- BHA FPX 4003 Assessment 1 The Affordable Care Act and Beyond.
The Affordable Care Act and Beyond
In the United States, the ACA considers healthcare delivery’s current and future. ACA and MACRA (Affordable Care Act and Medicare Access and CHIP Reauthorization Act) have different objectives and histories. This study will discuss the following goals: In addition, it will discuss how these projects are related, how they are transforming the American healthcare system at present, and what their implications might be for future healthcare policy and services.
Sources Addressing the Affordable Care Act
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in health insurance coverage and access to care. Health Affairs, 39(3), 395–402.
https://doi.org/10.1377/hlthaff.2019.01394
This source claims that the ACA has helped the US reduce gaps in health insurance coverage and access. Specifically, disparities in insurance have decreased mainly because several non-Hispanic Blacks and Hispanics gained insurance compared to whites. This good result depicts the healthcare system evolving to be fairer over time. Despite the changes that have been made, only some have health insurance.
Although the process of getting healthcare services has been made more accessible through the Affordable Care Act, the issue of healthcare equality may not be easily attained because black and Hispanic people are still vulnerable to a lack of health insurance compared to their white counterparts.
Gruber, J., & Sommers, B. D. (2019). The Affordable Care Act’s effects on patients, providers, and the economy: What we have learned so far. Journal of Policy Analysis and Management, 38(4), 1028–1052.
https://doi.org/10.1002/pam.22158
The literature review of the last ten years reveals that the ACA’s measures, such as expanding Medicaid and creating health insurance exchanges, have increased the number of insured individuals. Since the law has extended the possibility of more people accessing health care, health status may have improved. Despite the concern, there are still issues with the entry of providers, the workforce, and the financial requirements of the state governments.
As we approach the ACA’s tenth anniversary, it is becoming increasingly clear that this legislation has significantly improved the availability and quality of healthcare in the United States. This milestone provides an opportunity to reflect on the ACA’s impact over the past decade and its implications for the future of healthcare policy and services.
Lantz, P. M., & Rosenbaum, S. (2020). The potential and realized impact of the Affordable Care Act on health equity. Journal of Health Politics, Policy, and Law, 45(5), 831–845.
https://doi.org/10.1215/03616878-8543298
According to Lantz and Rosenbaum (2020), health care has become more affordable under the ACA, and the quality of care has increased; race-based disparities in access to care have decreased. The study thus reveals that healthcare performance has dramatically improved since the ACA became a decade old. The law has also assisted in the accessibility of insurance, visiting primary care physicians, and insurance utilization.
This has decreased the incidences of racism and economic discrimination. The ACA has also allowed community health centers to expand the scope and types of services they can provide, which has helped them generate more revenues. Thus, Section 1557 of the ACA enhanced human rights in health care to address the issue of fairness.
The impact of the increase in Medicaid on health outcomes and health equity is not well understood; however, it has been quite effective in reducing some social determinants of health, including mortality and preterm births. This indicates that through the ACA, healthcare has become better and more accessible in many ways, as discussed in BHA FPX 4003 Assessment 1 The Affordable Care Act and Beyond.
Sources Addressing the Medicare Access and CHIP Reauthorization Act (MACRA) (2015)
Abodunde, B., Slater, C., & Coustasse, A. (2020). MACRA and accountable care organizations. Journal of Ambulatory Care Management, Publish Ahead of Print (9).
https://doi.org/10.1097/jac.0000000000000350
This paper focuses on the transformation of Accountable Care Organizations under MACRA. The data clearly demonstrate that MACRA has significantly improved healthcare, as evidenced by the success of ACOs. This success should reassure the audience about the quality of care under MACRA.
Cheng, J., Kim, J., Bieber, S. D., & Lin, E. (2020). Four years into MACRA: What has changed? Seminars in Dialysis, 33(1), 26–34.
https://doi.org/10.1111/sdi.12852
Therefore, Medicare workers receive a certain amount of Money from the program, depending on what they spend and the quality of service. MACRA’s Advanced APM and the Merit-based Incentive Payment System require that providers provide patients with good care at an affordable cost. First Results from Different Payment Models with a Strong Academic Base (ESRD) It is stated that integrated service companies have low cost and high quality. The 2019 executive order also mentioned new medicines, home dialysis, and organ transplants as measures of controlling the prices and enhancing the outcomes of kidney diseases. Politicians, nephrology professionals, and patient support groups should be involved in this process to ensure that measures taken to change the care delivery structure do not harm the patients and benefit them.
Soylu, T. G., Goldberg, D. G., Cuellar, A. E., & Kuzel, A. J. (2020). Medicare Access and CHIP Reauthorization Act in small to medium-sized primary care practices. The Journal of the American Board of Family Medicine, 33(6), 942–952.
https://doi.org/10.3122/jabfm.2020.06.200142
Macra has been described by Heart of Virginia Healthcare as having altered the standards and ease of access to primary care for small and medium-sized practices in the following ways. Although independent practices were more conscious of MACRA, various practices had different levels of knowledge. There are problems even with practices, especially private ones, that attempt to implement MACRA. Thus, the authors recommend that lawmakers pay attention to the unintended consequences of payment reform policies and ensure that they help to smooth the transition to the new payment model in the healthcare system. Thus, both Availability and quality of care will be sustained to meet the population’s needs.
Impacts of the ACA and The Medicare Access and CHIP Reauthorization Act (MACRA) (2015) on the US. Health Care Ecosystem
Affordable Care Act Overview
The Patient Protection and Affordable Care Act, commonly known as the ACA, was signed into law by President Obama in 2010 (Zhao et al., 2020). It started by solving problems such as high uninsured rates, increasing healthcare costs, and inequalities in the quality of care. Obamacare, or the Affordable Care Act, is a healthcare law that seeks to expand health insurance coverage, decrease costs, and enhance the quality of care.
The Affordable Care Act is a bill designing the transformation of the American healthcare system with the help of several strategies. Measures such as offering health insurance marketplaces for individuals and small businesses, offering medical coverage to more low-income individuals and companies, and protecting the consumer by banning exclusion based on pre-existing conditions are crucial (Zhao et al., 2020).
Impact of the Affordable Care Act and MACRA on Healthcare Delivery
The Affordable Care Act (ACA) requires the insured population to obtain health insurance and offers them essential health benefits, including preventive care services that are affordable or even free. This paper will argue that more people can access quality healthcare services through the ACA. Zhao et al. (2020) mentioned that the Affordable Care Act (ACA) enhanced insurance status, reduced the rate of uninsurance, and offered healthcare services to individuals and families via the expansion of Medicaid and the establishment of insurance marketplaces.
This paper focuses on the Medicare Access and CHIP Reauthorization Act (MACRA) (2015). The MACRA (Medicare et al. Act) 2015 changed this program’s payment systems. The purpose of its development is to optimize a more sustainable and value-based system of healthcare delivery. The Medicare Access and CHIP Reauthorization Act (MACRA) started a new payment system to encourage efficient and high-quality health care, replacing the Sustainable Growth Rate formula that determined Medicare physician payments.
MIPS and the Advanced APMs are critical in MACRA’s bid to reward physicians as it seeks to achieve its aim. In the study by Jones et al. (2019), MIPS assesses the quality of care delivery and the level of resource utilization by healthcare providers. However, APMs support new care models involving risk and reward payments to doctors based on efficient and quality services.
It is necessary to note that the main idea of MACRA is to change the payment model of services provided under Medicare from fee-for-service to value-based care. MACRA aims to enhance, reintegrate, and reduce by relying on paymenwards with quality efficiency indicators (Jones et al., 2019). Healthcare organizations are urged to adopt new payment methods that focus on managing populations and the value of services. The legislation seeks to transform Medicare into a sustainable and patient-focused MACRA system.
Effects on the United States Health Care Environment
To a large extent, MACRA was designed by the ACA. First and foremost, MACRA focuses on value-based care and quality improvements of services, as the ACA does (Chernew et al., 2020). The ACA also shifted the payment model from fee-for-service to value-based purchases and ACOs. Second, MACRA could depend on the technological framework of the ACA’s emphasis on health information technology and electronic health records provided (Chernew et al., 2020). The legislation that MACRA focuses on improving the quality of care delivered to patients with the help of EHRs and the ACA’s meaningful use provided the impetus for this goal.
Impact of ACA and MACRA on Healthcare Quality and Access
The effects of the ACA and MACRA on American healthcare are far-reaching. The Affordable Care Act has expanded the insured population, reduced the rate of uninsured citizens, and improved preventive health care. The ACOs and other ACA measures have helped improve the quality of healthcare and care coordination. Chernew et al. (2020) have pointed out that MACRA has encouraged value-based payment and quality reporting through MIPS and APMs.
The ACA’s emphasis on early health care and insurance may encourage other endeavors towards attaining equal health care access and decreasing health disparities (Chernew et al., 2020). MACRA’s focus on value-based and alternative payment models creates a foundation for future work to align payment incentives with the obtained quality outcomes (Chernew et al., 2020). The newly released MACRA rules, emphasizing interoperability and health information exchange, are well-positioned to address the next generation of healthcare technology and data sharing, thus laying the foundation for more coordinated and patient-centered patient-centered care delivery models.
Conclusion
The US healthcare system has much to look forward to, owing to the ACA and the MACRA. These laws have entirely shifted the system depending on the part of the world that one is from. Due to such rules, the system is prepared for value-based care, more people can obtain it, and the uninsured population has decreased. Value-based payment methods and responsible care organizations demonstrate how people cooperate to improve the healthcare system. Interoperability and health IT are two of MACRA’s new concepts connected to the reimbursement program. Explore our blog BHA FPX 4006 Assessment 4 Voluntary Accreditation for complete information about this class.
References
Abodunde, B., Slater, C., & Coustasse, A. (2020). MACRA and accountable care organizations. Journal of Ambulatory Care Management, Publish Ahead of Print (9).
https://doi.org/10.1097/jac.0000000000000350
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in health insurance coverage and access to care. Health Affairs, 39(3), 395–402.
https://doi.org/10.1377/hlthaff.2019.01394
Cheng, J., Kim, J., Bieber, S. D., & Lin, E. (2020). Four years into MACRA: What has changed? Seminars in Dialysis, 33(1), 26–34.
https://doi.org/10.1111/sdi.12852
Chernew, M. E., Conway, P. H., & Frakt, A. B. (2020). Transforming Medicare’s payment systems: Progress shaped by the ACA. Health Affairs, 39(3), 413–420.
https://doi.org/10.1377/hlthaff.2019.01410
Gruber, J., & Sommers, B. D. (2019). The Affordable Care Act’s effects on patients, providers, and the economy: What we have learned so far. Journal of Policy Analysis and Management, 38(4), 1028–1052.
https://doi.org/10.1002/pam.22158
Jones, R. T., Helm, B., Parris, D., Grubbs, S. S., Choy, H., & Kapetanovic, K. (2019). The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) made it simple for medical and radiation oncologists. JAMA Oncology, 5(5), 723.
https://doi.org/10.1001/jamaoncol.2018.5631
Lantz, P. M., & Rosenbaum, S. (2020). The potential and realized impact of the Affordable Care Act on health equity. Journal of Health Politics, Policy, and Law, 45(5), 831–845.
https://doi.org/10.1215/03616878-8543298
Soylu, T. G., Goldberg, D. G., Cuellar, A. E., & Kuzel, A. J. (2020). Medicare Access and CHIP Reauthorization Act in small to medium-sized primary care practices. The Journal of the American Board of Family Medicine, 33(6), 942–952.
https://doi.org/10.3122/jabfm.2020.06.200142
Zhao, J., Mao, Z., Fedewa, S. A., Nogueira, L., Yabroff, K. R., Jemal, A., & Han, X. (2020). The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years. CA: A Cancer Journal for Clinicians, 70(3).