In Theory the Act will Save Money
The Affordable Care Act in theory focuses on providing improved medical services to the Medicare recipient. The Act was signed into law on March 23rd, 2010 and is the largest expansions of healthcare benefits to US citizens since the inception of Medicare and Medicaid in 1965. A major benefit of the Affordable Care Act is that insurance companies are prohibited from denying benefits due to pre-existing conditions. ACA is described as one of the most significant pieces of legislation in American history. It seems several administrations have tried and failed to get a health care bill passed before ACA. The Affordable Care Act inception and implementation focuses on improving the U.S. fragmented and misaligned health care delivery system. Improvements needed to be made in the infant mortality rate, the general health of the citizens and the performance of the system. The ACA is expected to increase efficiency, keep prices of healthcare insurance controlled, reduce waste, fight abuse and fraud, and improve the quality of care for individual along with strengthen the Medicare system (Foster, 2010).
Preventative Services Under the Act
- Abdominal Aortic Aneurysm (one time screening) for men of specified ages who have smoked.
- Alcohol Misuse screening and counseling
- Aspirin use for men and women of certain ages to prevent cardiovascular disease.
- Blood Pressure screening for all adults
- Cholesterol screening for adults over 50
- Colorectal Cancer Screening for adults over 50
- Depression screening for adults
- Diabetes (Type 2) screenings for adults with high blood pressure
- Diet Counseling for adults at higher risk for chronic disease
- Hepatitis B Screenings for people at high risk
- Hepatitis C screening for adults at increased risk, and one time for everyone born in 1945-1965
- HIV screening for everyone ages 15-65, and other ages at increased risk
- Immunizations for adults: Hepatitis A, Hepatitis B, Herpes Zoster, Human Papillomavirus, Influenza (flu shot), Measles, Mumps, Rubella, Meningococcal, Pneumococcal, Tetanus,
- Diphtheria, Pertussis, Varicella
- Lung Cancer Screening for adults 55-80 at high risk for lung cancer
- Obesity screening and counseling for all adults
- Sexually Transmitted Infections (STI) prevention counseling for adults at higher risk
- Tobacco Use Screening for all adults an cessation interventions for tobacco users
Improvement in the Delivery System
ACA is expected to reduce the number of hospital readmissions saving $8.2 billion during a ten year time frame. Improvement in care is expected to reduce the chance of contacting another disease while in the hospital such as MRSA or some other infection; this has an attached savings of $3.2 billion in ten years. ACA has promoting accountable care organizations, establishing the Independent Payment Advisory Board as key provisions under improving the delivery system which is projected to save over $26 billion over a ten year period. The biggest projected saving is under the strategy of pricing services and modernizing the financing systems. If ACA can end overpayments, improve productivity, expand competitive bidding, a savings of $319 billion is expected (Foster, 2010). Physicians will be rewarded for delivering better care to their patients with a measuring system called a “value-modifier” (Foster, 2010).
What Does This Mean to You
The ACA is estimated to increase the time nurses and physicians are able to spend with their patients. The coordination of care and its delivery systems will improve through the formation of accountability in care organizations. The policy proposes that it will reduce the waste, fraud and abuse in the health care system through a few strategic processes. One way is through keeping the illegitimate providers out from enrolling in Medicare; in 1994 more than $250 million in false claims were paid by the Medicare program (Foster, 2010). The Affordable Care Act is meant to provide stability in this area for all individuals.
The Affordable Care Act did make changes to the Medicaid and Medicare system in addition to increasing coverages for the underserved individuals. The changes to Medicare are few yet could have a significant influence on the services provided to the 65 and older population.
Partial content for this provided by: https://www.healthcare.gov/preventive-care-adults/
Foster, R. Centers for Medicare & Medicaid Services, (2010). Estimated financial effects of the “patient protection and affordable care act,” . Retrieved from DEPARTMENT OF HEALTH & HUMAN SERVICES website: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ActuarialStudies/downloads/PPACA_2010-04-22.pdf