DQ 2-2 1. The ACA was signed in 2010 by President Obama, this plan had 3main goals; to reduce the cost of medical coverage, provide health insurance for more people and to protect patients from the insurance companies in areas such as denial of coverage or increased cost due to pre-existing conditions. Health insurance is something that no one should be without, preventative care and treatment for illness is very expensive without a plan. The ACA has provided coverage for so many people that did without due to costs, lack of access or pre-existing conditions.  Medical insurance premiums continually increase and this has had some affect on the ACA premiums.  While the ACA costs have risen since 2010 there are continued efforts to keep these premiums affordable.  "Moreover, premiums are rising at a much slower rate than they were prior to the implementation of ACA – one of the slowest rates in the last 50 years." (The Affordable Care Act in 2017: Myths and Facts, 2017)   The Affordable Care Act has proven successful when looking at the number of people now receiving medical benefits.  "In 2010, 16% of the country’s population was uninsured. In 2016, only 8.6% of the country was uninsured. 91.4% were insured" (The Affordable Care Act in 2017: Myths and Facts, 2017)  Rules were put into place with the ACA that coverage could not be denied as a result of a prexisting condition such as asthma or diabetes.  Increasing the cost of coverage as a result of a pre-existing condition is also not allowed.  "They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition." (HHS.gov, 2017)  However, there are rules in place about having a plan before 2010 that did have rules about pre-existing conditions.  According to HHS.gov (2017) if you purchased a policy before March of 2010 the changes with the ACA will not affect your private health care plan. The ACA has worked in providing more people with health insurance, removing the pre-existing condition clause for many plans, extending the coverage age to 26 and lowering the cost of healthcare.  There are still many things that can be done to improve the system for everyoone involved.  From the healthcare provider side this is opening up new issues.  With the baby boomers getting ready to retire we will lose many healthcare providers and gain new patients.    "Expanded coverage under the ACA is projected to increase demand for services. In addition, the population is growing at about 0.8 percent per year, and the population is aging." (The Evolving Health Workforce, 2017)The shortage of staffing with the influx of new patients will only get worse unless something can be done to get new people into the medical field. 2. Going through the slides helped me find more information than what the video presented. After going through the slides it was interesting to read about the reporting which the DHHS. They publicly report informat.

1. DQ 2-2
1.
The ACA was signed in 2010 by President Obama, this plan had
3main goals; to reduce the cost of medical coverage, provide
health insurance for more people and to protect patients from
the insurance companies in areas such as denial of coverage or
increased cost due to pre-existing conditions. Health insurance
is something that no one should be without, preventative care
and treatment for illness is very expensive without a plan. The
ACA has provided coverage for so many people that did without
due to costs, lack of access or pre-existing conditions.
Medical insurance premiums continually increase and this has
had some affect on the ACA premiums. While the ACA costs
have risen since 2010 there are continued efforts to keep these
premiums affordable. "Moreover, premiums are rising at a
much slower rate than they were prior to the implementation
of ACA – one of the slowest rates in the last 50 years." (The
Affordable Care Act in 2017: Myths and Facts, 2017)
The Affordable Care Act has proven successful when looking at
the number of people now receiving medical benefits. "In 2010,
16% of the country’s population was uninsured. In 2016, only
8.6% of the country was uninsured. 91.4% were insured" (The
Affordable Care Act in 2017: Myths and Facts, 2017) Rules
were put into place with the ACA that coverage could not be
denied as a result of a prexisting condition such as asthma or
diabetes. Increasing the cost of coverage as a result of a pre-
existing condition is also not allowed. "They cannot limit
benefits for that condition either. Once you have insurance, they
can't refuse to cover treatment for your pre-existing condition."
(HHS.gov, 2017) However, there are rules in place about
having a plan before 2010 that did have rules about pre-existing
conditions. According to HHS.gov (2017) if you purchased a
policy before March of 2010 the changes with the ACA will not
affect your private health care plan.

2. The ACA has worked in providing more people with health
insurance, removing the pre-existing condition clause for many
plans, extending the coverage age to 26 and lowering the cost of
healthcare. There are still many things that can be done to
improve the system for everyoone involved. From the
healthcare provider side this is opening up new issues. With the
baby boomers getting ready to retire we will lose many
healthcare providers and gain new patients. "Expanded
coverage under the ACA is projected to increase demand for
services. In addition, the population is growing at about 0.8
percent per year, and the population is aging." (The Evolving
Health Workforce, 2017)The shortage of staffing with the influx
of new patients will only get worse unless something can be
done to get new people into the medical field.
2.
Going through the slides helped me find more information than
what the video presented. After going through the slides it was
interesting to read about the reporting which the DHHS. They
publicly report information about certain hospitals so people
can see their success or failure rates. An example of these
reports are the infection rates and hospital acquired conditions.
These reports affect hospitals tremendously as technology has
been so easily used for patients to find which hospital they
would like to visit based on review and ratings. Because of
these conditions the ACA has also created a Hospital-Acquired
Condition Reduction Program.
These hospitals will be subject to a 1 percent payment reduction
in the FY 2018 HAC Reduction Program, hospitals with a Total
HAC Score greater than 0.3687 may be subject to a payment
reduction (CMS, 2017). These conditions have raised over the
years and have been unreported for years. The federal
government will cut 769 hospitals' Medicare payments in fiscal
year 2017 for having the highest rates of hospital-acquired
conditions (Haefner, 2016). The amount of hospitals reported
for cutting in payment is tremendously high. This helps to prove

3. a point, however to show how important it is to focus the need
for a change. Hospitals are to treat patients, not to cause more
harm. Even though hospitals cannot be 100%, it is set out to be
improved.
Haefner, M. (2016). 769 hospitals see Medicare payments cut
over high HAC rates. Clinical Leadership & Infection Control.
Retrieved from
https://www.beckershospitalreview.com/quality/769-hospitals-
see-medicare-payments-cut-over-high-hac-rates-7-things-to-
know.html.
Hospital-Acquired Condition Reduction Program (HACRP).
(2017). Centers for Medicare & Medicaid Services. Retrieved
from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-
Payment/AcuteInpatientPPS/HAC-Reduction-Program.html
3.
The goal of the ACA was to provide health care for millions of
Americans who could not currently afford it. The changes that
were planned to take effect were the patient centered care, and
the accountability with patient satisfaction. These changes were
intended to provide patients with a better type of health care
that may help prevent future hospital visits by utilizing
education and preventative measures that the patients can use.
Quality of care instead of quantity of care was to be top
priority.
The accountability that was required by this bill seems to be in
effect, as Medicare and Medicaid will not reimburse hospitals if
the patient has a fall or a hospital acquired infection (cms.gov).
Denying reimbursement in these situations creates a higher
level of concern in these areas, in turn leading to a higher
quality of care. The ACA has definitely accomplished it's goal
of increasing the amount of people insured in our country but it
has increased the need for more health care providers as well.
According to the ncbi, the workforce has had a greater demand
on it than ever before. This demand has lead to an increase in

4. the need for quality health care providers, and a greater need of
expanding roles for current providers.
The ACA has created new ACO's, accountable care
organizations, that incentivize doctors and providers to work
together to provide coordinated care plans for the patients to
improve quality. There are over 250 organizations that
participate in Medicare ACO's, providing more than 4 million
Medicare beneficiaries access to this high quality care
throughout the nation (health affairs, 2017). This organization
has helped the ACA in acheiving a higher quality of care while
also creating savings in the health care field due to less medical
errors and more prevention in hospital readmissions.
References:
The Evolving Health Workforce (n.d) Retrieved December 13,
2017 from
https://www.ncbi.nlm.nih.gov/books/NBK241393/
Hospital Acquired Conditions. (2015, November 25). Retrieved
December 14, 2017,
from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-
Assessment-Instruments/Value-Based-Programs/HAC/Hospital-
Acquired-Conditions.html
(n.d.). Retrieved December 14, 2017, from
https://www.healthaffairs.org/do/10.1377/hblog20130320.02940
8/full/
4.
What stood out in the video is the information regarding
“experience of payment”. Being paid for outcome is very
important because focus on taking care of the patient is vital.
No medical professional will base their treatment by being paid
but being paid for how they treat the patient and depending on
the patient’s satisfaction. “Readmissions” was mentioned and
how insurance companies have changed their ways of
reimbursing hospitals. To include patient and their families with
their care is very important. When the Affordable Care Act
mandated to reduce hospital stays for COPD patients to 30 days

5. or otherwise incur a penalty, have reduced readmission from 20-
30% down to 16.9% (Hanlon, 2017). Reducing readmission and
length of stays for hospitals has saved tremendous amount of
money and all this is due to the Affordable Care Act (ACA) and
health reform. I currently see the model of care becoming more
successful and I cannot wait to see what the future holds for
upcoming changes of our health care system. "Today, more
than 1,300 health centers operate over 9,000 service delivery
sites and provide health care services to 1 in 14 people in the
United States. The Budget invests $5.1 billion for health
centers, including $3.75 billion in mandatory resources, to serve
over 27 million patients in FY 2017" (U.S. Department of
Health and Human Services, 2017).
***Ferley
Hanlon, P. (2017). Reducing COPD Readmissions with or
without the Affordable Care Act. RT: The Journal For
Respiratory Care Practitioners, 30(5), 12-14. Retrieved from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com
/login.aspx?direct=true&db=ccm&AN=124494472&site=eds-
live&scope=site
U.S. Department of Health and Human Services. (2017). FY
2017 Budget in Brief- Overview. Health Care Centers.
Retrieved from:
https://www.hhs.gov/about/budget/fy2017/budget-in-
brief/index.html
5.
The thing that stuck out to me the most from the video was
medical facilities being reimbursed based off of patient
outcomes, not getting paid just for having patients. This is
something that has been in the works for a long time. The
Affordable Care Act (ACA) is shifting their focus from the
physician or clinician standpoint to that of the patient. The ACA
wants to bring it back to where how the patient feels is the most
important element. There have been many studies to see if this
reimbursement system is effective but most studies say that it is

6. too early to come up with a conclusion, However, one study
showed that this methods may eventually prove effective in
reducing healthcare costs overall and that there was an increase
in provider reimbursement related to an increase in patient’s
that have been insured by Medicaid due to the ACA expanding
Medicaid (Bowling, Newman, White, Wood, and Coustasse,
2017). I think it is too early to tell just the actual total impact of
the ACA but many studies and early statistics are showing a
positive trend.
References
Bowling, Brandon, M.S., Newman, David, M.S., White, Craig,
M.S., Wood, Ashley, M.S. & Alberto Coustasse, Dr. PH. (2017),
“Provider reimbursement following the Affordable Care Act,” in
Business & Health Administration Proceedings, Avinandan
Mukherjee, Editor, pp.168-175.
Title
ABC/123 Version X
1
Chi-Square Worksheet
PSYCH/625 Version 4
2
University of Phoenix MaterialChi-Square Worksheet
Look at the following chi-square output, and answer the
questions below it.
Chi-Square Test

7. Frequencies
Preference
Observed N
Expected N
Residual
Nuts & Grits
9
20.0
-11.0
Bacon Surprise
27
20.0
7.0
Dimples
16
20.0
-4.0
Froggy
17
20.0
-3.0
Chocolate Delight
31
20.0
11.0
Total
100
Test Statistics
Preference
Chi-Square
15.800a

8. df
4
Asymp. Sig.
.003
a 0 cells (0.0%) have expected frequencies less than 5. The
minimum expected cell frequency is 20.0.
Answer the following questions about this chi-square output:
1. How many categories are listed for analysis?
2. What is the expected N size?
3. What is the chi-square value?
4. How many degrees of freedom are there?
5. What it the test statistic and what does it tell you about the
probability?
Copyright © XXXX by University of Phoenix. All rights

9. reserved.
Copyright © 2017 by University of Phoenix. All rights reserved.