Hi, I am a qualified and excellent writer, but too much busy and have Five Modules incomplete assignments ( Healthcare policy course / Master's degree), including a course project due on 10th Dec. R
Sheena Lamon
Manage Discussion Entry
Healthcare policy has a direct impact on the health and health services provided to the public in the United States. There is no healthcare service that does not rely on funding from government insurance programs; therefore, policies surrounding reimbursement for these services are the focus of any healthcare system. Policies that focus on quality of care and outcome measures (pay for performance model) and paying through bundles has resulted in initiatives for same day discharge, nursing care management programs to reduce readmissions, and a push for everyone who works in healthcare to think differently about how we care for our most complex patients. As summarized by Cutler (2015), the two areas that the Affordable Care Act (ACA) that we need to focus on is “continuing to slow the increase in health costs and improving the practice environment for physicians” (p. 337). By switching to a value based payment model from a volume base model, the goal is to eliminate waste. As a result, individuals with backgrounds in Lean Six Sigma from the technology and business world are being recruited to the healthcare industry to try their hand at helping hospitals and physicians reach these new policy standards. (de Koning, 2006)
Bundle payments and reducing the payment for some surgical procedures has caused several physician surgical organizations to oppose policies for a decrease in their bundle payments. They believe that decreasing the payment will result in private practice surgeons to not be able to provide certain services due to the loss in revenue by doing so, resulting in a decrease in surgeons performing those procedures. This could be an example of how some policies are developed with the wrong interpretation of the data or as Patel & Rushefski (2006) stated, “it is often not the magnitude of numbers but rather the interpretation of numbers that influence policy making” (p. 3). With the wrong information driving policy decision, there can be unforeseen consequences to the health and services that are available to the public.
References
Cutler, D. (2015, July). From the Affordable Care Act to affordable care. Journal of the American Medical Association. 314(4): 337-338.
de Koning, Henk MSc; Verver, John P. S.; van den Heuvel, Jaap MSc; Bisgaard, Soren PhD; Does, Ronald J. M. M. Lean Six Sigma in Healthcare, Journal For Healthcare Quality: March 2006 - Volume 28 - Issue 2 - p 4-11 doi: 10.1111/j.1945-1474.2006.tb00596.x
Patel, K., & Rushefski, M. (2006). Health care politics and policy in America (4th ed.). Armonk, NY: M.E. Sharpe. ISBN: 0765614790.
Ansley Rushing
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Healthcare policies directly affect the healthcare patients receive. Healthcare policies are not guaranteed to always work in the interest of the patients. However, any attempt to improve the system is valuable. The affordable care act is not a solution meant to last forever. The primary focus of this act was to expand the insurance coverage for the country (Cutler, 2015). This is something that was necessary to help people have options for health insurance. This policy changed many aspects of healthcare coverage.
Another aspect of the ACA is the high cost-sharing plans. In theory these should work. Patients will want to save money and will be less likely to go to the doctors. In personal experience this is counterproductive. Without the reduction in costs of healthcare the high cost-sharing plans only reduces people who receive care. This goes for people receiving preventative care as well. Preventative care is one of the better ways to save money in healthcare (Cutler, 2010). This is important to note because the patients are not the only ones that benefit from preventative care.
A third aspect that the ACA focuses on is cost reduction. It is built to support innovations that reduce healthcare costs (2020). This is a huge section that will benefit everyone. If healthcare costs are lower then patients costs are decreased and providers profit margin can increase. This is an area that is most interesting for myself due to the ability to benefit all.
References
Affordable care Act (ACA) - HEALTHCARE.GOV GLOSSARY. (2020). https://www.healthcare.gov/glossary/affordable-care-act/.
Cutler, D. (2010, June). How health care reform must bend the cost curve . Health Affairs, 29(6), 1131-1135
Cutler, D. (2015, July). From the Affordable Care Act to affordable care. Journal of the American Medical Association. 314(4): 337-338.
Melanie Coffey
Manage Discussion Entry
If this last year has taught us anything, it's how much health policy both helps and hurts people and their access to care in this country. Over the last decade, more people than ever have finally had access to health insurance, making it easier to access the care they need through the Affordable Care Act. The ACA was put in place to help Americans and cut costs of wasteful expenses in order to give more people access to affordable care. Although the ACA has been challenged for its inclusion of an individual mandate, making it a requirement that most individuals have insurance or face a tax penalty (Henry J. Kaiser Family Foundation), that mandate was upheld and determined lawful by the Supreme Court, which helped cut costs for many Americans. The mandate was in place until Trump put an end to it through executive order, causing some costs to skyrocket. In order to keep costs down, there need to be other ways, besides the mandate to cut them. As Cutler points out, healthcare grows at a rate of 1-2% above the economies growth and that by eliminating the wasteful spending, which is estimated at 1/3 of medical costs, not only would rates lower, but health care would be more affordable for all (2015). Another way to cut costs is through cost sharing, having patients pay a higher cost for their services to cut down on wasteful treatments (Cutler, 2015). Both ideas have merit. We need to make healthcare more mainstream, saving insurance companies, hospitals, and other health facilities both time and money. This will allow them to lower costs while still making a profit. Having patients be more responsible for their care through cost sharing could cut down on needless tests and services, also helping save money.
While costs play a huge role in both policy and access, so do some of the rules put in place. When the ACA was introduced, it allowed anyone to have access to care, regardless of pre-existing conditions. There was the market place, which was opened once a year to allow people to sign up, expanded employer coverage, and Medicaid expansion in some states. As I pointed out, healthcare policy has both helped and hurt people, especially over the last year. With the loss of 27 million plus jobs last year, many people also lost their employer based health coverage (Liu, 2020). This loss opened up some of the ongoing issues with access to care in this country. With people's coverage is linked to employment, many found themselves with no other options during the worst public health crisis most of us have lived through. I live in Virginia, which luckily expanded Medicaid in 2018. My sister was one of those who lost her job due to the pandemic and was able to access Medicaid almost immediately. She was lucky, but many are not.
It always boggles my mind that we live in what's supposed to be the greatest country in the world and we cannot find a way to make access to care a right of all members of our country. I think that as long as partisanship is as decisive as it has been for at least the last decade, our policies and the needs of our country will never align.
References:
Cutler, D. (2015). "From the Affordable Care Act to affordable care." Journal of the American Medical Association. 314(4): 337-338.
Liu, J. (2020) "U.S. health care policy." Rand Corporation. https://www.rand.org/health-care/key-topics/health-policy.html (Links to an external site.)
The Henry J. Kaiser Family Foundation. (2012). "A guide to the Supreme Court’s Affordable Care Act decision." Focus on health reform. 1-10.
