The And Skewed State Of The U.s. Health Care

In 2010, the United States created The Affordable Care Act (ACA). The objective was to share the responsibility of costs between the government, individuals, and employers to provide affordable access to quality health insurance. “However, health coverage remains fragmented, with numerous private and public sources, as well as wide gaps in insured rates across the U.S. population.” (“United States: International Health Care System Profiles,” n.d.). Each individual state within the US, generally has control over private insurance.

The Accountable Care Organization (ACO) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients (McCarty, B., 2016). For example, Medicare Shared Savings Program was created by The Center for Medicare & Medicaid Services to monitor and establish that all ACO’s are meeting the quality performance benchmarks and reduce Medicare spending by certain percentages (H., 2017). The growth of ACO’s from 2011 to 2016 is astonishing, in 2011 there was 64 ACO’s and by 2016 they have risen to 838 in the U.S. (H., 2017).

The ACA is made up of a series of additions of and changes, to the multiple laws that are made up from the legal framework of the U.S. healthcare system. This act establishes the basic legal protections that have been nonexistent to the United States, will now guarantee access to affordable health insurance coverage for Americans, from when they are born, all the way through his or her retirement. The act hopes in cutting the number of uninsured Americans by more than half of the U.S. population (Rosenbaum, 2011, p.130). This law hopes to result in health insurance coverage for about 94% of the American population (Rosenbaum, 2011, p. 130). This will reduce the population of uninsured Americans by 31 million people, and increase Medicaid enrollment by 15 million recipients (Rosenbaum, 2011, p. 130). Approximately 24 million people are still expected to remain without a coverage plan. The act has several goals. For instance, one goal of the ACA is to have a close to universal coverage system, with the help and responsibility among individuals, employers, and largely, the government. The second goal is to improve the fairness, condition, and affordable prices of health insurance coverage for Americans (Rosenbaum, 2011, p. 130). Lastly, a third goal is to improve the quality of health care through value, excellence, and effectiveness while trying to reduce inefficient spending and making the healthcare system more reachable to a diverse population (Rosenbaum,

The Medicare Shared Savings Program was established by section 3022 of the Affordable Care Act and aims to improve beneficiary outcomes and increase the value of care by providing better care for individuals, better health for populations, and lowering growth in expenditures (Lieberman, & Bertko, 2011). The Affordable Care Act created ACOs, which is part of Medicare since January 2012, together with a Shared Savings Program it has the potential to lower costs, improve the quality of care, facilitate delivery system reform, and promote innovation in health care ( Lieberman, & Bertko, 2011).

One of these examples is the Meridian Health Accountable Care Organization. “In January 2013, Meridian was selected by the Centers for Medicare &Medicaid Services (CMS) to participate as a Medicare Accountable Care Organization (Meridianhealth.com). When a system is selected to become an Accountable Care Organization it can choose one of three routes. They are Medicare Shared Savings Program, Advanced Payment ACO Model, and Pioneer ACO Model. Meridian Health chose the shared savings program. This program goals include better care for individuals, better health for populations and lowering growth in expenditures. The Shared savings program also rewards “ACOs that lower growth in health care costs while meeting performance standards on quality of care and putting patients first” (CMS.gov). The next type of ACO is the Advanced Payment Model. This model is “designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the Medicare patient they serve… selected participants will receive upfront monthly payments”(CMS.gov). This form of ACO is for systems that do not meet the requirements for Shared Savings because they are too small in size and they do not have access to capital so that they can invest in upgrading their system. So far there are 35 ACO using this model and so that they can

Providers could shape these ACOs willingly. On the other hand, they could be practical ACOs acknowledged during analysis of claims data showing shared use of medical services in a population served by hospitals and their medical staffs (Fisher, Shortell, Kreindler, Van Citters, and Larson, 2012).

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

Affordable Care Act (ACA), arguably the most comprehensive health care reform of the American medical system in several years. The act alters the scope of the uninsured in the United States, requires that most, if not all, residents have health insurance, expands public insurance and subsidizes private insurance coverage, generates additional revenue from new taxes, and reorganizes spending under the nation’s largest health insurance plan, Medicare. The ACA seeks to establish a drastically different health care model for the United States in the years to come, if fully implemented.

The Health Care Reform Act is also known as the Affordable Care Act (ACA) was signed into law by President Barrack Obama on March 23, 2010, (Touhy & Jett, 2014, p. 111). Its goals are to expand coverage, control health care costs, and improve the health care delivery system. It focuses on health promotion and greater emphasis on preventive care. The new legislation allows people and small businesses to purchase health insurance coverage through the health insurance market places—a virtual insurance mega mall where private insurers compete for business. The market exchange ensures that insures follow strict guidelines and compete fairly allowing people the opportunity to compare plans that best suits their needs.

Accountable care organizations are growing. Accountable Care or Coordinated Care is putting consumers at the front at our evolving healthcare industry. Accountable Care Organizations (ACO) strive to improve outcomes and reduce costs with improved patient care coordination (Robinson, J. C., Schaffer, L. D. 2015). Coordinated Care is defined as the Right care, at the right time, with no duplication, and to prevent errors. The Affordable Care Act encourages health care organizations to improve quality of care and reduce spending. In 2013, there were 320 ACO’s and as of 2014 there are now 700. 2/3 of the population now live in an area that services ACO’s. One out of three hospitals have ACO plans (Perficient Inc. 2015).

The Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA) for short, is the new health care reform law in the United States of America and is often referred to by its nickname Obama Care. The Affordable Care Act was signed into law on March 23, 2010, to reform health care in the United States of America. ACA is a part of the Democratic Congress and President Obama’s efforts to reform the American health care system in order to provide health insurance to millions of uninsured American citizens and lower the expenses linked to health care. This new health care act is one that contains various enhancements to the quality and availability, as well as the affordability of health insurance. There have also been improvements with the new cost cutting measures, rules and regulations for both public and private health insurance companies along with the health care industry. Since the ACA was signed into law,

Given huge potentials and resources, the healthcare system in the United States stands among the best in the world; however, it has been constantly plagued with issues of cost, access, quality and distribution.1 The national health expenditure levels on per capita basis as well as the percentage of GDP has for several years remained higher than other OECD countries but has in contrast, been ranked low on significant health indicators.1,2 As part of the ongoing healthcare reform efforts, the Affordable Care Act (ACA) was passed in 2010 which led to outright and possible immense changes in healthcare.1 Accountable Care organizations (ACOs) were presented as the healthcare delivery system signature of the ACA, as a novel Medicare payment model.3

I am aware that there is many components to this process and transitioning to this style of patient care may be quite challenging. The primary six guidelines to creating a successful ACO is only the groundwork or blueprint to base organizations on, which most hospitals are expected to adhere by whether they are part of an ACO or not. These six guidelines tie in two major aspects of an organizations financial profile in terms of market characteristics and competitive pressures. Some of

There are three core principles to any ACOs. First, provider-led organizations with primary maintenance and a strong base are liable communally and total per capita costs for quality with full continuum for the population of care for patients. Second, excellent improvements will have linked to also have complete costs reduced, and third, progressively and reliable sophisticated measurement performance to improve, support, and provide the savings of confidence are achieved with improvements of care, , McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES (2010).

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