The Patient Protection And Affordable Care Act

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,

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).

In this paper you are going to learn all about the Accountable Care Organization (ACO). Also, how does it pertain to the healthcare system? We will also be learning about the reimbursement rates for Medicare patients. Who makes up the Accountable Care Organization? We will also take a look into the Affordable Care Act and how the ACO is a part of that.

CMS defines ACOs as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.” The goal of coordinated care is, “to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary

Organization such as “Accountable Care Organizations”4 is one of the ways to ensure the quality of care for Medicare patients. The organizations combination of doctor, hospitals, and other health care providers who came together to ensure the quality of care for Medicare patients. This will help with effective communication with patients and clinicians, and help avoid medical

I work as an home care occupational therapists in the field and provide services to people from children to old age. I see the effects of laws and policy discussions not only on the patients but also on the workplace itself. The Patient Protection and Affordable Care Act (ACA) is one such example that has changed not only how we deliver patient services but also team dynamics within the healthcare providers. When I started working, we had a multidisciplinary team model that has since been changed to an interdisciplinary team model, we used to have separate teams of nurses, rehabilitation therapists and social workers but now we have been integrated into a team based on geographical location. Whereas, patient care delivery used to be fragmented and performed in the respective care provider services, this has now been transformed where greater integration is seen from the way we share information; more information has been coming from all providers and not only from the home care agency that I work for but also from outside providers such as the hospitals and nursing homes.

The Patient Protection and Affordable Care Act (PPACA) has been one of the most controversial laws in the history of The United States. One of the key components of the law is the creation of health insurance exchanges. The states had the option to establish a state managed exchange, partner with the federal government, or let the federal government establish the exchange for them. Several states have opted to let the federal government establish the exchange for them. As of May 28, 2013, there are 17 State-based Marketplaces; 7 Partnership Marketplaces; 27 Federally Facilitated Marketplaces.1

The Patient Protection and Affordable Care Act is a highly controversial act of the United States government commonly referred to as ObamaCare. Designed to “ensure that all Americans have access to quality, affordable health care,” (Patient Protection) this bill has received a large amount of opposition for a variety of reasons, but it is also widely supported, therefore garnering it attention from interest groups. Many interest groups, including religious organizations, attempt to change laws and legislation in American politics in order to advance their religious beliefs. The Catholic Bishops and the National Organization of Evangelicals are no exceptions to this. They attempt to advance their positions through a variety of means within the United States’ pluralist system, and both have very motivated opinions on the Patient Prevention and Affordable Care Act.

The Patient Protection and Affordable Care Act, or Obamacare would be very beneficial for the economy and health reform if it was repealed. Many statistics and studies have been done to show the issues and concerns that have risen from the act. Where is the money coming from to fund all of these new health insurance plans to those who could not afford it before? Overall, the biggest issue is funding, but that can be said for most legislation passed. No piece of legislation will ever please every single American, because there are flaws within everything. But Obamacare, does not seem logical sense. President Obama had good intentions behind the bill, but he fails to realize the harm it has done to those who do not need the health reform act. It may sound punitive, but there should be consideration for the ones who have to pay extra to keep the act alive. Obamacare should be repealed for many reasons, including industry standards, patients guarantees, the individual and employee mandate, subsidizing of money, healthcare exchanges, the secrecy and privacy behind act, pricing and cancellations of consumer insurance, and the law adding to the national deficit; there should be no reason why it should continue.

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act in Law. The health reform law establishes a national, voluntary insurance program for purchasing community living services supports known as the Community Living Assistance Services and Supports Program (CLASS ACT). The CLASS program is designed to expand options for people who become functionally disabled and require long-term services and supports, including home care, adult day care, or a stay in a nursing home. In exchange for paying premiums during their healthy, working years, people would get a daily cash benefit to help defray the costs of these forms of assistance. The CLASS program was made effective on January 1,

Nurses have a unique positon on the healthcare team; nurses are, literally and metaphorically, at the patient’s bedside to influence care on several avenues. The nursing profession already plays a critical role in cost control, quality of care, and patient safety, The Affordable Care Act (ACA) will increase opportunities for nurses to improve both individuals and the Healthcare system for healthier outcomes (Health care reform: Improving quality of care, 2016). To do so nurses must understand what the ACA is about and how our profession will play a large part to facilitate a positive outcome for all.

On March 20, 2010 President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). With that signature, a new healthcare paradigm set into motion. Under Title III: Improving the Quality and Efficiency of Healthcare, Section 3506 requires establishment of programs that develop, test and disseminate “patient decision aids”. Tools that are designed to facilitate collaborative shared decision making between health care providers and patient beneficiaries. This provision outlines requirements to promote engagement of all stakeholders in informed decision making, mandates provision of up-to-date clinical evidence for all treatment options and promotes decision making that accounts for individual beliefs, preferences and circumstances.

With the current implementation of the Patient Protection and Affordable Care Act (PPACA) and Medicare’s performance-based payment incentives, a streamlined model to help improve patient outcomes and decrease healthcare costs must be developed for the perioperative setting (Berwick et al 2012). Established in 2010 by the PPACA, Accountable Care Organizations (ACOs) hold multiple providers accountable for achieving high quality of care and reducing the cost per capita when they are directly involved in providing services for a designated patient population within an integrated system (Kash et al 2014; Ferrari et al 2015). In order to comply with these ACO requirements, the anesthesiologist must be involved in the coordination of the

Under the ACA, there are several tax provisions that is scheduled to take effect as different sections of the health reform legislation are implemented. The US government has given the IRS the authorized to provide premium tax credits to individuals and insurance companies. The calculations are based on the family size specifically those that are making between 138% and 400% of the federal poverty levels, in states that have expanded the Medicaid eligibility and 100% to 138% are available in states that have not accepted the expansion. Another requirement is individuals not eligible for Medicare and Medicaid and Individuals whom have purchase qualifying health insurance plans on federal and state – run exchanges.

The Patient Protection and Affordable Care Act (PPACA) has brought about a reform in the healthcare industry. With the increased emphasis on more positive patient outcomes and cost-effective treatments, it is challenging healthcare practitioners to deviate from the norm of everyday medicine and holding them accountable for how they practice healthcare. The success of the PPACA reform is being measured through comparative research initiative and through the establishment of the Patient-Centered Outcomes Research Institute (PCORI). The PCORI data is used by the federal government in order determine if the PPACA is in fact effective in reducing healthcare costs while still ensuring positive treatment outcomes. The PCORI