Stakeholders in Health Reform

Health Care in the United States is a vast industry that has many different types of people involved in the delivery of care. There are stakeholders that affect the daily operations of health care and they are not necessarily in a hospital setting. The Agency for Healthcare Research and Quality, AHRQ, defines a “stakeholder” as persons or groups who have a vested interest in the clinical decision and the evidence that supports that decision ("Effective health care," 2011, p. 1). These stakeholders are making decisions that impact costs, procedures, and the future of

The American Health Care system needs to be constantly improved to keep up with the demands of America’s health care system. In order for the American Health Care system to improve policies must be constantly reviewed. Congress still plays a powerful role in public policy making (Morone, Litman, & Robins, 2008). A health care policy is put in place to reach a desired health outcome, which may have a meaningful effect on people. People in position of authority advocates for a new policy for the group they have special interest in helping. The Health care system is formed by the health care policy making process (Abood, 2007). There are public, institutional, and business policies related to health care developed by hospitals, accrediting organizations, or managed care organizations (Abood, 2007). A policy is implemented to improve the health among people in the United States. Some policies

Stakeholders are a big part of a healthcare organization. They play a major role in the Healthcare Delivery System that plays a part in the performance and the health of the organization. Five of the major stakeholders consist of government, providers (which includes doctors, nurses, pharmacists, and other healthcare providers), patients, insurance companies, and pharmaceutical companies. Based off of the healthcare delivery system where it stands now, there are some recommendations that the stakeholder can do to have a positive effect on the healthcare delivery system.

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.

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

In today’s day and age, American households can all agree that health insurance is not a luxury, but a necessity. Without it, costs of emergency room visits and prescription medicines can be financially devastating. However, in the past many families and individuals have taken the risk of not being insured due to the high cost of the insurance itself. To attempt to reform this unfair system, the Obama administration signed into law the Patient Protection and Affordable Care Act in 2010. The law, coined “Obamacare,” has received much opposition due to its expansion government programs and increase in spending. It brings to question how much the government should be involved in an area that for the majority of America’s history, has been

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

Dr. Donald A. Barr in Introduction to US Health Policy discusses the different methods in which states attempt to expand health care coverage throughout his book. In chapter eight, The Uninsured, Barr focusses on one such successful expansion. Massachusetts increases the number of people insured in their state through individual mandate, a term used to describe when a government requires individuals to obtain health care (240). After the success of Massachusetts, the federal government attempted a similar system through a policy called the Affordable Care Act (ACA). How does the ACA compare to the Massachusetts’s policy? Though the ACA was made to reflect the Massachusetts’s individual mandate policy, they also have some key differences.

Since the implementation of the Affordable Care Act (ACA) in 2010, there has been a continuous debate about the effects it will have on the United States economy. Many people argue that expanding insurance coverage for all people will create crippling cost burdens for the economy and taxpayers. While others believe that the ACA will in fact give the economy a much-needed boost. In 2006 as a measure to improve overall healthcare, the state of Massachusetts implemented the Health Care Insurance Reform Act. This paper looks at the positive and negative effects of the Massachusetts Health Care Insurance Reform Act (MHRA). Using a literature review of public health studies ranging from 2009-2012, I argue that there are both positive and negative effects of the Massachusetts Health Care Insurance Reform. While the Massachusetts Reform increased health insurance coverage for all citizens and decreased the number of uninsured citizens accessing emergency rooms, it also did very little to decrease already existing racial, ethnic, and socioeconomic disparities among minorities and whites in the state of Massachusetts. Understanding the Massachusetts Health Care Insurance Reform Act may help in the goal of trying to achieve near-universal healthcare. This paper provides an understanding of the missing pieces in the Massachusetts Health Care Insurance Reform Act and constitutes a starting place from which to understand the Affordable Care Act.

There are many people who have a stake in the healthcare industry. There are several stakeholders such as the patients, healthcare providers, insurance companies, organizations, and those who enforce policy. The patients’ interest is the need of the best healthcare procedure to be healthy. As a healthcare provider the quality of care that can be useful for patients. Insurance companies sells health insurance to patients or employer that can be beneficial to providers. Organizations develop plans that are used for patients. Policymakers create and implement laws that to improve quality care to the public. These stakeholders can play a major role in the safety concern of patients. The concern for the safety issues of vaccination in children

Also by rejecting the Medicaid expansion community-based providers, including hospitals are casualties. Hospitals will continue to provide care to the uninsured without sufficient compensation, increasing shift costs to the privately insured. This also has a chilling effect on enrollment in private insurance plans through the new federally facilitated marketplace. Opposing the Medicaid expansion also ignores the real needs of the uninsured and the massive financial burden shouldered not only by the hospitals but taxpayers and businesses. (Stultz, 27)

It has been proven that stakeholders, either an individual or an health care organization play a key role within strategic implementations and policy developments

In 2006 the state of Massachusetts wanted to help its millions of citizens who were uninsured. The state legislators as well as the governor put into place a plan to help citizens get insurance. A law was passed to reform insurance in Massachusetts, which was known as Chapter 58 of the Acts of 2006 of the Massachusetts General Court; its long form title is An Act Providing Access to Affordable, Quality, Accountable Health Care.

According to Ingols and Brem (as cited in Swayne, Duncan, and Ginter, 2006), Massachusetts is known across the world for computer technology, education, and health care. In the words of the authors, Massachusetts' "health care expenditures per capita were between 27 and 29 percent higher than the national average from 1990 to 2000." At the time, there was a general consensus that Boston's health care was relatively expensive as a result of the region's cutting edge and high quality services (Ingols and Brem, 2006). During the 1990s, a number of healthcare insurance plans at the national level chose to merge in an attempt to further enhance their ability to compete effectively. This trend according to Ingols and Brem (as cited in Swayne, Duncan, and Ginter, 2006) was also replicated in Massachusetts where the eventual formation of three large competitors had far-reaching consequences. One consequence of the increasing power of these three formations in the marketplace was reduced payments.

Each of the stakeholders of the healthcare industry can be directly affected by one changing component of the system (VanDurme et. al., 2014). An interlocking network in healthcare consists of patients, physicians, hospitals, insurers, employers, and regulators. Working for a nonprofit hospital, the stakeholder education and audience reassurance remain the priorities. They struggle to cope with the operational consequences of the reform law in the threatening economy. Over the past three years, mass layoffs have occurred in hospitals to reduce costs and increase efficiencies. This is a prime example of how each stakeholder is directly affected. When layoffs occur, the patients may not have the proper care that is needed and can cause physicians