Health Policy

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,

Patient access to affordable health care is an ongoing issue in the United States. The first portion of the policy process involves three different stages, the formulation stage, legislative stage, and the implementation stage. Three main stages exist in the process to transform a topic into a policy (Morone, J. A., Litman, T. J., & Robins, L.S., 2008). Coupled with the implementation stage is an evaluation of all the stages to determine effectiveness and gather information for use in future public health care policy making. In the formulation stage, the ideas, concepts, and information steam from this process of policy making. The

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

Hospitals should be encouraged to participate because improving hospital care is likely to be essential to success (McClellan et al, 2010). Accountable care organizations can be implemented through different payment models. These could include opportunities to share in demonstrated savings within a fee-for-service environment, in which providers took on no new financial risk. They could also include limited or substantial capitation arrangements, in which payments were unrelated to the volume of services provided, to the intensity of service use, or to the frequency of face-to-face meetings, and in which providers took on some financial risk for poor-quality results or failure to control costs (McClellan et al,

North Carolina Institute of Medicine (NCIOM). Examining the Impact of the Patient Protection and Affordable Care Act in North Carolina, 2012. Retrieved from http://www.nciom.org

In the past few years the American health care system has changed in many ways. First there was the passage of the Affordable Care Act, which is a law that is giving Americans the opportunity to obtain health care. Under this new law, in 2011, the Department of Health and Human Services decided to create Accountable Care Organizations (ACO) to help doctors, hospitals and other providers better coordinate care (AthenaHealth.com). The first idea of an Accountable Care Organization was brought up in 2006 by Elliot Fisher, MD, and now there are over 400 in the United States (Healthcatalyst.com). An ACO’s primary job is to improve health care delivery, performance, and payment. This is done through physicians and

Providing enhanced access to a better quality health care system is reliant upon the identification and modification of various barriers, which must be addressed. Complex health care systems and politics generate barriers to the delivery of high-quality access to care through knowledge deficits. Consumers are tasked with understanding what services are needed as well as their abilities comprehend their diagnoses are challenged. They must also over come barriers to communication to converse effectively with caregivers. Most importantly, they must understand their role in the process as patients and citizens when accessing health care services. (Ricketts, 2013) Comprehensive provisions built into the ACA help to energize endeavors aimed towards developing ways to ensured enhancements to the quality and access to health care provided in North Carolina. Accountable care organizations (ACO) were

The goal of this policy brief is to support Alabama’s current decision to continue Medicaid Primary Care Parity, as first enacted by congress in 2010 to all states under section 1202 of the Affordable Care Act (ACA). However, as Alabama is facing budget cuts to its Medicaid services, supporting the “Ensuring Access to Primary Care for Women and Children Act” will extend federally funded Medicaid primary care parity without harming the state budget and negate the consequences of limiting Medicaid enrollee access and benefits. The federal government proposed to pay 100% of Medicaid services mandated under section 1202, from 2013 to 2014, which has since expired in December 2014. This program requires certain primary care services to be reimbursed at higher rates equivalent to those rates paid by Medicare for equivalent primary care services. Limited provider participation, limited Medicaid beneficiary access & decreased enrollment of physicians, physician assistants (PAs) and nurse practitioners (NPs) into primary care can be improved through this monetary incentive.

With the implementation of the ACA, many states have expanded their Medicaid programs to include a larger population of low income individuals and families that were not able to obtain health insurance prior to the law. Some of the issues that state legislators struggle with are the overall cost of providing services for the additional recipients, staying within budget, determining an adequate approach of offering quality care, and providing adequate coverage for each recipient. Even though the cost of Medicaid expansion within each state has increased the budget for the program, new appraisals has shown that Medicaid programs spend less per enrollee than commercial health insurance and much of the increase in Medicaid expenses originate from the increase in enrollment in the programs (Coughlin, Long, Clemens-Cope, & Resnick, 2013).

The accountable care organization I researched is called the Physician Organization of Michigan ACO (POM ACO). The POM ACO is a joint venture of the U-M Health System and physician groups around the state, with the aim of improving care for 81,000 Michiganders enrolled in traditional Medicare and slowing the growth of health care costs, according to the announcement by the U-M Health System (Daly, 2013). The group was launched on January 1, 2013 under the Medicare Shared Savings Program. 12 physician organizations from around Michigan came together to take part in a Medicare-sponsored program that strives to improve on the quality of care for traditional Medicare recipients, while also containing cost growth. In 2014, POM ACO expanded to include all the University of Michigan faculty physicians and thousands of other providers from the University of Michigan Health System. The POM ACO is now one of the largest accountable care organizations nationwide. More than 5,700 physicians and other providers are now involved in the POM ACO. Therefore, the POM ACO is organized as a physician-hospital organization. Hence, the patient has more flexibility in where and how their care is delivered. The patient can still use any doctor or hospital that accepts Medicare at any time.

The financial analysis of the health sector was done in the Belhaven town to have favorable health. The Accountable Care Organization played a great role in doing the study of the major hospitals in the city. The organization is concerned with setting up of hospitals and doctors that would share health and financial responsibilities in controlling care spending in the institutions. It is a requirement of every Affordable Care Act that each Accountable Care Organization should attend the health needs of over 4000 Medicaid patients for about three years (Bard & Nugent, 2011). The Belhaven Township worked in collaboration with the other organizations in creating a feasible plan for the Accountable Care

The years 1996 to 1997 brought about another wave of health care reform for Massachusetts. The expansions in 1996 and 1997 resulted in an increase in the number of people enrolled in MassHealth (Massachusetts Medicaid program). As well, one of the key elements of Massachusetts’s safety net is

This paper focuses on analyzing the Massachusetts health care system. Specifically it addresses how the 2006 health care reform law sought to increase health insurance coverage for the uninsured, underinsured, children, young adults, and low income residents. Its desire was for universal coverage for all its residents, and that it would be both reasonably priced and of value. The Law addressed need to decrease the barriers to health care, such as racial disparities, and overall health care costs while increasing access to provider, utilization of services, with a focus on quality care. This paper will exam how the Massachusetts health reform addressed these health care issues.

This paper focuses on analyzing the Massachusetts health care system. Specifically it addresses how the 2006 health care reform law sought to provide health insurance coverage for the uninsured, underinsured, children, young adults, and low income residents. In addition it diminished the demand side rationing that was occurring in Massachusetts. Its desire was for universal coverage, and would be both reasonably priced and of intrinsic value. The law addressed the need to decrease barriers to health care, such as racial disparities, and overall health care costs while increasing access to provider, and utilization of services. It was to focus on quality care. This paper will exam how the Massachusetts health reform addressed these

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the over