 2013, a marketplace exchange was finally opened for the American people to compare and purchase

The current health care sector is too costly and too fragmented with a lot of variation in care even with established evidence based guidelines. Providers lack the tools, support and information they need to offer the coordinated health management that can reduce cost and improve outcomes. Primary Care Physicians are constrained in their abilities to perform any proactive care that involves avoiding Hospital or ER visits, and influencing healthy lifestyles.