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American Citizens Making Health.docx
1. [From 10$/Pg] American Citizens Making Health
[From 10$/Pg] American Citizens Making Health RESPOND 300 WORDS:The Patient
Protection and Affordable Care Act (PPACA) is also known as the Affordable Care Act, ACA
and Obamacare. This is a federal law on healthcare reform that became law on March, 23,
2010 (“Patient Protection”, n.d.). The PPACA was enacted to provide numerous rights and
protections to American citizens making health care coverage fairer and easier to
understand, along with subsidies insuch as “premium tax credits” and “cost-sharing
reductions” to make it more affordable (“Patient Protection”, n.d.). Depending on the type of
care that is needs determines the insurance used. When it comes to the PPACA, being that it
is a law it does not make a payment to any healthcare facility but what it does do is help
reduce cost patients and insurance companies concerning preventive care. Patients can get
colonoscopies, mammograms and other preventive care treatment at no cost to them
(American Cancer Society, n.d.). Commercial insurance is not funded by the government
but by private insurance companies. It can be a for profit or not for profit insurance
company. Policies offered from commercial insurance companies have monies paid to them
for coverage purpose from the patient and the rates range on what policy level or term is
selected. Often employers will cover some of the insurance loss. Traditional Medicare is a
federally funded insurance program that services the elderly (65 years and older), people
who are disabled or dealing with the end stages of renal disease (“Original Medicare, n.d.).
Medicare is broken down in parts. Part A and Part B. One is for hospital insurance and the
other covers basic medical insurance. Each facility will be paid the contracted amount based
on the procedure done. When it comes to patients on Medicare depending on eligibility and
election, all recipients have the same coverages under that plan and program. Different
funding types within healthcare facilities can puts constricts on the facilities. Healthcare
operates on margins and with the different funding times all paying different amounts for
the same services would take a strategic plan to be able manage finances and grow. A
strategic plan considering the finances and payments will allow the facility to create more
efficient, service to be able to increase volume also increasing service. RESPOND 300
WORDS: The Patient Protection and Affordable Care Act (PPACA) has brought in various
payment reform models that hold providers accountable for the cost and quality of care to a
specific population. Accountable care organizations (ACO)s have implemented Medicare,
commercial insurance, and federal health coverage as their funding sources to deliver
quality and safe healthcare services to the public. The fee-for-service program, or
Medicare, overseen by the federal government, has traditionally been the most popular type
2. of compensation (Mafi et al., 2021). Healthcare practitioners are compensated depending on
the number of services they offer. In the contemporary era of healthcare facilities, more
providers are turning to accountable care organizations (ACOs) as payment reform
alternatives to fee-for-service. Commercial insurance companies provide health plans
through Preferred Provider Organization (PPO) frameworks to encourage members to seek
care from network providers. Healthcare professionals are compensated based on a set fee
schedule or their actual charges. The PPCA requires insurance companies to spend 80
percent on healthcare coverage and provide comprehensive healthcare coverage options
(Mulcahy et al., 2018). The latter ensures that healthcare organizations can serve many
patients and receive timely payment. The Patient Protection and Affordable Care Act
(PPACA) has significantly impacted how the healthcare sector operates and is structured
today. To adapt to this new paradigm, health managers must analyze and apply new tactics.
Patient Protection and Affordable Care Act (PPACA) has led to an increase in the number of
people who can access healthcare services through its affordable health coverage model
(Mulcahy et al., 2018). Due to an increase in patients, more physicians would be needed to
meet the demand while still providing high-quality treatment. Furthermore, hospital
managers who have become reliant on the present price structure for acute care services
will have to balance the quest for cost reductions in the inpatient environment with the
development of capabilities that will enable them to serve more patients. Since outside
commercial insurance companies and the government pay the majority of doctor’s visit
charges, patients usually are unaware of or unconcerned about the cost, which is, to some
extent, the cause of our rising human services costs.