Please identify and describe three payment reform initiatives in the Patient Protection and Affordable Care Act.
Will there ever be (in your opinion) an acceptable solution for providing Health-Care Insurance to all?
Do you feel it is acceptable to expect “the haves” to provide Health care Benefits for the “have nots” through the expansion plans for Medicaid?
Is there a necessity for patient education with respect to insurance, both for private and government coverage? How should a patient education program be structured and delivered?
American Speech-Language-Hearing Association. (n.d.). Medicare Prospective Payment Systems (PPS) a Summary.
the difference between prospective and retrospective payment systems are:Prospective payments- The prospective payment system is a method of reimbursement in whichMedicare payment is made based on a predetermined, fixed amount (CMS, 2019). The paymentamount for a service is derived based on classification system of that services (CMS, 2019). It isa 468-diagnosis related group.Retrospective payment system- is the traditional reimbursement method, whereby fees for thedelivery of health care services is delivered organizations (Stanhope & Lancaster, 2016).Organizations are reimbursed by changes and services.Affordable Care Act & Payment ReformThe Affordable Care Act was passed to improve quality and lower health care costs, provideaccess to care and provide for consumer protection.Bundled PaymentsProviders and/or healthcare facilities are paid a single payment for all services performed to treata patient undergoing specific episode of care (Adams, 2015).Global PaymentsGlobal payments are usually paid to a single health care organization, and cover a wider array ofservices for a larger population of patients over a longer period (Adams, 2015).Accountable Care OrganizationThis was formed by health care providers. These health care providers agree to takeresponsibility for the quality and total cost of care for a population of patients (Adams, 2015).Health Care for AllIn my opinion, there are already acceptable solutions. Medicaid and Medicare could work foreveryone. I think most providers do not prefer this because it would lessen the money in theirpockets being that the rules of Medicare are rigid. However, the laws that govern Medicare andMedicaid can change at any time. It could be made into an actual policy for working Americans,and they can pay a monthly or biweekly premium to help aid the funding.Have and Have NotsI believe that health care should be a right. I do believe the “haves” should contribute in someway to help provide insurance for all. Without optimal care, some are enduring long sufferingand turn to other habits to try to manage failing health. I think it’s important to recognize howpeople without health care are affected.Patient EducationPatient education about insurance is of the utmost importance. I can tell you that I was able toteach my mother things about Medicare since taking this course. A lot of patients do not have theunderstanding when it comes to their insurance and prices of health care. It should be structed toexplain to individuals how to use insurance and what services are covered. First start by givingan introduction and letting people know what the benefits are. They will need to be taught aboutdeductibles, meeting them, and how prices will change after doing so.
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