The adoption of the Affordable Care Act has been deemed as a revolution within the healthcare system that was due to occur and one that holds significant benefits to the American people. The intention of the ACA was to first increase the access to care and to optimize the utilization of the available resources to reach those underserved populations that have previously remained unattended and sidelined (Reeve, Wizemann, Eckert & Altevogt, 2014). A key element and the flagship tag for the ACA was the aspect of universal coverage. This flagship tag of universal coverage more than anything focuses on increasing the enrollment to the available healthcare insurance plans within Medicare and Medicaid with a particular insistent on the low income groups as well as the marginalized groups.
Apparently, the flagship tag however remains a far away target since projections indicate that even by the end of 2016, more than 30 million Americans will be uninsured and this is attributed to the varying decision at state level to initiate full transition to universal coverage with a preference for gradual transition especially in reference to eligibility expansion (Shaw, Asomugha, Conway & Rein, 2014). This idea at state level is regarded as one that will shut out up to six million elderly adults out of the coverage within Medicaid. The overall benefits of the ACA in the long run and in specific as we approach the year 2020 will however be achieved as it is predicted that more policies at federal will be enacted that will require states to expand their eligibility laws and policies.
In terms of payments and reimbursements, the ACA is targeting to shift from the current volume-driven reimbursement formula to a more reliable and accountable value-driven formula. This value-based formula has its emphasis on incentives for high quality service, meaningful outcomes, cost-effectiveness, efficiency and safety (Reeve, Wizemann, Eckert & Altevogt, 2014). A particular reference in this case is the policy within the ACA which limits the reimbursements for hospital acquired infections and thus indicating that healthcare facilities have to take up the costs that arise from such HAIs (Kocher & Adashi, 2011). This decision or policy for instance has an impact on patient safety as care facilities have now a greater responsibility to manage HAIs by adopting strict policies. On the other hand, the strict polices at the institution level ensure that costs associated with HAIs do not compromise the other services within the healthcare system or even so the budgetary planning within those institutions. This means that healthcare providers or facilitates are at all times take full responsibility and account financially for issues relating to patient safety and the quality of care within the concepts of meaningful and measurable outcomes (Sommers, Buchmueller, Decker, Carey & Kronick, 2013). This demand at policy and reimbursement level implies that patients are assured or more likely to receive quality and safe care while also limiting the chances of healthcare providers collaborating with the insurers to make unjustified payments for services that are not economically or clinically relevant and necessary (Clemans-Cope, Kenney, Buettgens, Carroll & Blavin, 2012).
Further, the fact that healthcare providers have a significant room to negotiate with the insurance companies means that they can advocate and protect their patients from exploitation by the competing insurance companies out there that are out to make business and increase their profits (Kocher & Adashi, 2011). This in itself was a sure way that the population out there is protected from exploitation within the open market where aggressive insurance companies are trying to outdo and outsmart each other even at the cost of the client exploitation. On a further note, the ACA has provided the platform on which the healthcare workforce can be empowered. The focus has been on opening up the channels for education within the view that an educated workforce serves the aspects of patient-centered, collaborative care and integrated care that assures of safety, quality and satisfaction (Reeve, Wizemann, Eckert & Altevogt, 2014).
References
Clemans-Cope, L., Kenney, G. M., Buettgens, M., Carroll, C., & Blavin, F. (2012). The Affordable Care Act’s coverage expansions will reduce differences in uninsurance rates by race and ethnicity. Health Affairs, 31(5), 920-930.
Kocher, R. P., & Adashi, E. Y. (2011). Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. Jama, 306(16), 1794-1795.
Reeve, M., Wizemann, T., Eckert, B., & Altevogt, B. (2014). The Impacts of the Affordable Care Act on Preparedness Resources and Programs: Workshop Summary. National Academies Press.
Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient Protection and Affordable Care Act: opportunities for prevention and public health. The Lancet, 384(9937), 75-82.
Sommers, B. D., Buchmueller, T., Decker, S. L., Carey, C., & Kronick, R. (2013). The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health affairs, 32(1), 165-174.
