There are a plethora of health care economic and financial policies .docx

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There are a plethora of health care economic and financial policies in effect at both the state and federal levels. Each policy has implications that are relative to consumers, providers, and insurers. Expand on a policy that has yielded negative implications (for the consumer, provider, or insurer) and provide recommendations to alleviate or eliminate such negative implications. Write a minimum of 1,000 words that describe and explain the background of the topic. Topic: The Patient Protection and Affordable Care Act (PPACA) aims to bridge the underinsured and uninsured gap in the United States by mandating that individuals obtain health insurance. Depending on circumstance, this shifts the medical cost from the insurer (government) to the consumer, or in some instances, the employer. Must include: Policy development Intended purpose of the policy Capitalism, socialism, or a mix? Supporters and critics of the policy ...

Education

There are a plethora of health care economic and financial policies .docx

This document provides instructions to research and write an 8-10 page paper on one of the following health policy issues: medical marijuana, assisted suicide and euthanasia, vaccines for children, the Patient Protection and Affordable Care Act, or right to health care. The paper should address the political, financial, and economic background of the issue; who will be eligible for services and who will provide them; the impact on recipients and providers; eligibility requirements and application process; involved government programs and their roles; and budgetary considerations like funding sources.

Chapter 18 Private and Government Healthcare Systems Pri

MorganLudwig40

Chapter 18 Private and Government Healthcare Systems Private and Government Healthcare Systems In the United States, health insurance coverage is generally classified as either private (non-government) coverage or government-sponsored coverage. Healthcare Coverage vs. Uninsured The National Center for Health Statistics defines health insurance as public and private payers who cover medical expenditures incurred by a defined population in a variety of settings. In the United States, the risk of becoming uninsured increases significantly for those earning low wages, the unemployed, and when employers are unable to provide insurance to workers. Table 5-2 presents the trend of declining health insurance coverage. Private Health Insurance The concept of insurance is to combine the healthcare experiences of many enrollees in order to reduce expenses for any one individual to a manageable prepayment amount. Employment-Based Plans is coverage offered through one’s own employment or a relative’s employment. It may be offered by an employer or by a union. Private Health Insurance Continued Direct-Purchase/Fee-For-Service Plans are the traditional type of healthcare policy. The physician sets a price for each type of service delivered, and then the client or insurance company pays the fee. This type of health insurance provides the most choices of doctors and hospitals. Private Health Insurance Continued The two kinds of fee-for-service coverage are basic and major medical. Basic covers some hospital services and supplies, such as X-rays and prescribed medicine. Major medical insurance covers the cost of long-term, high-cost illnesses or injuries plus whatever basic did not cover. Private Health Insurance Continued Group Contract Insurance—to make hospitals and physicians products and services affordable to ordinary people in the United States. With unmanaged care (fee-for-service) payments, healthcare providers could increase the number of single services they deliver in order to increase profit. Private Health Insurance Continued Managed Care—manages the cost and delivery of healthcare services, the quality of that healthcare, and access to care. Managed care influences how much healthcare clients can use. Health Maintenance Organizations (HMOs) are prepaid health plans. The goal of an HMO is to provide affordable, well-organized healthcare by allowing clients to prepay (capitation payment) on a regular monthly basis for all services provided. Private Health Insurance Continued Including physicians’ visits, hospital stays emergency care, surgery, laboratory (lab) tests, X-rays, and therapy for all members and their families. There may be a small co-payment for each office visit, such as $15 for a doctor’s visit or $50 for hospital emergency room treatment. Private Health Insurance Continued Point-of-Service Plans (POS) offer enrollees the option of receiving services from participating or nonparticipating prov ...

Health Care Reform in the United States

Craig B. Garner

hapter 5What Are the Governmental AlternativesThe United Stat

JeanmarieColbert3

hapter 5 What Are the Governmental Alternatives? The United States has tried an alphabet soup of health policy options: HSAs, HMOs, IPAs, PPOs, POS plans, ACOs, and so on. Health care analysts often must look beyond specific organizational and financial alternatives and address issues at a higher level and deal with the threads of economic and political thought behind different proposals while considering the overall criteria of access, cost, and quality of care. Politicians and businesspeople from outside the health care sector advocate many alternatives. To offset their tendency to ignore professional issues, in this chapter we discuss alternatives affecting professional status and roles and institutional responses to them. Table 5-1 presents an array of federal alternatives organized by their primary criteria—access, quality, or cost—and then by the economic philosophies behind them. The items in this array are not intended to be either mutually exclusive or collectively exhaustive; rather, the table provides a framework for looking at both the broad policy picture and specific health care actions taken at various times and places. Later in the chapter, another table (Table 5-3) summarizes policy alternatives added by state and local governments. Many of these alternatives were included as provisions of the Affordable Care Act (ACA). They are still included here, partly because they may be subject to reconsideration in the future. Table 5-1 Illustrative Federal Government Health Policy Options Access to Care • Administered systems • Universal coverage • Expand or reduce eligibility or benefits • Mandate coverage and services • Captive providers • Control insurance industry practices • Mandate employer-based insurance coverage • Consumer-driven competition • Implement insurance exchanges • Encourage basic plans with very low premiums for low-income workers and “young invincibles” • Mandate individual coverage • Allow states flexibility to reallocate federal funds for vouchers • Oligopolistic competition • Expand or contract coverages in entitlement and categorical programs • Allow states to reallocate federal uncompensated care funds • Eliminate ERISA constraints on the states • Expand the capacity of the system Quality of Care • Administered system • Mandate participation in quality improvement efforts in federal plans and programs • Add more pay-for-performance incentives • Select providers and programs on the basis of quality excellence • Consumer-driven competition • Encourage or mandate transparency of quality reporting in federal plans and programs • Oversee licensure and credentialing of foreign-trained providers • Oligopolistic competition • Work reporting of quality care and adverse events into purchasing specifications for federal programs and disseminate to the public • Encourage wider use of health information technology Cost of Care • Administered system • Use full bargaining power in negotiation of ...

Fight Formyway.pdf

Vograce

State Health Reform

soder145

hCentive Health Insurance Exchange Platform

Alisha North

The document discusses the establishment of state-based health insurance exchanges under the Affordable Care Act beginning in 2014. The goal is to expand coverage, slow cost growth, and provide subsidies. Prior state-run insurance cooperatives and purchasing pools had mixed results. Implementing exchanges will be challenging given each state's political environment and the economy. Stakeholders must work together to address complexities of reform.

August Newsletter

mikewojcik

The document discusses rising healthcare costs in the US and a new study projecting that healthcare spending will increase substantially over the next decade. It also summarizes strategies that large employers are implementing to better manage costs, such as health improvement programs, engagement of employees, accountability measures, and use of technology. Finally, it provides legislative updates on expanded preventive care coverage for women and subsidies available through the Affordable Care Act.

An Obamacare Primer -- cutting through the complexity

Adrian Ho

An Overview of the ACA (aka Obamacare), October 2013

Adrian Ho

Policies and PerspectivesComplete the Health Policy and Perspect.docx

sarantatersall

Policies and Perspectives Complete the Health Policy and Perspectives grid based on the scenario that your instructor has provided to you. --Scenario -- the government has decided to change its policy on AIDS/ HIV care. They will be investing millions of dollars in education, treatment, and possible cure. the policy goes into effect Oct 1 2014 and also mandates that insurance companies provide the medications for free . Some members of congress are upset because that money was supposed to go to senior care including helping with the care of dementia patients. Identify 4 to 5 stakeholders whose perspectives must be considered in the policy. For example - patients, providers, insurance companies. Complete all sections (note: Fill in every box with statements, not X's or check marks) of the grid with a statement on the varying perspectives of the various stakeholders that you have identified and who are involved in the policy issue. For example -- United Health Care has lobbied against this policy because of the huge economic commitment Identify 4 to 5 stakeholders whose perspectives must be considered in the policy. Complete all sections of the grid with a statement on the varying perspectives of the various stakeholders that you have identified and who are involved in the policy issue. List 4-5 Stakeholders who would be affected by this policy: Possible perspectives held by these stakeholders: Conservative Liberal Legal Religious Ethical Cultural Societal Economic Be sure to properly cite any references used in APA format. .

HCS 410 ACA.edited final copy

Gina Leymeister

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.

care the affordable care act and.docx

stirlingvwriters

The document discusses the key goals and provisions of the Affordable Care Act (ACA). It outlines three primary goals: 1) Make affordable health insurance available to more people through subsidies, 2) Expand Medicaid eligibility, and 3) Support innovative healthcare delivery to lower overall costs. The ACA aims to increase access to healthcare through mandates, subsidies, and Medicaid expansion. Nurses can help support public health by educating families and communities about accessing insurance coverage under the ACA.

Morgan2011

Virginia Rural Health Association

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.

Implications for The Medicare Program Discussion.docx

4934bk

This document discusses implications for the Medicare program given demographic trends in the aging US population. It outlines 10 issues arising from an increasing senior population and the implications for Medicare delivery and costs. It also discusses potential solutions to issues providing healthcare for seniors, including maintaining the political and fiscal viability of Medicare in the future.

Second essayTopic Monopoly in the united state of America.docx

rtodd280

Second essay Topic: Monopoly in the united state of America 800 words Note: This assignment is an essay (not a research paper), which will detail your point of view concerning a current economic problem. frame the problem, analyze the problem, and develop a proposed solution to the problem using economic knowledge and critical thinking skills. Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings Michael T. French, Jenny Homer, Gulcin Gumus, and Lucas Hickling Objectives. To conduct a systematic literature review of selected major provisions of the Affordable Care Act (ACA) pertaining to expanded health insurance coverage. We present and synthesize research findings from the last 5 years regarding both the imme- diate and long-term effects of the ACA. We conclude with a summary and offer a research agenda for future studies. Study Design. We identified relevant articles from peer-reviewed scholarly journals by performing a comprehensive search of major electronic databases. We also identified reports in the “gray literature” disseminated by government agencies and other organizations. Principal Findings. Overall, research shows that the ACA has substantially decreased the number of uninsured individuals through the dependent coverage provision, Medicaid expansion, health insurance exchanges, availability of subsidies, and other policy changes. Affordability of health insurance continues to be a concern for many people and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care. All of these changes are certain to ultimately impact state and federal budgets. Conclusions. The ACA will either directly or indirectly affect almost all Americans. As new and comprehensive data become available, more rigorous evaluations will provide further insights as to whether the ACA has been successful in achieving its goals. Key Words. Affordable Care Act (ACA), health insurance, health care, systematic review On March 23, 2010, following a long and controversial political and legislative process, President Obama signed the Patient Protection and Affordable Care Act (ACA) into law, ushering in the most significant changes to the U.S. health care system since the passage of Medicare and Medicaid in 1965. The ACA © Health Research and Educational Trust DOI: 10.1111/1475-6773.12511 POLICY-MANAGERIAL IMPACTARTICLE 1735 Health Services Research includes a series of ambitious reforms that build upon the existing system of employer-sponsored insurance (ESI) and creates new requirements for individuals, employers, health care providers, and insurance companies. It is intended to address three main areas: access to health insurance, health care costs, and the delivery of care (Blumenthal, Abrams, and Nuzum 2015). Cer- tain elements of the law became active soon after i.

Newsletter Discussing Debt

The Horton Group

The document summarizes recent studies and trends related to rising healthcare costs in the US. It discusses projections that healthcare spending will grow faster than GDP over the next decade and account for 20% of national spending by 2020. It also outlines strategies that large employers are using to better manage costs, such as engaging employees in wellness programs, linking provider strategies to quality outcomes, and using health technology. Additional sections provide updates on provisions and guidelines under the Affordable Care Act.

Newsletter Discussing Debt

The Horton Group

The document discusses rising healthcare costs in the US and a new study projecting that health care spending will grow faster than GDP over the next decade. It also summarizes strategies that large employers are using to control costs, such as account-based health plans, engagement of employees in wellness programs, and accountability measures. Updates on the Affordable Care Act include expanded preventive coverage for women and guidelines for employer health subsidies in 2014.

Obama care

Sabita Shahi

The Affordable Care Act, also known as Obamacare, aims to provide more Americans with access to affordable health insurance and reduce health care costs. It expands Medicaid eligibility and subsidizes private insurance premiums. Key provisions include prohibiting denial of coverage for pre-existing conditions, allowing children to stay on parents' plans until age 26, and mandating that most Americans obtain health insurance or pay a penalty. The law has led to over 20 million Americans gaining health insurance coverage.

National Health Reform Proposals

guest93c4323a

There is broad consensus around the structure of national health reform proposals but disagreements remain around key details. Most proposals include subsidies for lower-income individuals, a health insurance exchange, a mandate for individuals to have coverage, new rules for insurers, and efforts to slow cost growth through payment reforms. However, important questions remain around issues like how much subsidies should cover, who will run the exchange, how affordability will be determined, and how the proposals will be financed without adding to the federal deficit.

Health Care Reform

Write My Paper In Apa Format University Center

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.

N.J. Health Reform update - 2019

Employers Association of New Jersey

This document summarizes New Jersey's efforts to reform its health care system and preserve the Affordable Care Act. It discusses the state's high health care costs and rates of uninsured prior to the ACA. The new law in New Jersey requires residents to have minimum essential health coverage, establishes a state-run health insurance exchange, provides reinsurance to insurance companies, and levies a tax on commercial policies to fund the exchange. However, the reforms do little to control escalating health care spending or prices in New Jersey. Challenges remain such as the potential for insurers to cherry-pick healthier customers through the use of stop-loss insurance.

LECTUREUnit ObjectivesAfter completing this unit, you should b.docx

gauthierleppington

LECTURE Unit Objectives After completing this unit, you should be able to define moral hazard , adverse selection , and cost-shifting identify the major public programs for the financing of health care compare and contrast Medicare and Medicaid list and describe the four sub-programs of Medicare describe different reimbursement approaches for health services Unit Lecture When asked how health care services are paid for, many of us think immediately of health insurance. However, we typically don't think about the dynamics behind health insurance or the various types of programs through which it is delivered. At its most basic level, health insurance is a tool for mitigating risk. An individual purchases health insurance to mitigate the risk of having to pay an enormous medical bill in the event of sickness or injury. Those who provide health insurance—insurance companies—also work to mitigate risk, albeit from the other side. They attempt to create a risk pool containing a large number of healthy people to offset the expenses accrued by those who do get sick or injured. Premiums , the fees paid for ownership of health insurance, are used to subsidize the cost of the health care provided to those who use the insurance. Factors that insurance companies need to be mindful of include moral hazard , whereby an insured individual is more prone to seek care than if he or she were paying the medical bill him- or herself; and adverse selection , whereby insurance is mainly purchased by those most in need of it. As with any financial enterprise, if the costs of providing the product or service exceed the revenue, the company goes out of business. There are several types of insurance programs, both public and private. Together, these programs cover not only individual health services, but public health services, research, and the administration of the delivery and financing of health care in the United States. The majority of public and private expenditures—approximately 81 percent—are directed toward hospital care, provider and clinical services, long-term care, and prescription drug provision (Kovner & Knickman, 2011). As mentioned in the week 4 lecture, health insurance is a relatively new mechanism for financing health services, and it has grown substantially since the mid-1900s, when only 9 percent of the US population had health insurance (Blumberg & Davidson, 2009). Health insurance can be broken down into private and public insurance. Private health insurance is primarily employment-based, meaning that individuals receive coverage through commercial health insurance plans for which their employers either pay the premiums or subsidize them, with the employee paying the balance. Some larger employers choose to self-insure, which means that they administer their own plans and accept the financial risk of doing so. In essence, they act as the insurer of their employees. Some individuals, either through necessity or choice, opt to purchase t.

SAC410 chapters 9 and 10

BealCollegeOnline

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.

Healthcare Reform CHRONIC DISEASE, PREVENTION & QUALITY

Christopher Owens

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 Proposed Health Care Reform’S Impact On Marketing

Stone 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.

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There are a plethora of health care economic and financial policies .docx

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