The Role of Affordable Care Act in Reducing Unnecessary Hospital Readmissions - Essay Example

"The Role of Affordable Care Act in Reducing Unnecessary Hospital Readmissions" is an outstanding example of a paper on the health system.
The urgent need to better health care facilities is needed to improve inpatient settings to incorporate other care settings. Through sec.3026 [42U.S.C. 1395-1 note] on community –based care transitions program, the establishment of such centers will require eligibility in accordance with the act. The services can be in conjunction with hospitals or high-risk Medicare beneficiary who has attained a minimum hierarchical condition category score based on a diagnosis of multiple chronic conditions. The ACA helps to reduce unnecessary hospital readmissions and their associated complications and cost. Different hospitals and Medicare centers run this program.

The John C. Lincoln North Mountain, West Valley Hospital, Scottsdale Health Osborn Medical Center, and John Lincoln Deer Valley Hospital have a past experience in dealing with the aged (McKenzie, Pinger & Kotecki, 2011). They currently provide care transition services through an administration on aging –funded care Transitions mini-pilot program, started in October 2010 targeting medically underserved populations. The healing at home program targets Medicare FFS beneficiaries residing in Maricopa County, Arizona discharged with at least one qualifying diagnosis with or without comorbidity of congestive heart failure (CHF), acute myocardial infarction (AMI), or pneumonia.

The Atlanta community-Based Transitions program in conjunction with Emory University Hospital Midtown, Gwinnett Medical Center, Piedmont Hospital, Southern Regional Medical Center, and Wellstar Kennestone Hospital is essential in the pursuit of affordable care. The Atlanta transitions pilot project is divided into two; one, three hospitals participate in the Coleman coaching model and service support package, and two, integration of care transitions practices into the Area Agency on Aging (AAA) work (McKenzie, Pinger & Kotecki, 2011). This includes information and assistance, existing care management systems, and community education. Their target through the national statistics and the individual Root cause Analysis (RCA) findings of the 6 participating hospitals supported targeting these 3 diagnoses; AMI, CHF, and PNEU. These interventions were based on the findings on the analysis carried out and they include poor medication management, lack of follow-up with primary care physicians, and lack of adequate community support systems and services.

The southern Maine Agency on Aging has five participating hospitals which are the southern Maine medical center, Maine Medical Center, Midcoast Hospital, Miles hospital, and Pen Bay Medical Center (HRH) (McKenzie, Pinger & Kotecki, 2011). In the year 2006, care management staff received training in the Care Transition Intervention (CTI) model as the first step toward implementing a care transitions pilot project in 2007. This project was aimed at targeting the 5700 beneficiaries living in the five southern Maine counties with multiple chronic conditions identified as being at risk based upon either; 100% of Readmissions having polypharmacy or need for med reconciliation, only 50% of patients had a scheduled follow up visit; of those that did, 43% did not keep the appointment, 30% did not understand their medication and 30% left the hospital unprepared to meet their health management responsibility (McKenzie, Pinger & Kotecki, 2011). These, therefore, show the need to have outpatient care services to follow up on patients who live in the hospital and still need proper care. These should be made available especially to those having a low income.

The transition caregivers should be well trained and the patients should meet with caregivers before discharge to develop an individualized, person-centered care plan. This will help the patient create a health care diary with a master medication list that will be taken to all physician appointments. Affordable health care improves the health of individuals through timely detection of complications before they turn to be fatal.