Experimental Models of Healthcare Delivery
The passage of the Affordable Care Act (also known as Obamacare or the ACA) in 2010 represented the most significant US healthcare reform since the creation of Medicare.
Perhaps the most well-known (and hotly contested) portion of the law mandates that small business owners with more than 50 full-time staff must provide some form of health insurance coverage for their full-time employees or risk paying a financial penalty for each full-time employee left uninsured.
The Affordable Care Act was designed to address the vast number of American citizens (over 50 million in 2012) who did not possess health insurance coverage.
The Small Business Health Options Program (SHOP) accompanies the ACA and provides a means for small business owners to directly compare the cost and benefits of public health insurance packages for their employees.
Despite the fact that these programs offer large-scale healthcare reform, healthcare delivery systems in the United States resist experimentation due to the massive infrastructure already in place.
That is, the present landscape of private health insurance companies is already firmly entrenched and as such the Affordable Care Act (and its accordant public health insurance options) will face a long uphill battle to reach full implementation.
Simply because experimental models of healthcare delivery are difficult to implement does not mean that experiments do not take place.
Accountable Care Organizations (ACOs) are being created to accompany the Affordable Care Act's implementation.
While not much was known about Accountable Care Organizations at the outset of the Affordable Care Act, ACOs have since begun to coalesce.
The fundamental principle behind their creation is that Accountable Care Organizations will serve as networks of physicians, healthcare providers, and hospitals that have incentive to work together.
These networks will coordinate care and information exchange to reduce the possibility of patients receiving healthcare services disproportionate to their conditions (e.
g.
heading to the emergency room instead of primary care) The ACOs will then re-absorb the funds into the healthcare delivery system to compensate healthcare providers and physicians.
Other experimental models for healthcare delivery include several adjustments to the Centers for Medicare & Medicaid Services (CMS) in terms of how hospitals are compensated for services rendered when the hospital treats patients of a certain age or income level.
Under the Affordable Care Act, federal Medicare funding provided to hospitals will be more closely tied to hospital performance.
Hospitals and other healthcare providers that receive federal Medicare revenue will need to review their readmission rates, mortality rates, and average length of stay (LOS) among other hospital procedures to make certain their performance falls within the standard set by the Affordable Care Act.
Perhaps the most well-known (and hotly contested) portion of the law mandates that small business owners with more than 50 full-time staff must provide some form of health insurance coverage for their full-time employees or risk paying a financial penalty for each full-time employee left uninsured.
The Affordable Care Act was designed to address the vast number of American citizens (over 50 million in 2012) who did not possess health insurance coverage.
The Small Business Health Options Program (SHOP) accompanies the ACA and provides a means for small business owners to directly compare the cost and benefits of public health insurance packages for their employees.
Despite the fact that these programs offer large-scale healthcare reform, healthcare delivery systems in the United States resist experimentation due to the massive infrastructure already in place.
That is, the present landscape of private health insurance companies is already firmly entrenched and as such the Affordable Care Act (and its accordant public health insurance options) will face a long uphill battle to reach full implementation.
Simply because experimental models of healthcare delivery are difficult to implement does not mean that experiments do not take place.
Accountable Care Organizations (ACOs) are being created to accompany the Affordable Care Act's implementation.
While not much was known about Accountable Care Organizations at the outset of the Affordable Care Act, ACOs have since begun to coalesce.
The fundamental principle behind their creation is that Accountable Care Organizations will serve as networks of physicians, healthcare providers, and hospitals that have incentive to work together.
These networks will coordinate care and information exchange to reduce the possibility of patients receiving healthcare services disproportionate to their conditions (e.
g.
heading to the emergency room instead of primary care) The ACOs will then re-absorb the funds into the healthcare delivery system to compensate healthcare providers and physicians.
Other experimental models for healthcare delivery include several adjustments to the Centers for Medicare & Medicaid Services (CMS) in terms of how hospitals are compensated for services rendered when the hospital treats patients of a certain age or income level.
Under the Affordable Care Act, federal Medicare funding provided to hospitals will be more closely tied to hospital performance.
Hospitals and other healthcare providers that receive federal Medicare revenue will need to review their readmission rates, mortality rates, and average length of stay (LOS) among other hospital procedures to make certain their performance falls within the standard set by the Affordable Care Act.
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