Use the framework presented in Stone’s Policy Paradox and the expertise you have developed in your previous assignments (position paper, discussion boards, web exploration, and readings) to consider y

Introduction 

The Affordable Care Act (ACA) has been a continuing healthcare process to enhance the affordability of healthcare given within the United States (US). However, the ACA affects the patient and the healthcare system expected to deliver care (Henry, 2013). Whether patients or outpatient, several patients are affected by these decisions. 

Quality of Life 

Quality of care involves many aspects of patient care (Piekes, 2020). Providing high-quality care certifies that care is safe, effective, patient-centered, timely, efficient, and reasonable. The care providers, insurers, delivery systems, and quality improvement organizations are focused on improving the quality of care. Several approaches can be taken to safeguard the quality-of-care standards are met. They can entail evidence-based decisions, performance assessment, and explicit efforts to improve quality, reduce errors, and involve patients in care decisions. However, inequalities and inconsistency can exist in care quality, leading to health disparities (Piekes et al., 2020).  

ACA and the Impact on Telehealth

According to Gilman (2013), there has been a long-standing hope that Telehealth could be used to conquer a lack of local medical specialists in rural areas. To support rural access to care, Medicare covers telehealth services provided through live, interactive videoconferencing between a beneficiary located at a certified rural site and a distant practitioner. These services include office psychiatry visits, other office visits, and additional physician visits (e.g., consultations). Since 1999, Medicare payment rates for telehealth services have increased, the number of telehealth services that Medicare covers have increased, provider requirements have been reduced, and federal grants advocating telehealth adoption have been provided. This study aims to assess growth in various types of Medicare-paid telehealth services. Despite higher payments and lower regulatory burdens, growth in Telehealth adoption among providers has been modest (Gilman et al., 2013). 

Gilman (2013) suggests promises for tele pharmacy and tele-emergency care, where consulting pharmacists supervise remote pharmacy technicians in rural pharmacies and hospitals, and central emergency room physicians consult with remote primary care providers treating patients in emergency rooms. The Commonwealth Fund organized a report on North Dakota’s experience with tele pharmacy and found that tele pharmacy extended access to patients in their rural communities and was economically (Gilman, 2013). 

During the COVID-19 pandemic past few years, our practice used Telehealth for our patients in the office and patients in rural communities. According to Brotman (2021), telehealth reimbursements for office visits for evaluation and management of established patients with low complexity were 30% lower than the corresponding non-telehealth service. Corresponding with the Centers for Medicare and Medicaid Services (CMS), Reimbursement by clinical diagnosis code also tended to be lower for Telehealth than non-telehealth claims. Lower reimbursements may hamper widespread adoption of Telehealth for telehealth services relative to face-to-face services (Brotman, 2021).

References

Brotman, J. J., & Kotloff, R. M. (2021). Providing outpatient telehealth services in the United States: before and during coronavirus disease 2019. Chest, 159(4), 1548-1558.

Centers for Medicare & Medicaid Services. (2021, November 8). BPCI ADVANCED: CMS Innovation Center. Innovation Center. Retrieved May 21, 2022, from https://innovation.cms.gov/innovation-models/bpci-advanced#pricing (Links to an external site.).

Gilman, M., & Stensland, J. (2013). Telehealth and Medicare: payment policy, current use, and prospects for growth. Medicare & Medicaid research review, 3(4), mmrr.003.04.a04. https://doi.org/10.5600/mmrr.003.04.a04

Henry J. Kaiser Family Foundation (2013, April 23). Focus on health reform: Summary of the Affordable Care Act. https://files.kff.org/attachment/fact-sheet-summary-of-the-affordable-care-act (Links to an external site.)

Peikes, D., Taylor, E. F., O’Malley, A. S., & Rich, E. C. (2020). The Changing Landscape Of Primary Care: Effects Of The ACA And Other Efforts Over The Past Decade: A description of primary care delivery system reform models developed and tested over the past decade by the Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act. Health Affairs, 39(3), 421-428.