The Patient Protection And Affordable Care Act

Moreover, we see that some providers are focusing on what providers do and how they get reimbursed rather than what the patient needs, which is a focus that does not prioritize quality of care and therefore does not align with the Triple Aim framework. The problem presented regarding this matter is that the health care system lacks a patient-focused care of medical conditions that puts patients and their health needs first. For example, when we think of provider reimbursement, it is not in the patient’s best interest for the system to only have a simple fee-for-service structure. A structure like this one will only lead to an increase of health care expenses. Also, it fails to incentivize high-value service, which also does not align with the Triple Aim framework health care providers should go by. It is very crucial for the health care system in the United Stated to find a better balance between medical groups reimbursement and patients needs in order to reduce the risk of overutilization.

The care delivery enterprise must be re-tooled so that it functions in a fee-for-value reimbursement environment as is has in a fee-for-service reimbursement environment. The Centers for Medicare and Medicaid Services (CMS) is leading the

Health care costs have been rising for several years. Expenditures in the United States on health care surpassed $2.3 trillion in 2008, more than three times the

Health care cost has been constantly rising and a problem in this country for years. Millions go without much needed medical care every year due to the lack of health care. For many the emergency room is their first contact with medical care. The Patient Protection Affordable Care Act (PPACA) intends to significantly decrease the number of uninsured in American. The PPACA, is said to be most comprehensive insurance reform since 1965, (the year in which Medicare and Medicaid were implemented) was signed into law on March 23, 2010 by President Obama. PPACA will renovate the entire United States’ insurance market. PPACA requires most citizens to either purchase health care coverage privately or through their employer, or face a penalty.

The Patient Protection and Affordable Care Act (PPACA) signed into law by president Obama on March 23, 2010 is arguably the most extensive reform of health care law ever to be enacted in the U.S. It will impact the way professionals practice health care, the way insurance companies handle health care as a product, and the way consumers purchase and use health care as a service. The Affordable Health Care Act is primarily aimed at reducing the number of uninsured Americans and reducing the overall costs of health care from an administrative and consumer standpoint. The PPACA requires insurance companies to cover all applicants and offer the same rates to all applicants of the same age

The Patient Protection and Affordable Care Act (PPACA) of 2010, also known as the Affordable Care Act (ACA), is a legislation designed to extend coverage to the uninsured, eliminate practices that include rescission and denial of coverage due to pre-existing conditions, and lower health care costs. Moreover, the PPACA provides incentives to businesses to offer health insurance or impose penalties on business that do not provide coverage, and require individuals without health insurance to purchase reasonably priced polices through health insurance exchanges (Martocchio, 2014, p. 143). This health reform legislation was taken into effect in 2010, and is expected to complete implementation over the next few years.

In addition, it also measures the quality of care and patient satisfaction. In 2015, the US Secretary of HHS has announced a goal of 85 percentages of Medicare Fee for Service payments tied to quality or value. In addition, many new payment models are associated with HRRP; for instance, forthcoming Skilled Nursing Facility VBP program and Dialysis Adequacy measure , potentially specifies preventable readmission measures. As the system is moving from quantity to quality, it is beneficial to implement quality of standards to optimize future benefits for the community and Central Health as well. Currently, Central Health has higher readmission rate than national average with an overall rating of 2 out of 5. Penalties incurred due to below standard of care could strain hospital resources to utilize for the betterment of our facility. Furthermore, the incentive structure has concerned Central Health to reevaluate the mode of practice and care provided engaging healthcare providers and patients. Central Health is committed to reducing readmission rates by identifying and sharing best practices for long term benefits. Given the flexibility of penalty under the 21st Cure Act, the initial program will focus on readmission prevention within 30 days of hospital

One major trend in the healthcare environment is the shift from volume based reimbursement towards value based reimbursement. Many provider practices remain on a volume based or fee for service reimbursement plan. This system tends to reward high quantity of services with less regard for the quality or performance of the service. However, with a renewed focus on value, reimbursement plans

The rise of the cost of healthcare has been a hotbutton political issue in the United States in recent years, especially with the passage of the Patient Protection and Affordable Care Act, commonly known as Obamacare. In 1995, the United States spent a little over 13 percent of its GDP on healthcare. By 2013, spending on healthcare had increased to around 17 percent of GDP (World Bank). This trend is projected to continue; healthcare spending will reach some 34 percent of GDP by 2040, with state and federal Medicare and Medicaid spending reaching 15 percent of GDP (Council of Economic Advisors). For comparison, the entire US federal government spent only 20.7 percent of GDP in 2015 (Office of Management and Budget 163) What is driving this

On March 23, 2010, the Patient Protection and Affordable Act was signed by President Obama into law. Since the last 45 years it has been the most inclusive ameliorate of the United States medical system. This Act (ACA) changed the insurance market in the United States, directives were given that most citizens must have subsidized private insurance coverage, health insurance, raises revenues from a variety of new taxes, and lower and restructure spending under Medicare.

The goal of the initiative is to increase efficiency of care, improve quality of care, and lower costs. This initiative consists of four different bundled payment models. The first three bundled payment models are retrospective payment arrangements based on patients’ historical data. However, the fourth model is proposed for the future. Centers for Medicare & Medicaid Services (CMS) make a single bundled payment to the hospital for all services during inpatient stays for hospitals, physicians, and other medical professional specialists.

The Patient Protection and Affordable Care Act of 2010 (PPACA)is a highly complex and multifaceted policy in addition to being political controversial. Changes made to the law by subsequent legislation, focuses on provisions to expand coverage, control health care costs, and improve health care delivery system.

Over the years health care insurance reform, in the U.S has been a political debate for provider consumers. One thing that Americans agreed that the reshaped of the U.S health care system; an effort by President Obama was successful in March 2010, the Patient Protection Affordable Care Act or PPACA was signed into law

The U.S. spends more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. 10 of the 20 occupations

The positive outcomes that have resulted due to value base programs have caused the model to gain traction and ignite one of the largest changes in history in the health care marketplace. By linking reimbursements to service quality, insurers such as the Centers for Medicare and Medicaid Services have facilitated a massive leap forward in the performance of United States health care providers. This achievement is a considerable accomplishment in the face of an institution that has received reimbursement from insurers via a fee-for-service model during the last 75 years. Soon, valued based payment models will represent the norm as more insurers support initiatives such as shared savings program, integrated clinical care, and accountable care payment models.