I’m working on a health & medical discussion question and need support to help me understand better.
Please write a discussion and respond to this 2 peers’ Discussion Prompts
Health care organizations will need to make changes to comply with the new healthcare reform legislation.
- Describe the financial impact the Affordable Care Act (ACA) will have on HCOs, as well as proactive ways HCOs can mitigate these financial impacts.
- Respond to at least two (2) of your classmates’ or your instructor’s posts. Your responses should include elements such as follow-up questions, a further exploration of topics from the initial post, or requests for further clarification or explanation on some points made.
- ALL citations and references needs to be APA 7th edition format. THANK YOU!
In March of 2010, President Obama signed into law the Affordable Care Act, ACA (Nowicki, 2015). This act was designed to provide insurance coverage to an additional 32 million Americans, increasing the health insurance coverage to 94% of the population (Nowicki, 2015). According to LaPointe (2016), the ACA has significantly changed the health care revenue cycle management landscape since its passage. After the ACA, care transitioned to value-based and there was a rise in patient consumerism. The ACA set out to provide health insurance coverage to more Americans, but this also caused a rise in patient consumerism (LaPointe, 2016). LaPointe (2016) states that of the 12.7 million consumers, 90% of them enrolled in high-deductible health plans in 2016. Because of this, providers are finding it difficult to collect full payments from patients. Patients gained a sense of empowerment and they began choosing providers based on their expectations and needs (LaPointe, 2016). Providers had to improve their patient satisfaction scores to attract and retain patients (LaPointe, 2016).
The ACA also changed the payments that providers received, so providers had to reshape their care to receive the full incentive under the value-based care model (LaPointe, 2016). Providers reported that lower reimbursement rates for increasing patient volumes was a top concern after the implementation of the ACA (LaPointe, 2016). Some Medicare and Medicaid reimbursement rates declined under the ACA as a way to transition HCO’s away from the fee-for-service model. HCOs were rewarded for high-quality, affordable care rather than volume. To avoid declining reimbursement payments, HCOs should look to monitor quality improvements, more robust population healthcare management techniques, and upfront patient billing strategies as a way to mitigate the financial impacts of the ACA (LaPointe, 2016).
The Affordable Care Act has helped millions of Americans obtaining healthcare coverage. Millions of lives, been saved because of this, and strengthened the health care system. “The Affordable Care Act codified protections for people with preexisting conditions and eliminated patient cost sharing for high-value preventive services.” Centers for American Progress (2020, October 6).
Some of the ways that Affordable Care Act been impacting the HCOs are with the increase of the number of Americans with healthcare insurance. Another point is the accessibility of people with preexisting conditions are being able to receive the proper medical care without feel discriminated. No healthcare provider can deny care for this patient and with it, they healthcare provided been having an increment on revenues at their side. One of the ways that is it possible is because of the Medicaid expansion, allowing more people been able to qualify for medical insurance. “Some of the Medicaid benefits expansions are the capability of diagnosis and treatment of health ailments, including cancer, mental illness, and substance use disorder”. Centers for American Progress (2020, October 6).
A proactive way of mitigating the impact of the Affordable Care Act in the Health Care Organizations is providing better training and more mechanisms to their medical staff and increment the productivity. Increasing the productivity and the customer service at the HCOs will be ending in the volume incrementation of patients and less distress for the staff. This include the implementation of new software’s and the implementation of Telehealth, allowing the clinic to increment services and minimize errors.