Care Act Speech

The challenge America now faces is the number of people reaching retirement will double in number by 2030, and the U.S. population will increase almost 20 percent ("Our Aging Nation," 2015). The goal is for the elderly to maintain and live with independence and dignity, as well as, provide a wide range of professional health and social service expertise, home care, and residential support and services that will be needed ("Our Aging Nation," 2015). Since the number of caregivers needed for this population will not be able to meet the demands other resolutions are considered necessary.

In the U.S, one in four will be aged 60 years and older by 2050 (U.S. Census Bureau). This represents an overwhelming number of people who will either be in the caretaker role or be the ROC. Like today, most of the care will be provided by informal unpaid caregivers. The number of informal unpaid caregivers is expected to rise from 20 million in 2000 to 37 million in 2050 (Office of the Assistant Secretary for Planning and Evaluation [ASPE], 2003). Because of the burden of care giving, many caregivers will experience depression, poor health and quality of life (Etters, Goodall, & Harrison, 2008). Their well-being is an important public health concern.

This model reimburses hospitals based on quality of care instead of the volume of patients. The quality of care is assessed by patient questionnaires and if hospitals are unsatisfactory penalties may be imposed (Edwoldt, 2012). The value-based system also affects Medicare and Medicaid. It was reported that Medicare readmissions within 30 days of discharge cost 17 billion dollars annually (Edwoldt, 2012). Due to the high costs of readmissions Medicare and Medicaid have implemented a Hospital Readmission Reduction program. A formula is utilized to evaluate readmission rates within 30 days of discharge for any medical reason related to their original admission such as heart failure and pneumonia. Upon review the hospital is potentially penalized. It is important that nurses strive to provide excellence in care despite their beliefs on the ACA. Nurses have the ability to provide a safe patient environment and reduce the risk of hospital associated infections by following hospital protocols such as hand washing.

Last year Congress passed the Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act. This act supports and advises families with caregivers. "This bill directs the Department of Health and Human Services (HHS) to develop, maintain, and periodically update a National Family Caregiving Strategy." (www.congress.gov) Former President Barak Obama also supported contributed to the AARP organization by creating the Obama Care Bill. This bill helped families of any age receive health care. The Federal government is also tackling the illegal discharge of patients in nurse

At last, the law gave new alternatives and motivating forces to help states rebalance their Medicaid long haul mind programs for group based administrations and backings as opposed to institutional care. All in all, these arrangements have quickened Medicaid advancement effectively in progress in numerous states. Also improved with the ACA besides Medicaid, is Medicare. The Affordable Care Act incorporates a progression of Medicare changes that will create billions of dollars in reserve funds for Medicare and fortify the care Medicare recipients get. The new law secures ensured benefits for all Medicare recipients, and gives new advantages and administrations to seniors on Medicare that will help keep seniors solid. The law likewise incorporates arrangements that will enhance the nature of care, create and advance new models of care conveyance, suitably value administrations, modernize our wellbeing framework, and battle waste, extortion, and mishandle. A big topic that is affected from ACA is businesses. The Patient Protection and Affordable Care Act -- otherwise known as Obamacare -- is putting such a small dent in the profits of U.S. companies that many refer to its impact as 'not material' or 'not significant. Even after a provision went into effect this year requiring companies with 50 or more full-time workers to provide coverage, and after more workers are choosing to enroll in existing company coverage because of another requirement that all Americans get

As you may know, Rep. Greg harper(R-MO) introduced H.R. 3099 in July of 2015. The bill directs the Department of Health and Human Services (HHS) to develop, maintain and regulatory update a National Caregiving strategy. In addition, the bill directs HHS to convene a Family Caregiving Advisory Council to advice on supporting caregivers.

The Affordable Care Act was enacted to improve health care and to lower health care cost in America. The ACA developed different strategies to meet these goals called the “pay for performance” programs. These strategies are aimed at the different providers to improve quality care. The strategy that I selected is the “Hospital Readmissions Reduction Program” this program/strategy is also known as the HRRP and was begun in October of 2012. HRRP is aimed at hospitals and penalizes hospitals that have a high 30 day readmission rate. The penalties are assessed and based on a number of comparisons, those such as, performance, patient demographics, comorbidities and frailty.

The Hospital Readmissions Reduction Program (HRRP) was passed in 2012 under the Affordable Care Act, to help hospitals to improve patient care and reduce costs. (Danner, 2016). The diagnoses with the highest readmissions rates associated with the highest expense are: acute myocardial infarction (AMI), pneumonia, and congestive heart failure. CMS also extended their program in 2015 to incorporate reimbursement reduction for hip/knee replacements, Chronic Obstructive Pulmonary Disease (COPD), and they also have plans in 2017 to include the

The aim of the Affordable Care Act (ACA) is to reduce hospital readmission and to increase implementation of transitional care coordination for low health care cost. One benefit of establishing this

To encourage efforts of hospitals to reduce readmission, the Hospital Readmission Reduction Program (HRRP) was created under Affordable Care Act. The HRRP is mainly a payment penalty program designed to reduce hospital readmission rates for medically expensive conditions- such as heart attack, pneumonia, health failure (penalties levied in 2013 - ‘14). Under this program, hospitals with readmission rates that exceed the national average are penalized by payment cut across all-of their Medicare admissions. For 2015, CMS has added COPD, and elective hip or knee replacement, while types of pneumonia cases following CABG are included starting 2017. In addition to new conditions, the maximum penalty will increase up to 3 percent of the Medicare payment. This penalty is not limited to only above mentioned six conditions, but apply to all Medicare patients. (For HRRP program overview, see attachement-1)

Under the Affordable Care Act, “the scope of the Medicaid program was expanded and the number of individuals the States must cover was increased”. If states do not abide by

Policy makers created the Medicare Hospital Readmissions Reduction Program (HRRP) in an attempt to improve quality of patient care and lower costs (James, 2013). In order to avoid these penalties, healthcare leaders must recognize that CMS has identified a correlation between readmissions and a lack of quality care. Therefore, the aim is not to focus solely on hospital readmissions, but to seek clinical excellence by investing in quality improvement (Silow-Carrol, Edwards & Lashbrook, 2011). However, reducing readmissions is a complex undertaking, because not all readmissions can or should be prevented. Indeed, some readmissions are planned as part of sound clinical care. Furthermore, while hospitals work to reduce readmissions caused

We can’t purport to have a national goal to “eliminate health disparities” and continue to accept the social inequities that come from such a major gap in wealth. If we hope to solve the pressing issues of eldercare, these inequities must be addressed head on now and in the future. Otherwise, those who are caregivers now may not have access to the care they will need in the future.

Recidivism in healthcare is custom of patients to return to hospitals for treatment within a certain time period. Patient recidivism have increased. Readmission raters are included in the reimbursement for CMS as part of the ACA which punishes health systems with a readmission rates through the hospital readmission reduction programs. Since the start of this penalty there have been programs to help lower the readmission rates. “Medicare uses an “all-cause” definition of readmission, meaning that hospital stays within 30 days of a discharge from an initial hospitalization are considered readmissions, regardless of the reason for the readmission”( Casillas 2017).

Obamacare covers a variety of screenings and preventive services that will help patients in the long run to avoid or delay major health problems.