Healthcare reform aims to provide affordable, quality healthcare to all Americans while reducing healthcare spending growth. Key provisions include prohibiting denial of coverage for pre-existing conditions, keeping children on parents' plans until age 26, closing the Medicare prescription drug "donut hole," and fining companies with over 50 employees that do not provide insurance. However, critics argue it may increase insurance premiums and reduce benefits. An important part of reform is Title IV which focuses on preventing chronic diseases through lifestyle changes and screenings in order to reduce healthcare costs and improve public health.
The document summarizes the history of healthcare reform efforts in the United States from the early 20th century to the present. It discusses key proposals and legislation over time including those under Theodore Roosevelt, Harry Truman, John F. Kennedy, Lyndon B. Johnson, Richard Nixon, Jimmy Carter, and Barack Obama. It also outlines provisions and goals of the 2010 Affordable Care Act related to expanding coverage, improving the healthcare workforce, lowering costs and improving quality, and how the act is funded. Finally, it discusses the development of the patient-centered medical home model as a joint solution to transform primary care delivery.
This document provides an overview of the Patient Protection and Affordable Care Act (PPACA). It discusses the long history of healthcare reform efforts in the United States stretching back over a century. It also outlines the major components and provisions of the PPACA, including the creation of health insurance exchanges, expanded Medicaid eligibility, subsidies for individuals and businesses, and improvements to the quality and performance of the healthcare system. The PPACA builds upon but also differs from healthcare reform proposals put forth by previous administrations such as President Clinton's 1993 plan, which included a more regulatory approach with greater government involvement in the industry.
Vermont is implementing a universal healthcare system to reduce costs and increase access. Currently 50,000 Vermonters are uninsured and 150,000 are underinsured. The system will be funded by payroll taxes on employers and employees. Governor Shumlin has set four goals for the reform: reducing costs and growth, ensuring access to care, improving population health, and creating a fair financing system. Strategies include expanding Medicaid eligibility, establishing minimum coverage standards, and transitioning payments to focus on preventative and coordinated care rather than fee-for-service. The reform aims to lower costs for employers and individuals while improving health outcomes across the state.
This document discusses the Affordable Care Act and its provisions regarding pre-existing conditions. It notes that the ACA aims to expand insurance coverage, reduce costs, and increase quality and affordability of healthcare. A key part is that it prohibits insurance companies from denying coverage or charging more due to pre-existing conditions. While this improves access, it may also increase insurance costs. The document also examines strengths like expanded choice and protections, but weaknesses like potentially higher overall healthcare costs. It recommends focusing on lowering costs to prevent insurer bankruptcies from high medical bills.
This chapter provides an overview of economics concepts relevant to health policy and discusses key provisions of the Affordable Care Act. It covers demand, supply, markets, and why health reform is difficult in the US. It then summarizes previous reform attempts and the major ACA provisions, including the individual mandate, state exchanges, subsidies, employer requirements, insurance regulations, and financing mechanisms.
Affordable Care Act (ACA) : What's in it ? - Healthcare Reform 101Manoj Jain MD
The document provides an overview of key aspects of healthcare reform under the Affordable Care Act. It discusses how the reform addresses issues with the current healthcare system by increasing access to insurance, trying to contain costs, and focusing on improving quality of care. Specifically, it expands who is eligible for Medicaid, creates state-based insurance exchanges to allow more people to purchase insurance, and establishes programs and payment reforms to incentivize higher quality and value-based care.
The document discusses the similarities and differences between the Massachusetts health reform law known as "Romneycare" and the federal Patient Protection and Affordable Care Act known as "Obamacare". Both laws require individuals to have health insurance, create state-based health insurance exchanges, and provide subsidies for lower-income households. However, the ACA covers more people nationwide and optionally expands Medicaid eligibility, while Romneycare only expanded coverage for certain groups in Massachusetts. The document also outlines some perceived pros and cons of the ACA.
This document provides an overview of major public health insurance programs in the United States, including Medicaid, CHIP, and Medicare. It discusses eligibility requirements, covered benefits, financing structures, and changes made by the Affordable Care Act. The document also examines quality control measures like licensing and accreditation. It describes efforts to define and improve healthcare quality, as well as legal standards and theories of liability for medical negligence. Federal preemption of state laws by ERISA is also summarized.
The document summarizes the history of healthcare reform efforts in the United States from the early 20th century to the present. It discusses key proposals and legislation over time including those under Theodore Roosevelt, Harry Truman, John F. Kennedy, Lyndon B. Johnson, Richard Nixon, Jimmy Carter, and Barack Obama. It also outlines provisions and goals of the 2010 Affordable Care Act related to expanding coverage, improving the healthcare workforce, lowering costs and improving quality, and how the act is funded. Finally, it discusses the development of the patient-centered medical home model as a joint solution to transform primary care delivery.
This document provides an overview of the Patient Protection and Affordable Care Act (PPACA). It discusses the long history of healthcare reform efforts in the United States stretching back over a century. It also outlines the major components and provisions of the PPACA, including the creation of health insurance exchanges, expanded Medicaid eligibility, subsidies for individuals and businesses, and improvements to the quality and performance of the healthcare system. The PPACA builds upon but also differs from healthcare reform proposals put forth by previous administrations such as President Clinton's 1993 plan, which included a more regulatory approach with greater government involvement in the industry.
Vermont is implementing a universal healthcare system to reduce costs and increase access. Currently 50,000 Vermonters are uninsured and 150,000 are underinsured. The system will be funded by payroll taxes on employers and employees. Governor Shumlin has set four goals for the reform: reducing costs and growth, ensuring access to care, improving population health, and creating a fair financing system. Strategies include expanding Medicaid eligibility, establishing minimum coverage standards, and transitioning payments to focus on preventative and coordinated care rather than fee-for-service. The reform aims to lower costs for employers and individuals while improving health outcomes across the state.
This document discusses the Affordable Care Act and its provisions regarding pre-existing conditions. It notes that the ACA aims to expand insurance coverage, reduce costs, and increase quality and affordability of healthcare. A key part is that it prohibits insurance companies from denying coverage or charging more due to pre-existing conditions. While this improves access, it may also increase insurance costs. The document also examines strengths like expanded choice and protections, but weaknesses like potentially higher overall healthcare costs. It recommends focusing on lowering costs to prevent insurer bankruptcies from high medical bills.
This chapter provides an overview of economics concepts relevant to health policy and discusses key provisions of the Affordable Care Act. It covers demand, supply, markets, and why health reform is difficult in the US. It then summarizes previous reform attempts and the major ACA provisions, including the individual mandate, state exchanges, subsidies, employer requirements, insurance regulations, and financing mechanisms.
Affordable Care Act (ACA) : What's in it ? - Healthcare Reform 101Manoj Jain MD
The document provides an overview of key aspects of healthcare reform under the Affordable Care Act. It discusses how the reform addresses issues with the current healthcare system by increasing access to insurance, trying to contain costs, and focusing on improving quality of care. Specifically, it expands who is eligible for Medicaid, creates state-based insurance exchanges to allow more people to purchase insurance, and establishes programs and payment reforms to incentivize higher quality and value-based care.
The document discusses the similarities and differences between the Massachusetts health reform law known as "Romneycare" and the federal Patient Protection and Affordable Care Act known as "Obamacare". Both laws require individuals to have health insurance, create state-based health insurance exchanges, and provide subsidies for lower-income households. However, the ACA covers more people nationwide and optionally expands Medicaid eligibility, while Romneycare only expanded coverage for certain groups in Massachusetts. The document also outlines some perceived pros and cons of the ACA.
This document provides an overview of major public health insurance programs in the United States, including Medicaid, CHIP, and Medicare. It discusses eligibility requirements, covered benefits, financing structures, and changes made by the Affordable Care Act. The document also examines quality control measures like licensing and accreditation. It describes efforts to define and improve healthcare quality, as well as legal standards and theories of liability for medical negligence. Federal preemption of state laws by ERISA is also summarized.
The document summarizes key aspects of the 2010 Federal Healthcare Reform and plans by Mitt Romney to replace it. The Federal Reform aims to reduce costs through prevention and coordinated care while expanding access. It includes insurance market reforms, new funding for prevention, and payment reforms to incentivize quality. Romney's plan would block grant Medicaid, limit federal standards, and promote free markets through tort reform and interstate insurance purchases.
The document summarizes the key provisions and benefits of the 2010 Patient Protection and Affordable Care Act. It discusses that the law aims to expand health insurance coverage to millions of uninsured Americans, protect people with pre-existing conditions, help families and small businesses afford coverage, and lower the growth of health care costs over time through increased prevention, quality improvements, and market reforms. The law is paid for through a combination of savings, taxes and fees, and is projected to reduce the federal deficit.
This document discusses universal health care in the United States and its potential effects on society. It first defines universal health care as a system that provides health insurance to all citizens. It then compares the systems in other countries like Canada, Great Britain, and Germany. In the US, over 45 million people are uninsured despite health care being declared a basic right. The document outlines several potential effects of universal health care on employment, government spending, households, and the economy. Both pros and cons are discussed. In conclusion, it states that most cannot afford treatment without insurance and increasing costs may raise the uninsured population.
The document discusses key concepts in US healthcare including:
1. US healthcare follows a medical model focused on treating illness rather than wellness and prevention.
2. Both social and medical factors influence health outcomes and disparities exist.
3. A holistic approach addressing social determinants through policies, community programs, and individual behaviors is needed to significantly improve population health.
The significance and function of accountable care organizationsPhilip McCarley
This paper provides a discussion and detailed analysis of the development, performance, and importance of Accountable Care Organizations as a vital component of health care reform from the time of the passage of the Affordable Care Act in 2010 through early 2015.
The document summarizes key provisions of the Affordable Care Act and how they relate to rural health care. It discusses expanding insurance coverage through Medicaid expansion, health insurance exchanges, and high-risk pools for those with pre-existing conditions. It also addresses improving quality of care through initiatives like accountable care organizations and reducing hospital-acquired conditions and readmissions. Additionally, it outlines provisions to strengthen the rural health infrastructure and workforce, such as National Health Service Corps funding and programs to expand training opportunities.
This chapter overview describes the goals and essential services of public health institutions and systems in the United States. It identifies the roles of local, state, and federal public health agencies, as well as global health organizations. It also illustrates the need for collaboration between governmental and non-governmental organizations to achieve public health goals.
Please Help Me Understand the Affordable Care Act....No Politics Please!!!!HRBIMS
The document defines key terms related to the Affordable Care Act, provides some statistics, discusses the year 2015, and notes that forms can be found. Specifically, it defines terms like essential health benefits, grandfathered health plans, and the health insurance marketplace. It also outlines the different categories of health plans in the marketplace based on costs and covers.
The document summarizes the Affordable Care Act and identifies some of its flaws and deficiencies. It discusses two main goals of the ACA - to increase the number of insured individuals while reducing overall healthcare costs. However, it notes the ACA has yet to achieve these goals. One deficiency is that individuals who remain uninsured face a penalty fee, which does not actually encourage accessing healthcare. Another issue is the "coverage gap" where many remain uninsured. The document proposes solutions like a state-run program to cover those in the gap and bundled payments to replace fee-for-service. It argues more reform is still needed to control rising costs while expanding access.
The preliminary plan_of_long-term_care_insurancenobisyu
The document outlines a preliminary plan for long-term care insurance in Taiwan. It discusses the background of aging population trends driving the need for reform. The plan proposes a single social insurance system managed by the Bureau of National Health Insurance. Two options are considered for eligible individuals - all people or those over age 40. Benefits would include both in-kind services and possible in-cash benefits. Financial resources would come from premiums paid by insured individuals, employers, and government subsidies. The plan aims to establish a legal framework and integrate long-term care with the existing health insurance system through measures like sub-acute care coverage.
Obamacare - The Patient Protection and Affordable Care Act - ACAAndrew F. Bennett
This short presentation will help bring you up to speed on the Affordable Healthcare act, eligibility requirements to buy in the online marketplace, and coverage that will be available.
Presentation delivered by Dr Awad Mataria, Regional Adviser, Health Systems Development at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean
Health Reform in America: An Overview of the Patient Protection and Affordabl...Adam Dougherty
A lecture to the UC Davis School of Medicine community covering the basics of the health reform law passed in early 2010. Presented by Adam Dougherty, MPH, MS1
This Presentation was presented to Mr.Wasif Ali Waseer Lecturer Sociology UMT,Lahore. Which describe the power, politics and health care system of Australia and Pakistan. It also provides few suggestions that can healp in improving health care system of Pakistan
This document discusses public health preparedness and policy. It describes public health preparedness as the ability to prevent, respond to, and recover from health emergencies that could overwhelm routine capabilities. Public health emergencies include intentional or accidental chemical/biological/radiological/nuclear releases, natural epidemics/pandemics, natural disasters, and environmental disasters. Key federal agencies related to preparedness policy include the Office of the Assistant Secretary for Preparedness and Response, CDC, NIH, FDA, USDA, FBI, DOD. Preparedness requires cooperation among federal, state, and local governments according to their respective responsibilities.
The document discusses how the Affordable Care Act aims to address problems in the US healthcare system like the large number of uninsured, rising costs, and quality and access issues. It will expand coverage to 32 million uninsured through Medicaid expansion and health insurance exchanges. Reforms to payment and delivery systems are also expected to help slow premium growth and reduce costs over time. Implementation will occur gradually through 2019, with many provisions taking effect in 2014 such as the individual mandate, Medicaid expansion, and state-based insurance exchanges.
This document provides an overview of the US healthcare system. It discusses healthcare finance, including spending as a percentage of GDP and sources of insurance. It addresses healthcare access, such as barriers from lack of insurance or inadequate coverage. It also examines healthcare quality and compares the US system to other countries' public or socialized insurance models.
A simple overview on heatlhcare costs and reasons why there is a global increase in the field. The presentation concentrates the Omani setting with a comparison to what is available in public reports.
Federal Health Reform Overview & Considerations for the Oregon Health Policy ...DHS Communications
The document provides an overview of the federal health reform law and its implications for Oregon. Key points include:
- The law significantly increases funding for prevention, community health centers, and delivery system reforms. It also expands Medicaid and provides subsidies for private insurance.
- This creates opportunities for Oregon but also challenges around implementing the insurance exchange, determining essential health benefits, and ensuring adequate health workforce.
- Oregon faces many decisions around how to implement the law, such as whether to set up its own exchange, explore a public plan option, expand coverage early, and pursue other state-level reforms.
Employer challenges go beyond healthcare reformAaron Ness
The document discusses how employer challenges will go beyond just health care reform. It notes that health care reform will decrease flexibility in benefits plan design due to new coverage mandates and the excise tax on high-cost plans beginning in 2018. This will result in employer plans becoming more similar over time. Rising health care costs are also projected to exceed the thresholds for the excise tax by 2018 based on projections, meaning plan design will be less able to differentiate employers. Instead, factors like participant experience with online tools and carrier/vendor interfaces will become more important for employer plans.
The document discusses health care reform in the United States, known as the Affordable Care Act or Obamacare. It was signed into law in 2010 with the main goal of ensuring affordable health insurance is available to all US citizens. Key aspects of the law include prohibiting denial of coverage due to pre-existing conditions for those under 19 and allowing coverage for children under parents' plans until age 26. The law also expanded Medicare and added new benefits while fighting fraud and improving care. Both positives and criticisms of the law are discussed.
The document summarizes key aspects of the 2010 Federal Healthcare Reform and plans by Mitt Romney to replace it. The Federal Reform aims to reduce costs through prevention and coordinated care while expanding access. It includes insurance market reforms, new funding for prevention, and payment reforms to incentivize quality. Romney's plan would block grant Medicaid, limit federal standards, and promote free markets through tort reform and interstate insurance purchases.
The document summarizes the key provisions and benefits of the 2010 Patient Protection and Affordable Care Act. It discusses that the law aims to expand health insurance coverage to millions of uninsured Americans, protect people with pre-existing conditions, help families and small businesses afford coverage, and lower the growth of health care costs over time through increased prevention, quality improvements, and market reforms. The law is paid for through a combination of savings, taxes and fees, and is projected to reduce the federal deficit.
This document discusses universal health care in the United States and its potential effects on society. It first defines universal health care as a system that provides health insurance to all citizens. It then compares the systems in other countries like Canada, Great Britain, and Germany. In the US, over 45 million people are uninsured despite health care being declared a basic right. The document outlines several potential effects of universal health care on employment, government spending, households, and the economy. Both pros and cons are discussed. In conclusion, it states that most cannot afford treatment without insurance and increasing costs may raise the uninsured population.
The document discusses key concepts in US healthcare including:
1. US healthcare follows a medical model focused on treating illness rather than wellness and prevention.
2. Both social and medical factors influence health outcomes and disparities exist.
3. A holistic approach addressing social determinants through policies, community programs, and individual behaviors is needed to significantly improve population health.
The significance and function of accountable care organizationsPhilip McCarley
This paper provides a discussion and detailed analysis of the development, performance, and importance of Accountable Care Organizations as a vital component of health care reform from the time of the passage of the Affordable Care Act in 2010 through early 2015.
The document summarizes key provisions of the Affordable Care Act and how they relate to rural health care. It discusses expanding insurance coverage through Medicaid expansion, health insurance exchanges, and high-risk pools for those with pre-existing conditions. It also addresses improving quality of care through initiatives like accountable care organizations and reducing hospital-acquired conditions and readmissions. Additionally, it outlines provisions to strengthen the rural health infrastructure and workforce, such as National Health Service Corps funding and programs to expand training opportunities.
This chapter overview describes the goals and essential services of public health institutions and systems in the United States. It identifies the roles of local, state, and federal public health agencies, as well as global health organizations. It also illustrates the need for collaboration between governmental and non-governmental organizations to achieve public health goals.
Please Help Me Understand the Affordable Care Act....No Politics Please!!!!HRBIMS
The document defines key terms related to the Affordable Care Act, provides some statistics, discusses the year 2015, and notes that forms can be found. Specifically, it defines terms like essential health benefits, grandfathered health plans, and the health insurance marketplace. It also outlines the different categories of health plans in the marketplace based on costs and covers.
The document summarizes the Affordable Care Act and identifies some of its flaws and deficiencies. It discusses two main goals of the ACA - to increase the number of insured individuals while reducing overall healthcare costs. However, it notes the ACA has yet to achieve these goals. One deficiency is that individuals who remain uninsured face a penalty fee, which does not actually encourage accessing healthcare. Another issue is the "coverage gap" where many remain uninsured. The document proposes solutions like a state-run program to cover those in the gap and bundled payments to replace fee-for-service. It argues more reform is still needed to control rising costs while expanding access.
The preliminary plan_of_long-term_care_insurancenobisyu
The document outlines a preliminary plan for long-term care insurance in Taiwan. It discusses the background of aging population trends driving the need for reform. The plan proposes a single social insurance system managed by the Bureau of National Health Insurance. Two options are considered for eligible individuals - all people or those over age 40. Benefits would include both in-kind services and possible in-cash benefits. Financial resources would come from premiums paid by insured individuals, employers, and government subsidies. The plan aims to establish a legal framework and integrate long-term care with the existing health insurance system through measures like sub-acute care coverage.
Obamacare - The Patient Protection and Affordable Care Act - ACAAndrew F. Bennett
This short presentation will help bring you up to speed on the Affordable Healthcare act, eligibility requirements to buy in the online marketplace, and coverage that will be available.
Presentation delivered by Dr Awad Mataria, Regional Adviser, Health Systems Development at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean
Health Reform in America: An Overview of the Patient Protection and Affordabl...Adam Dougherty
A lecture to the UC Davis School of Medicine community covering the basics of the health reform law passed in early 2010. Presented by Adam Dougherty, MPH, MS1
This Presentation was presented to Mr.Wasif Ali Waseer Lecturer Sociology UMT,Lahore. Which describe the power, politics and health care system of Australia and Pakistan. It also provides few suggestions that can healp in improving health care system of Pakistan
This document discusses public health preparedness and policy. It describes public health preparedness as the ability to prevent, respond to, and recover from health emergencies that could overwhelm routine capabilities. Public health emergencies include intentional or accidental chemical/biological/radiological/nuclear releases, natural epidemics/pandemics, natural disasters, and environmental disasters. Key federal agencies related to preparedness policy include the Office of the Assistant Secretary for Preparedness and Response, CDC, NIH, FDA, USDA, FBI, DOD. Preparedness requires cooperation among federal, state, and local governments according to their respective responsibilities.
The document discusses how the Affordable Care Act aims to address problems in the US healthcare system like the large number of uninsured, rising costs, and quality and access issues. It will expand coverage to 32 million uninsured through Medicaid expansion and health insurance exchanges. Reforms to payment and delivery systems are also expected to help slow premium growth and reduce costs over time. Implementation will occur gradually through 2019, with many provisions taking effect in 2014 such as the individual mandate, Medicaid expansion, and state-based insurance exchanges.
This document provides an overview of the US healthcare system. It discusses healthcare finance, including spending as a percentage of GDP and sources of insurance. It addresses healthcare access, such as barriers from lack of insurance or inadequate coverage. It also examines healthcare quality and compares the US system to other countries' public or socialized insurance models.
A simple overview on heatlhcare costs and reasons why there is a global increase in the field. The presentation concentrates the Omani setting with a comparison to what is available in public reports.
Federal Health Reform Overview & Considerations for the Oregon Health Policy ...DHS Communications
The document provides an overview of the federal health reform law and its implications for Oregon. Key points include:
- The law significantly increases funding for prevention, community health centers, and delivery system reforms. It also expands Medicaid and provides subsidies for private insurance.
- This creates opportunities for Oregon but also challenges around implementing the insurance exchange, determining essential health benefits, and ensuring adequate health workforce.
- Oregon faces many decisions around how to implement the law, such as whether to set up its own exchange, explore a public plan option, expand coverage early, and pursue other state-level reforms.
Employer challenges go beyond healthcare reformAaron Ness
The document discusses how employer challenges will go beyond just health care reform. It notes that health care reform will decrease flexibility in benefits plan design due to new coverage mandates and the excise tax on high-cost plans beginning in 2018. This will result in employer plans becoming more similar over time. Rising health care costs are also projected to exceed the thresholds for the excise tax by 2018 based on projections, meaning plan design will be less able to differentiate employers. Instead, factors like participant experience with online tools and carrier/vendor interfaces will become more important for employer plans.
The document discusses health care reform in the United States, known as the Affordable Care Act or Obamacare. It was signed into law in 2010 with the main goal of ensuring affordable health insurance is available to all US citizens. Key aspects of the law include prohibiting denial of coverage due to pre-existing conditions for those under 19 and allowing coverage for children under parents' plans until age 26. The law also expanded Medicare and added new benefits while fighting fraud and improving care. Both positives and criticisms of the law are discussed.
The Affordable Care Act is a comprehensive health reform law that was passed in 2010. It expands access to health insurance coverage through Medicaid expansion, health insurance exchanges, and prohibiting denial of coverage for pre-existing conditions. It also enhances Medicare benefits, provides consumer protections, and focuses on prevention, wellness, and public health. The law aims to increase the number of Americans with health insurance and decrease the cost of health care.
This document discusses issues around rising healthcare costs in the US and Massachusetts. It outlines progress made on universal healthcare coverage through the Affordable Care Act and Massachusetts law. However, healthcare spending continues to grow much faster than economic growth. The document suggests focusing on preventing chronic diseases, which account for most healthcare spending, through workplace wellness programs and health plan designs that incentivize healthy behaviors. It proposes a state-level forum for businesses and healthcare experts to discuss driving innovation and efficiency in healthcare delivery to reduce costs.
An Obamacare Primer -- cutting through the complexityAdrian Ho
Much of what is reported on re the ACA (or "Obamacare") is politically motivated, or is more about the politics than the actual content of the law itself. This deck is my attempt to cut through all the complexity and distortions and simply explain what is in the ACA and why it is in there.
An Overview of the ACA (aka Obamacare), October 2013Adrian Ho
Theres a lot of noise out there about Obamacare, much of it politically driven. This presentation is my attempt to focus on the facts and boil down the over 2000 page law into a short succinct summary
hCentive Health Insurance Exchange PlatformAlisha North
Take advantage of hCentive's deep expertise in the healthcare insurance industry. Browse through or download our white papers to get an in-depth understanding of the industry.
The document provides an overview of key provisions and implementation timeline of the Affordable Health Choices Act. Some highlights include:
- Insurance market reforms like ending rescissions and pre-existing condition exclusions begin in 2010.
- Improved benefits like dependent coverage up to age 26, prevention coverage without cost sharing, and a temporary high risk pool also start in 2010.
- Medicare and Medicaid improvements such as filling the donut hole and primary care pay parity in Medicaid phase in between 2010-2019.
- Public health programs around community health centers, prevention, and the health workforce expand in 2010.
The document provides an overview of key provisions and implementation timeline of the Affordable Health Choices Act. Some highlights include:
- Insurance market reforms like ending rescissions and pre-existing condition exclusions begin in 2010.
- Improved benefits like dependent coverage up to age 26, prevention coverage without cost sharing, and a temporary high risk pool also start in 2010.
- Medicare and Medicaid improvements such as filling the donut hole and primary care pay parity in Medicaid phase in between 2010-2019.
- Public health programs around community health centers, prevention, and the health workforce expand in 2010.
The document discusses pay for performance (P4P) incentives in healthcare and their impact on quality, cost, and financing. It provides background on quality improvement efforts and defines key concepts like structure, process, and outcomes. It then outlines current legislation and initiatives like the Affordable Care Act that link reimbursement to quality metrics. P4P aims to change how care is delivered and financed to improve outcomes while reducing waste. However, it also impacts providers' finances as payments may decrease for preventable readmissions or hospital-acquired conditions.
Assignment 1Public Administration – The Good, th.docxtrippettjettie
Assignment 1
Public Administration – The Good, the Bad, the Ugly
hhhhhhh
Modern Public Administration
Prof. hhhhh
Date: hhhhh
The White House Issue: Health reforms
The Health Care Reforms are the best obsession for the United States, Majorly most of the American citizens who were responsible for originating the improvement found it helpful. Back in the year 2011, a countrywide crackdown was conducted as a way to oppose the frauds that were becoming a health concern, and the federal administration recovered almost $ 4.1 billion. The Health Care Improvement for capturing the healthcare frauds and scams allowed President Obama’s policy to enhance on strict penalties like compensation and fines. By providing the United States citizens with Patient Protection as well as, ACA (Affordable Care Act) was the ultimate presidential success for President Barack Obama (.whitehouse., 2014).
The public policy
As most of the leaders decided to adopt a firm stand with the many important issues within the American State, the essential point was the definition of the improvement of the Health Care in the United States by President Barack Obama and when discussing the fitness and care reform a lot of issues are put on focus.
The public policies are categorized into four groups which are the regulatory policy, the distributive policy, the redistributive policy and lastly the constituent policy. Every issue in the White House is organized it the way it is related to any of the four types of public systems (NCBI, 2016). The financial regime faces most of the significant issues, and many may need to be in a position to determine the problems which are related to funding system because some of these issues affect some of the American citizens.
Distributive policy as mentioned above, it is a policy that focuses on supporting the selected issues; the strategy that is behind the distributive health care is the local understanding and having a flexible organizational design. The idea of distribution is quite broad as it classifies distributive policy action towards including all the public processes that are responsible for developing as well as providing equitable access to the resources. In regards to the health issues, this may have financial aid for assisting the excluded to have access to the healthcare. Also, across funding aid to assist in the inside operations of the health institutions such as the combination of threats which enhances the inclusion of reasonably inadequate health services. Also, the appointment systems facilitate the secondary concern for the needy to access health services (Mackintosh, 2013). It also reduces the shifts regarding the fitness care regime in processes that will be able to satisfy and offer the proper access to those who are deprived by supporting the distributive promises that the government has made and having full access to healthcare services. In this kind of shift, the significant disadvantage is ...
The Proposed Health Care Reform’S Impact On MarketingStone Ward
The document summarizes key aspects of the proposed US health care reform plan, including:
1) It would require all Americans to have health insurance and businesses to provide it or pay a penalty. Subsidies would help lower-income families purchase insurance.
2) Health insurance exchanges would be created to allow consumers to compare plans starting in 2013.
3) While hospitals, doctors, and private Medicare plans oppose aspects of the plan, supporters argue it will reduce costs and improve care by covering more of the uninsured.
The document summarizes the future of America's health care system based on a presentation given to the Ventura Rotary Meeting. It discusses key aspects of health care reform including reducing the uninsured, expanding Medicaid, establishing health insurance exchanges, individual and employer mandates, and revenue generation strategies. Implementation will occur between 2010-2020 with the goals of increasing access to insurance and reducing costs over time. Concerns were raised about the increased costs and bureaucracy that employers and those with current coverage may face during the transition.
The document summarizes how health care reform will change the US health care delivery system. It discusses how reform will affect consumers, employers, and hospitals. Key provisions include expanding Medicaid eligibility, establishing health insurance exchanges and essential benefit packages, providing premium subsidies, and introducing delivery system reforms like accountable care organizations to improve quality and efficiency. Hospitals will face Medicare and Medicaid payment cuts to help finance expanded coverage but also opportunities to participate in innovative payment models.
The document discusses several issues related to health care in America, including rising costs, obesity, and proposed reforms. It focuses on costs, providing 3 potential solutions: increasing quality, increasing access through universal healthcare, and reducing costs. Reducing costs could involve cutting services, lowering prices, or implementing a single-payer system, which is proposed as a way to reduce administrative expenses which account for around 25% of total healthcare costs in the US.
The document discusses the implications of the Affordable Care Act on individuals, employers, and the healthcare industry. It finds that the Act will provide coverage to around 30 million uninsured Americans through Medicaid expansion and insurance subsidies. For individuals, there will be a penalty for not obtaining coverage starting in 2014. Employers with over 50 employees will face a penalty starting in 2015 if they do not provide affordable coverage. The healthcare industry will see both costs and revenues impacted, with insurers expected to gain many new customers but also facing new regulations, and hospitals losing some funding but gaining new insured patients. Overall the impacts are viewed as manageable for most employers and positive for the healthcare sector in the long run.
The document discusses the history of health care reform debates in the United States. It provides background on past reform efforts and outlines some of the key provisions and goals of the Affordable Care Act signed into law in 2010, including expanding access to health insurance coverage and aiming to reduce overall health care costs. The document also notes that health care reform remains a vital political issue and that significant obstacles have prevented major changes since 1965.
Similar to Healthcare Reform CHRONIC DISEASE, PREVENTION & QUALITY (20)
Healthcare Reform CHRONIC DISEASE, PREVENTION & QUALITY
1. Healthcare Reform
1
Healthcare Reform
CHRONIC DISEASE, PREVENTION & QUALITY
Shanise Thornton, Melinda Williams and Christopher Owens
Keller University
Health insurance & Managed Care
June 23, 2011
2. Healthcare Reform
2
Abstract
Healthcare reform has a tremendous effect on the economy. This paper will explore the reform as
well as its impact on chronic disease, prevention, and quality. Health care reform is thriving to
put American families and small business owners more in control of their own health through
several initiatives. There are several strengths and weakness within the reform. Employers with
more than 50 employees must provide health insurance or pay a fine … There are several key
elements under the reform, one of which is Title IV - Prevention of Chronic Disease and
Improving Public Health (Health Reform Details). This provision addresses the issues of costs
associated with health care services and is focused on changing the way the services are
delivered. Services will be provided for prevention of manageable illnesses.
3. Healthcare Reform
Healthcare Reform 3
CHRONIC DISEASE, PREVENTION & QUALITY
There has been a lot of criticism geared towards the reform, however change is inevitable. For
decades, the United States has been concerned with the high cost of medical care. The 2010
Healthcare Reform, otherwise known as the Affordable Care Act, consists of many aspects. We
will explore the reform as well as its impact on chronic disease, prevention, and quality.
Overview of the Healthcare Reform Initiative
In order to gain a better understanding of the Affordable Health Care Act of 2010 also known as
the Health Care Reform, let’s highlight key points of the bill. According to the reform, the main
objective is to provide affordable, quality health care for all Americans in an attempt to reduce
the growth in health care spending (George, 2011). The bill is pushing to create a stable
healthcare budget, to reduce the deficit by more than one hundred billion dollars over the next
ten years (Healthcare Reform Details, 2011). The coverage of this reform is expected to expand
towards thirty two million uninsured Americans (Jackson & Nolen, 2010). The health care
reform strives to put American families and small business owners in control of their own health
by implementing the following provisions:
·Making health insurance more affordable by the year 2014; providing the largest
middle class tax cut for health care in our nation’s history.
·Reducing premium costs for countless millions of families and small business
owners who are currently priced out of coverage.
·Setting up a new competitive health insurance market.
4. Healthcare Reform
·Ending discrimination against Americans with pre-existing conditions (Healthcare
4
Reform Details, 2011).
The reform will also focus on bridging the gap between the House and Senate bills and it will
include new provisions to crack down on waste, fraud and also abuse. The reform will reflect
many policies. Some of the key changes that the Reform will tackle are as follows:
·Eliminating the Nebraska FMAP (Federal Medical Assistance Percentage) provision and
providing significant additional Federal financing to all States for the expansion of Medicaid.
·Closing the Medicare prescription drug, in other words the “donut hole” coverage
gap by the year 2020.
·Increasing protections for out of pocket costs.
·Increasing the threshold for the excise tax on the most expensive health plans from
twenty three thousand dollars for a family plan to twenty seven thousand and fifty dollars and
starting it in 2018 for all plans (Healthcare Reform Details, 2011).
As you can see, the Health care reform bill has the potential to help the American society with
many changes that will start immediately as well as other changes which will start later. Seniors
that are affected by the donut hole within the current year shall receive a $250 rebate. However,
seniors receiving top shelf prescription brands will receive a fifty percent discount beginning
later in the year. One of the major benefit’s and outcomes that will come from this reform will be
that every citizen is going to be required to have health care which means that the percentage of
individuals that are healthy will increase.
5. Healthcare Reform
Strength and Weaknesses of Healthcare Reform
5
There are strengths and weaknesses of the Healthcare reform for individuals that live within the
United States which include the following:
Strengths-
• Prohibits preexisting conditions exclusions periods for children in all new plans (George,
2011). Therefore, if a child has a pre-existing condition he/she will not be denied for care
anymore.
• Prohibits dropping people from coverage when they get sick in all individual plans
(Uygur, 2010). This will allow all adults to be able to receive care without having to pay
too much out of pocket or being uncertain if they will be covered. According to
Davenport that passed this bill, this reform will also lower overall expenditures in tandem
with deficit reduction which is a good strength (Davenport, 2011). The implementation
of the bill will not only lower the overall expenditures but it will eliminate lifetime limits
and restrict annual limits on benefits on all plans (George, 2011). By ending lifetime
limits on care, patients will not have to worry about their care and coverage being
dropped mid way through the treatment.
• Within this reform it will allow college adults to stay on their parents coverage until the
age of 26, which is a positive aspect in certain cases for individuals who have not made it
on their own as of yet or who need a little more guidance.
Weaknesses-
• Include increasing insurance premiums.
6. Healthcare Reform
• If the secretary estimates for any fiscal year that the aggregate amounts available for
6
payment of expenses of the high-risk pool will be less than the amount of the expenses,
the Secretary shall make such adjustments as are necessary to eliminate such deficits,
including reducing benefits, increasing premiums, or establishing waiting list (George,
2011).
• Patient’s benefits may reduce which may decrease the quality perceived by some patients
and they will have longer waiting times.
• Negative effects on the insurance companies.
• Negative impact on individuals beginning in 2014; all citizens and legal residents must
have insurance. Violators will be subject to a phased-in excise tax penalty for
noncompliance which will be a $695 annual fine. However, there are some exceptions for
low-income people (Boomers, 2010).
• Employers with more than 50 employees must provide health insurance or pay a fine of
$2000 per worker each year if any worker receives federal subsidies to purchase health
insurance. Fines will be applied to the entire number of employees minus some
allowances (Boomers, 2010).
Despite the positive and negative aspects that people may think of the bill, the reform is still
seen as being very beneficial. One important element of the reform is Title IV - Prevention of
Chronic Disease and Improving Public Health section.
Chronic Disease
7. Healthcare Reform
In 2010, President Obama moved to reduce the problems our country faced under the current
7
healthcare system. The Healthcare Reform-Affordable Care Act was signed into policy in the
year 2010. Among the key elements under the reform, is Title IV - Prevention of Chronic
Disease and Improving Public Health (Health Reform Details). This provision addresses the
issues of costs associated with health care services and is focused on changing the way the
services are delivered. From treating the sick, to helping people live healthier lives by promoting
wellness and prevention, reducing the incidences of preventable illness (chronic disease), and
empowering families to be accountable for their own health.
Under Title IV provision, it is also stated that “investing in preventable diseases saves lives and
money not just for families but also for businesses and the nation” (Health Reform Details, n.d.).
So what is driving up the cost of healthcare? Many would say technology others would say
prescription drugs, and still more may say the aging population. The World Health Organization
(2010) states “populations are aging and increasingly, people are living with one or more chronic
condition for decades.” Chronic disease is a defined as a disease or condition that persists for a
long period of time, it may be progressive, it may contribute to disabilities, and oftentimes it has
been linked to deaths. Chronic diseases is usually the results of damaging behaviors such as
tobacco use, lack of physical activity, and poor eating habits (Medicine Net and Free Dictionary,
2011).
The most common types of chronic diseases are: heart disease, diabetes, asthma, obesity,
hypertension and cancer: One could also conclude that chronic disease is another cost driver of
the health care system. In fact, seventy percent of deaths are related to chronic diseases. Chronic
disease is the leading cause of death in the United States.
8. Healthcare Reform
Here are some alarming statistics by the Center for Disease Control (CDC) the relating chronic
8
diseases:
“7 out of 10 deaths among Americans each year from chronic disease”
“Heart disease, cancer and stroke account for more than 50% of all deaths each year”
“1 in every 3 adults is obese and almost 1 in 5 youths are obese with a Body Mass
Index (BMI) > 95th percentile of CDC growth chart”
“In 2005, 133 million Americans had at least one chronic disease”
“Diabetes continue to be leading cause of kidney failure, amputations and blindness”
(Center for Disease Control, et. tal, Mary 2011).
As you can see, these figures are startling. In 2009, healthcare expenditures grew at a rate of four
percent, totaling two point five trillion and accounting for seventeen point six percent of our
gross domestic product or an average of eight thousand eighty six dollars per person with
increases in spending for Medicaid, Medicare, and private insurers (Goldstein, 2011). The rate
affects all spectrums of our country-the consumer, the employer and our government. Even more
disturbing, out of all expenditures that contribute to our nation’s debt (military/defense,
education, transportation, etc) fifty one percent of these expenditure costs went towards hospital
care and physician services; Services such as dental, nursing home care, home health,
prescription drugs, government/public health activities, investments, and administration. This is
according to a briefing done by the Henry J. Kaiser Family Foundation (March 2010) which
suggests that controlling costs will mean understanding the root cause from which these costs
were generated.
Chronic disease not only affects healthcare costs in the United States, but is a global issue as
well. Disease management programs and preventive services are becoming more popular as
states and countries seek out ways to lower the costs of providing healthcare. In Japan, a
9. Healthcare Reform
preliminary program is being conducted in hopes of reducing the number of metabolic syndrome
9
patients by twenty five percent between 2008 and 2015. Etsuji Okamot (2007) states, “Japan has
the highest number of dialysis patients in the world at 194.3 per 100,000 in 2004. Since half of
chronic renal failure results from diabetes and annual cost for dialysis amounts to fifty thousand
dollars per year, it would be reasonable to assume that savings can be achieved by preventing
dialysis by one patient or by deterring it one year.” For employers, the issues of rising costs,
chronic disease and management are causing major concerns in terms of profits and cost-sharing;
such that it could also affect the status of the economy. For instance, if employers are spending
more on health care costs they may decide or even be forced to pass the higher costs to the
employee, reduce the amount of investments, or decrease employment. They may also have to
deal with higher taxes in order to finance health care expenditures or increase the amount of
government loans. These issues not only may reduce the competitiveness of the US but may also
deter consumer spending on goods and services, and alter retirement savings (Sood, Ghosh,
Escarse, 2007). The US Department of Health and Human Services (HHS) states employers
insure approximately three-fifths of Americans. Originally the employer sponsored health
insurance came into play because the contributions for income and payroll taxes were exempt.
However as insurance premiums continued to increase, employers began to see a potential threat
to their profitability and thus started to institute a change to put more of burden on the employee
such as: reducing benefits, changing providers, adding high deductible-consumer driven plans
(September 2007).
10. Healthcare Reform
Fortunately for consumers, The Affordable Care Act calls for employers to take a prospective
10
approach to seeking ways to lower costs, improve wellness and quality of care by offering
incentives and giving employee’s an opportunity to be in control of their health outcomes.
Management and Prevention
Consumers, as well as healthcare workers, see daily the destruction and devastation that chronic
disease and conditions can place on people’s lives. Beyond the emotional and physical pain,
there’s also the financial strain that people often bear. In an article by Democratic Representative
Jim Moran (Va.), he states “chronic diseases such as cancer, heart disease, diabetes, and arthritis
are the most prevalent and preventable health problems we face.” He goes on to say that
millions of Americans, forty million to be exact, “are without health insurance and one-third
suffer from chronic disease” (2009). Chronic diseases are preventable and can also be very well
managed. The goal of disease management, according to Kongstvedt (2001), is to “reduce
frequency and severity of exacerbation of a chronic illness so that readmission costs are
reduced.” Many of us are not aware and would be very surprised to hear that Pennsylvania was
ranked in the bottom 3rd of states for avoidable chronic disease - hospital related admissions or
that half of our residents have at least one chronic disease that accounts for eighty percent of our
state’s healthcare costs or that four billion was projected to be unnecessary hospital charges for
admissions that could have been avoided because of a chronic condition (Bricker, Baron, Sheirer,
DeWalt, Derrickson, Yunghans, &Gabby, 2010). These statistics were given from a report
presented by a commission put together among concerned healthcare providers, insurers, nurses,
consumers, educators, state government and labor unions to address the issue of controlling the
cost associated with chronic disease by implementing a program model to be tried and if
11. Healthcare Reform
successful to become part of the state’s healthcare reform initiative. The goals of the program
11
are:
• To create a reimbursement program that rewards the use of the “chronic care
model” to become team-based, patient-centered, and have quality outcomes…
• Promote learning and provide education sessions among constituents.
• To improve healthcare resources, utilization, clinical processes.
• Reducing the number of re-admissions, avoidable admissions, and ER visits with
savings from other cost measures (Bricker et al., 2010)
Some positive results from the initial reporting from model, results within the three years for
which the program has been conducted. For example: practices are finding better ways to
improve processes, better communication with staff as well as patients, disease management
programs were starting to see positive results in management and less exacerbations. Patients
were more satisfied with care being given, with the education and direction they are receiving,
and the better access to services and even thwarted changing of physicians.
This program model in Pennsylvania is only one example of what can be done in hopes of
preventing and managing chronic illnesses. Other resources that are being used and made
available are, telephone follow-ups, directing patient to website for educational resources, work-
shops and seminar and a host of others will become available as technology advances.
Ultimately, it is a way to begin to measure the quality and effectiveness of the programs and
services being provided all in the goal of restructuring healthcare.
Quality
12. Healthcare Reform
Throughout our entire lives, most, if not all, have dealt with the term “quality” in some shape or
12
form. Whether it was the quality of one’s livelihood, food choice, or even education, we’ve all
partaken in quality in some way. Even though we encountered this concept quite often, we all
have seemingly different various ways of defining the term. When asking a random
Philadelphian her definition of quality, she responded by stating: “Something that adheres to
high standards.” Standards are defined as something established by authority or general consent
as a model or example. Webster defines quality as a degree of excellence, social status, or even a
distinguishing attribute. (Webster, 2011) With all this being stated, we should grasp a clearer and
more concise understanding of quality in regards to healthcare.
Quality health care can be described as aspiring for excellent standards of care. This would
include evaluating the suitability of medical treatments and measures to continuously improve
personal health care in every fields of medicine. For example, accrediting or approving
physicians, offices, hospitals or other health care providers. This is achieved through
accreditation or inspection standards that ensure that proper procedures and staffing ratios are
met. The Institute of Medicine also aims to improve the quality of healthcare through the
following: safety, timely, effective, efficient, equitable & patient centered. Each concept deals
with the idea of continually improving healthcare.
An organization that regulates and sets the standards for accreditation is known as the Joint
Commission on Accreditation of Healthcare Organizations, also known as (JCAHO). The Joint
Commission on Accreditation of Healthcare Organizations is an independent nonprofit
organization which accredits more than nineteen thousand healthcare organizations across the
13. Healthcare Reform
United States. Their accreditation is known nationwide as the symbol of quality that reflects an
13
organizations commitment in meeting high performance standards. (Joint commission, 2011)
Another quality measuring organization is The National Committee for Quality Assurance also
known as (NCQA).
The Affordable Care Act of 2010 lists quality as one of many important elements covered in the
national healthcare reform. In short it aims for quality improvement through establishing national
priorities via performance improvement such as quality bonuses payments. Here’s a snippet of
what the bill addresses under title IV:
• Improving transparency of information on long term care facilities
o Nursing home compare Medicare website
o Improving staff training
o Preventive training
• Physician payments
The Affordable care Act goes into nursing home transparency by stating in limens term, that the
social security act has been modified by being required to disclose information pertaining to
ownership as well as any other disclosure parties involved. Such information includes facilities
workers information, I.e. name, position, basic bio of personnel. Also the organizational
structure, as well as a compliance and ethical program that is effective in the prevention of crime
and administrative violations under this act.
In referencing the physician payment section, which is noted as the sunshine provision, it directly
relates to confidentiality, delayed reporting, reporting, and entities that bill Medicare; it also
14. Healthcare Reform
involves quality bonus payments. Here medical professionals have the chance to gain additional
14
incentive for reporting particular quality measures. This gives the medical staff to gain from1.5
% to 3% their total allowed charges for covered Medicare physician fee schedule services. To
redeem this physician must report at least 80% of their eligible cases.
In relation to quality healthcare and chronic disease, Joanne Kenen, a blogger for The New
Health Dialogue, has managed to give a clear insight on current healthcare issues discussed at a
past AARP forum on Capitol Hill.“…They'll tell you about medical specialists who don't
coordinate with one another. Patients who are sent home from the hospital or rehab without
adequate information about follow up care and complex medication regimes. They’ll also speak
of delays in getting patients the care they need when they need it. In short, a fragmented,
disconnected system that seems unaware that it's supposed to be all about the patient…” In her
opening blog statement, I’ve found her critics all too accurately correct. Just as many other
citizens, I’m too dealing with a family member who’s recently been diagnosed with a chronic
disease. Throughout the past three years, physicians where confused and or unclear on their
patients diagnoses, and blatantly told use that they had flawed records that which where
supposed to be beneficial in effectively communicating their patents situation. There’s been to
many times where my loved one was admitted into the ER department to only be held for a few
days then discharged only to come home with a complex medication schedule, and have the
same situations re occur weeks later. All in all, not one facility has managed to grant my family
member the needed care in which he needs; I believe that because of this three year headache,
they’ve managed to turn an acute illness into a chronic one. Regardless of my personal
experiences with the quality of care, far too many others can relate to my story as well.
15. Healthcare Reform
15
The chart above illustrates a survey conducted roughly eleven years ago. It shows family
members overall quality concerns for vastly ill patients in various settings. Dark blue
representing patience’s sent home with hospice care; hospice care refers to providing humane
and compassionate care for people in their last phases of incurable disease so that they may live
as fully and comfortably as possible. The second color code is red which relates to Nursing
homes. Thirdly we have light blue which represents home with home care…I.e. Visiting nursing
services, basically all health and supportive services administrated at home. Last but not least we
have orange which represents hospital services. All in all through analyzing this chart one will
notice the poor quality in not one, but all healthcare settings, these numbers are far too high for
any health service group, especially for facilities that are heavily administrated through
accreditation agencies. These figures portray lack of compassion, communication, and
effectiveness when dealing with direct patient care.
16. Healthcare Reform
16
Conclusion
With many of its changes that will and have taken place, the Health care reform bill has the
potential to help the American society. Citizens that are affected by the large cost of prescription
drugs will have a decreased donut hole to look forward to via rebates and or discounts. Young
adults will be able to remain on their parents’ healthcare coverage up until the age of twenty six.
Most importantly, all will have coverage under the reform. This means more patient care that
will result in higher healthcare revenue, which will result in overall contribution to the nation’s
gross domestic production rate. This continues improvement will benefit an entire nation.
Through proper education, people can make better decisions, which then leads to prevention of
illnesses such as heart disease, diabetes, asthma, obesity, hypertension and cancer. Now that the
change has come it’s time for us to stand up to sickness and accept health. We must say no to
ignorance and yes to education. We can do this. We just have to take the steps…
17. Healthcare Reform
17
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18. Healthcare Reform
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19. Healthcare Reform
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