Impacts of Affordable Care Act on Health Facilities - Essay Example

? Impacts of Affordable Care Act on Health Facilities s s Introduction The Health and Education Reconciliation Act enactment by the USA congress facilitated amendment of Affordable Care Act (ACA), also known as Patient Protection and Affordable Care Act (PPACA) or Obamacare. The president of the USA signed it on 23 March 2010. Its full effect will start on January 1, 2014 when the provisions given to all people; young, those employed, old and employers will take course (Kaiser Family Foundation, 2010). ACA is a health reform, which was enacted with the aims of improving health service quality by lowering the cost of public care (America’s Health Insurance Plans, 2007). Therefore, ACA ensures quality health service is affordable to people regardless of their social class. The Act requires more individuals to get a health insurance coverage that will enable them access health facilities anytime without finance problems. As the ACA health reform seeks to achieve all this it will inject many changes in the health sector. This paper, therefore, addresses the impacts ACA has brought to the Health Sector. Patient to Physician Ratio After launching the new health reform on January 1, 2014, the entire healthcare system will shake from the huge number of individuals who will insure. Congressional Budget Office estimated that 14 million uninsured young people would join the group on January 1, 2014. By the year 2021, 16 million more will enter the brackets. When the newly insured people join the health system, the doctor workload will hike as the number of doctor visits will go up. Limited funding restricts people from visiting hospitals (America’s Health Insurance Plans, 2007). Besides, the health reforms anticipated will increase claim cost and cause delays in return to work. In simple language there will be issues related to scheduling of doctors’ appointments, ensuring quality healthcare, and availability of medical resources (Gruber, 2002). According to American Journal of Medical Quality published a report and projected a shortage of nurses across America between 2009 and 2030, the USA will be hit by a serious shortage of more than 90,000 physicians by 2020 and by 2025, the shortage it will upsurge to more than 130,000 (Gruber, 2002). Lastly, the health reform recommends implementation of other measures of appointments with nurses and physical assistants, which the worker’s compensation system does not recognize. Eventually, this will cause compensation issues and add client consent requirements (America’s Health Insurance Plans, 2007). Besides, ACA aims at reducing those physician`s shortages by providing loan-based refund programs to principal doctors and offer incentives to medical schools to increase the number of medical students (Gruber, 2002). However, the healthcare system may not see the light of the day soon until students will be under this program graduate and begin their careers. Effect on Tax-Exempt Hospitals ACA has a goal of increasing transparency concerning the payback that tax-exempt hospitals get. The act requires those hospitals to conduct a Community Health Needs Assessment (CHNA) every three years to portray how they are carrying out their duties to meet needs of their patients (Gruber, 2002). Secondly the tax-exempt hospitals will be required to come up with a written financial assistance policy which would include criteria for eligibility to financial assistance, basis for coming up with figures charged to patients, and measures to be undertaken in case of nonpayment (America’s Health Insurance Plans, 2007). The ACA will keep those tax-exempt hospitals on toes to increase transparency for quality of care to the patients. To crown it all, the health reform recommends penalizing the tax-exempt hospital that does not meet those rules up to $50,000. Health Care Funding Through Affordable Care Act, the Health Centre Program will award new funding which consist of the following. First, Health Center Base Adjustments where the Health Resources and Service Administration Health Center New Access Points (HRSA) awards $48 million to 1,193 health centers all over America in support of ongoing operations and quality improvement actions (U.S. Census Bureau, 2010). Secondly, Health Center New Access Points where HRSA give $19 million to establish 32 new health centers access points. The provisions support full-time service delivery sites for a complete primary and preventive health care services. Thirdly, Health Center Controlled Network whereby estimated $21 million is given to 43 network organizations in support of employing use of digital health records and use of wide health Information Technology to improve quality of service. The networks must include 10 Health Center grantees and overall will provide support to more than 700 health centers across the nation (Long, Sharon, and Paul, 2009). Lastly, Health center Outreach and Enrollment Assistance Supplemental Funding Opportunity whereby HRSA give a whopping $150 million to 1,159 health centers in support of reaching out and enrollment actions across the nation (U.S. Census Bureau, 2010). The funds facilitate enrollment of eligible patients and service area residents into insurance coverage they can afford. The ACA has also authorized nurturing of school-Based Health Center Capital Program. It has placed $200 million to fund this program from 2010-2013. The aim of the program is to address pressing capital needs and improve service delivery at school-based health centers (U.S. Census Bureau, 2010). HRSA give these funds to 470 School-Based Health Center Programs in order to carry out the following mandate. First, it creates new school based health sites in areas, which are medically underserved. Second, it expands preventive and primary health care services at already situated school based centers (Long, Sharon, and Paul, 2009). Change of Payment Systems ACA will enroll new payment systems in order to fix compensation to presentation. Implementation of the payment systems will facilitate lowering of the healthcare costs and increase the quality of patient care (America’s Health Insurance Plans, 2007). The payment systems include value-based purchasing and bundled payments. The Centers for Medicare and Medicaid (CMS) in 2007 for all hospitals initiated a Value-Based Purchasing (VBP) model and ACA mandate the Value-Based Purchasing (VBP) model effecting on October 1, 2012. The Value-based Purchasing model gives incentives to hospitals that meet or exceed certain performance benchmarks set by CMS (Gruber, 2002). Previously, before effecting the Value-Based Purchasing model, performance in certain areas of the hospitals reporting decided on how to award health personnel (America’s Health Insurance Plans, 2007). With ACA, reporting their performance is mandatory. In fact, it ties a percentage of Medicare reimbursement to achieving certain targets. Another payment system includes bundled payment. For the bundled payment, a single bundled repayment provides for an episode of care, beginning three days before admission to the hospital and ending thirty days after discharging the patient (America’s Health Insurance Plans, 2007). The goal of bundled payment is to lower hospital readmission rates (Gruber, 2002). Both hospitals and physicians will share a single payment thus this model will have a great impact on hospitals. Accountable care organizations (ACOs) ACA has improved ACOs. ACOs originally were doctors coordinating care for an assigned group of patients (Miller, 2011). Due to ACA, the ACOs now include large health plans collaborating with hospitals, health care systems, and doctors (Gruber, 2002). Initially ACOs only had relationship with Medicare. Today, they have expanded their wings to include private health agendas. They are also improving quality strategies to improve healthcare for their patients (Miller, 2011). The main objectives of ACOs are to higher the quality, manage costs, and improve coordination of care and timeliness. They endeavor to provide patient-centered treatment programs, which include wellness to persistent diseases (America’s Health Insurance Plans, 2007). In order to gear toward achieving those goals, they want full digital information sharing. ACA want to embrace fully the value-based compensation programs focusing on quality. Merging of Healthcare Facilities ACA is driving coming together among stakeholders of medical facilities. Hospitals and health organizations are continuing to merge day by day. Deloitte Center for Health Solutions conducted a survey and found that 31% of doctors moved into larger practice in the last two years (Gruber, 2002). Healthcare providers and hospitals think that they will need to offer end-to-end patient management in wellness, management of diseases, and care planning. Medical providers also bother widening their territory of offering service (America’s Health Insurance Plans, 2007). By hospital, insurance and technological firms coming together, they can use health information exchange to make referrals online and receive results quickly. Conclusion The main objective of ACA is to ensure quality healthcare to all regardless of their location and financial status. It will facilitate engagement that is more patient oriented; it will involve more communication and engagement with all parties, which includes patient, payer, and medical providers. ACA provide information through sharing on online or other platforms by the new dispensation. Fully implementation of ACA will revolutionize America’s health care system for years and years to come. How long ACA will have its full force felt in the health system remains unknown as it has projected impacts to bring change for a number of generations to come. How far it will go in slowing cost, reorganizing the whole payment system and increasing the effectiveness remains in the hands of all the stakeholders. As pregnant, as it may look, it can give birth to confusion if not calculated well. It may also results into many not receiving the healthcare they ever wanted. Recommendations The following are recommendations from the above analysis of impact of ACA on health facilities. The information concerning the health reform should be clear to a good chunk of the population. ACA implementation requires informing all stakeholders. Public is the most vulnerable participant and requires information from experts view with simple language as a way of becoming prepared for ACA`s great effects. Moreover, it requires thorough execution of strategies to ensure the payment modes are clearer and carried out well to avoid frustration to any of the participant. In addition, acquiring a better solution for the shortage of physicians before implementing ACA is necessary. The government, to ensure that medical practitioners are in place to prevent a crisis, should lay out a program. Otherwise, shortage of medical staff may haunt this program haunted. Finally, use of pilot programs ensures effectiveness before rolling out to the patients or healthcare providers. References America’s Health Insurance Plans (2007). Individual Health Insurance 2006-2007: A Comprehensive Survey of Premiums, Availability, and Benefits. Retrieved from http://www.ahipresearch.org/pdfs/Individual_Market_Survey_December_2007.pdf. Gruber J. (2002) Taxes and Health Insurance. Retrieved from http://www.nber.org/papers/w8657.pdf Miller S. (2011). The effect of Insurance on Outpatient Emergency Room Visits: An Analysis of 2006 Massachusetts Health Reform. Retrieved from http://www.researchgate.net/publication/228207238_The_Effect_of_Insurance_on_Emergency_Room_Visits_An_Analysis_of_the_2006_Massachusetts_Health_Reform U.S. Census Bureau (2010). Income, Poverty, and Health Insurance Coverage in the United States, 2009. Retrieved from http://www.census.gov/prod/2010pubs/p60-238.pdf Long S. K. and Paul B M. (2009). Access and Affordability: An Update on Health Reforms in Massachusetts. Retrieved from http://ehbs.kff.org/pdf/2010/8085.pdf Kaiser Family Foundation, 2010. Employer Health Benefits: 2010. Retrieved from http://ehbs.kff.org/pdf/2010/8085.pdf Read More