Health care spending grew 3.7 percent in 2012 and the traditional way medicine was practiced had to change (Edlin, Goldman & Leive, 2014). The Affordable Care Act and Population Health was designed based on the concept of “The Triple Aim” to foster change in patient care by providing better care for individuals, better health for populations and decrease the cost of health through improved care (Perez, 2014). As a result, population management has moved to the front by linking services, reducing hospital admission, risk stratification, pursing preventive medicine, ensuring medication review and lowering health care cost. Several organizations have follow in the pursuit of population management by forming Accountable Care Organizations …show more content…
In some areas of population health, technology in enhanced patient information is utilized to perform risk stratification to identify the high risk patients. These patient’s often have uncontrolled BP, diabetes with an HgbA1c over 9, COPD, etc. Once identified as high risk or potential high risk, these patients receive additional care or patient outreach to help manage their condition. Some organizations employee RN Health Coaches and Care Coordination teams to help these patients and identify gaps in care. The primary care physician assumes care of the patient along with striving for the patient to become active in their overall health thereby keeping them out of the hospital (Sanford, 2013). One enhanced area of population management is the PCMH model. PCMH practices increase patient’s engagement in shared decision making while providing compensation for care coordination, care management and medical consultation outside of traditional face-to-face visits (Berryman, Palmer, Kohl &Parham, 2013). A patient centered approach pushes for changes not only in the delivery of medicine but in traditional encounters. In addition, PCMH encourages increased access to the patient’s primary care physicians and improved patient satisfaction scores. PCMH and population health encourages providers to increase after hours care to decrease emergency department visits and/or hospitalizations. Thereby reducing cost and improving the patient’s
The Affordable Care Act was passed to provide American’s better access to health insurance coverage. In addition to better access the ACA improved health care quality and lowered health care cost. The ACA reformed health insurance by expanding coverage, holding insurance companies accountable, lowering health care costs, guaranteeing more choices, and enhancing the quality of care. Although some states have not implemented all the benefits of the ACA, most citizens do have access to health insurance. This paper will address some of the general highlights of the ACA, how it impacted healthcare and the nursing practice.
What is the Affordable Care Act and is it going to succeed or fail? The affordable care act is a law passed by the Obama Administration in 2010. This piece of legislation was passed to make health insurance affordable and accessible for all Americans. A lot of people refer to the affordable care act as Obamacare due to the fact that it was passed when President Obama was in office. The affordable care act was a major milestone for the United States in health care reform. It was the first time the United States passed a law that created a form of universal healthcare.
Texas’s decision the not expand Medicaid under the Affordable Care Act has took a toll on many Texans. Texas is one of many states yet to expand the Medicaid program. With the decision not to expand Medicaid, it have left many low-income families uninsured and without an option for affordable healthcare. Texas has the highest number of people uninsured in the Unites States of America. The change has now entered the third year and only 30 states have expanded the program. There is an ongoing outreach to get Texas state leaders to expand the coverage.
This paper will discuss what the Accountable Care Organization is, why did Congress include it in their law, benefits and challenges for physicians and patients, and how does the ACO work for patients. We will also identify the quantitative methods in the ACO and reflect on the information provided.
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;
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
As more provisions of the affordable care act continue to be implemented many find controversy ineffectiveness of the new health plan. On an annual basis the correlation seems to grow more positive on one end, and more negative on the other. Since the start of (2014), the approval percentage of the Affordable Care Act has increased from 10% to 16%, while the percentage saying it has hurt them has also gone up, and by a similar amount, from 19% to 27% (Riffkin, 2014). Overall 41% Americans approve of the affordable care act in comparison to 53% of Americans that disapprove. The complexity of the changes really affects populations differently based on their income levels. The 2010 Affordable Health Care Act passed through congress has
When the Affordable Care Act (ACA) was enacted on March 23rd, 2010, it transformed the lives of people all over the US, in states who expanded. It allowed families to qualify for government programs such as Medicaid, CHIP, and government subsidies, and for young adults to stay on their parent’s insurance until the age of 26. The ACA was a sign of relief and good news for all but two groups, lawful permanent residents and undocumented immigrants. In 2012, DACA recipients under the DREAM Act also became part of the groups excluded, leaving more than 6.5 million unable to access affordable care. In order to make a change, the New Mexico Rep. Michelle Lujan Grisham, from the Democratic party, introduced The Health Equity
In 2010 the American government passed new health care legislation, called the Patient Protection and Affordable Care Act (ACA), in order to reform the United States health care system. This health care reform opens the door for some Americans who have never been eligible for affordable health care insurance to obtain it beginning in 2014 (Sparer, 2011). All the states will enact this legislation but some will limit the provision provided to their citizens (Kaiser Commission, 2013). North Carolina is one of the states that have chosen not to enact all of the ACA’s provisions (Kaiser Commission, 2013). In this paper, I will look at health care
The Affordable Care Act is the new health reform law that was signed into action on March 23, 2010. The Affordable Care Act attempts to reform the healthcare system by providing Americans with affordable health insurance. It helps put individuals, businesses, and families in control of their own healthcare. By the sound of it, it really looks like this is something that will positively impact the lives of Americans, and make it easier for individuals to obtain health insurance. Unfortunately, what many Americans are unaware of is that there are so many underlying issues that make the Affordable Care Act not so affordable. Issues such as penalties and taxes that certainly rack up the cost on individuals, businesses and even hospitals that make it difficult for people and businesses to be in “control” of their health care.
Affordable Care Act (ACA), and the aging of the population are the three major factors driving healthcare costs at this time (CMS, 2014). The nursing profession has the ability to contribute to refining the cost-effectiveness and efficiency of care through the delivery of evidenced-based treatment strategies to known populations with communal needs, and by advocating for polices that address the fundamental aspects that influence health and healthcare (Curley & Vitale, 2016, p. 5). The NE must be well-informed of laws entrenched in policy, as well as those central to both healthcare delivery systems and payment structures. Having knowledge of policy and law will enable the nurse leader to provide financial stability and sustain quality
Basic changes were needed in the way Americans got health coverage. Trying to figure out what it was going to cost them starting in 2014, when major parts of the Affordable Care Act, also known as “Obamacare”, went into effect was the challenge. The four main ways Americans experience healthcare once the Health Reform Law was fully in effect were coverage by an employer, the government, buy it themselves or have none. About half of Americans get insurance through their jobs. About one third through the government like Medicare and Medicaid. About one in ten purchase insurance themselves. And still another 30 million, just under one in ten, no coverage at all.
The Affordable Care Act (Patient Protection and Affordable Care Act), commonly called "Obamacare," is a federal statute that was signed into law in March of 2010 (PDF, n.d.; Van de Water, 2011). It basically requires the vast majority of people in the United States who do not have insurance coverage to acquire that coverage or face penalties. People who already have insurance through their employers or on their own will not be asked to change companies. Additionally, anyone who is on federally-funded insurance such as Medicaid or Medicare and still qualifies for those programs will not be removed from their insurance. They will still be covered and protected. In order to find out more about the Act and really understand its main points and principles, however, it is very important to be aware of how it became a law and any changes that have taken place to it from its inception all the way through where it is today. Only then can a person have a clear understanding of the Act and form an opinion as to the value it may (or may not) provide to the American public. There is still much speculation and a great deal of misunderstanding about the Act and what it involves.
The Affordable Care Act (ACA) was signed into law on March 23rd, 2010 by President Barack Obama. This radical health care law was a much-needed step in comprehensive health insurance reform. Three important features of the Affordable Care Act are 1. Improving quality and lowering health care costs 2. New consumer protections and 3. Increased access to healthcare. (Key Features. 2014). Under the umbrella of these three key features additional benefits include free preventive care, drug discounts for senior citizens, increased protection against health care fraud, small business tax credits, increased access to health care through the health insurance marketplace, consumer assistance, and non-discrimination based on pre-existing conditions.
The American health care system has been victim to an escalation in the prices of health care services juxtaposed with inefficiency in delivery of care services. There has even been cases where State spending on the actual health care increased dramatically in the United States and one of the key components of curbing this problem which has been prevalent over the mass media and has been a major discussion among physicians is the advent of Accountable Care Organizations. Accountable Care Organizations (ACOs) is structured with the goal of trying to improve health care delivery and aid in the reduction of the overall cost of services (Weissert & Weissert, 2012). If there is insufficient coordination of high quality care delivery in the health care industry, this will have a negative impact on patient safety and diminish affordable care for patients. Hence, the development of ACOs is envisioned to be the savior of medical practices and can improve the overall fabric of the American society (Bresnick, 2013). ACOs serves as one of the answers for curbing the problem of high costs, low quality care and possible segmented delivery and as much as it serve as the major determinant for improvement in patient satisfaction, there are minor