Understanding the Health Care Reform Act



Understanding the Health Care Reform Act
Understanding the Health Care Reform Act

How has the Patient and Affordable Care Act of 2010 (the “Health Care Reform Act”) reshaped financial arrangements between hospitals, physicians, and other providers with Medicare making a single payment for all care received by a beneficiary from 72 hours before admission to 30 days after discharge from an inpatient facility?

Guided Response: Respond to at least two of your classmates’ posts. Invite your peers to think about how the Medicare payments already challenge the healthcare organizations to maintain profitability and how these changes may have an even greater impact.

MHA 612 Week 2 – Discussion
Your initial discussion thread is due on Day 3 (Thursday) and you have until Day 7 (Monday) to respond to your classmates. Your grade will reflect both the quality of your initial post and the depth of your responses. Refer to the Discussion Forum Grading Rubric under the Settings icon above for guidance on how your discussion will be evaluated.

MHA 612 Discussion – Understanding the Health Care Reform Act
Week 2 Discussion:

After its enactment in 2010, the Affordable Care Act (ACA) changed the financial operations of Medicare in the U.S. As a result, patient financial responsibility increased while instilling lower reimbursement rates to providers (LaPointe, 2016). The ACA has caused some positive effects for providers and negative effects for others. On the upside, value-based care has caused an increase in a higher quality of care (LaPointe, 2016). On the downside, the change has caused an increase in unpaid patient payments (LaPointe, 2016). Post ACA, patients are responsible for more of their out-of-pocket expenses than before the implementation of the ACA. More patients are also engaged in high deductible plans which contribute to the non-payment of out-of-pocket expenses, this includes Medicare patients as well. Providers can expect to collect only 50%-70% of out-of-pocket costs from their patients post ACA as patients are buying higher deductible plans to avoid high premiums (LaPointe, 2016). Overall, the ACA is affecting physician and provider’s bottom lines. As the ACA progressed, the Centers for Medicare & Medicaid (CMS) imposed penalties for any providers that do not comply with certain initiatives (Page, 2013). Primary care and preventative care services are of higher value than prior to the ACA. Between 2011 and 2015, Medicare paid physicians a 10% bonus for primary care services rendered.

Reference:

LaPointe, J. (2016). How the Affordable Care Act Impacted Healthcare Revenue Cycle. Retrieved from https://revcycleintelligence.com/news/how-the-affordable-care-act-impacted-healthcare-revenue-cycleLinks to an external site.

Page, L. (2013). 8 Ways the ACA is Affecting Doctor’s Incomes. Retrieved from https://www.nejmcareercenter.org/minisites/rpt/8-ways-that-the-aca-is-affecting-doctors-incomes/Links to an external site.


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