RESPOND 300 WORDS:
The Patient Protection and Affordable Care Act (PPACA) is also known as the Affordable Care Act, ACA and Obamacare. This is a federal law on healthcare reform that became law on March, 23, 2010 (“Patient Protection”, n.d.). The PPACA was enacted to provide numerous rights and protections to American citizens making health care coverage fairer and easier to understand, along with subsidies insuch as “premium tax credits” and “cost-sharing reductions” to make it more affordable (“Patient Protection”, n.d.). Depending on the type of care that is needs determines the insurance used. When it comes to the PPACA, being that it is a law it does not make a payment to any healthcare facility but what it does do is help reduce cost patients and insurance companies concerning preventive care. Patients can get colonoscopies, mammograms and other preventive care treatment at no cost to them (American Cancer Society, n.d.).
Commercial insurance is not funded by the government but by private insurance companies. It can be a for profit or not for profit insurance company. Policies offered from commercial insurance companies have monies paid to them for coverage purpose from the patient and the rates range on what policy level or term is selected. Often employers will cover some of the insurance loss.
Traditional Medicare is a federally funded insurance program that services the elderly (65 years and older), people who are disabled or dealing with the end stages of renal disease (“Original Medicare, n.d.). Medicare is broken down in parts. Part A and Part B. One is for hospital insurance and the other covers basic medical insurance. Each facility will be paid the contracted amount based on the procedure done. When it comes to patients on Medicare depending on eligibility and election, all recipients have the same coverages under that plan and program.
Different funding types within healthcare facilities can puts constricts on the facilities. Healthcare operates on margins and with the different funding times all paying different amounts for the same services would take a strategic plan to be able manage finances and grow. A strategic plan considering the finances and payments will allow the facility to create more efficient, service to be able to increase volume also increasing service.
RESPOND 300 WORDS:
The Patient Protection and Affordable Care Act (PPACA) has brought in various payment reform models that hold providers accountable for the cost and quality of care to a specific population. Accountable care organizations (ACO)s have implemented Medicare, commercial insurance, and federal health coverage as their funding sources to deliver quality and safe healthcare services to the public.
The fee-for-service program, or Medicare, overseen by the federal government, has traditionally been the most popular type of compensation (Mafi et al., 2021). Healthcare practitioners are compensated depending on the number of services they offer. In the contemporary era of healthcare facilities, more providers are turning to accountable care organizations (ACOs) as payment reform alternatives to fee-for-service. Commercial insurance companies provide health plans through Preferred Provider Organization (PPO) frameworks to encourage members to seek care from network providers. Healthcare professionals are compensated based on a set fee schedule or their actual charges. The PPCA requires insurance companies to spend 80 percent on healthcare coverage and provide comprehensive healthcare coverage options (Mulcahy et al., 2018). The latter ensures that healthcare organizations can serve many patients and receive timely payment.
The Patient Protection and Affordable Care Act (PPACA) has significantly impacted how the healthcare sector operates and is structured today. To adapt to this new paradigm, health managers must analyze and apply new tactics. Patient Protection and Affordable Care Act (PPACA) has led to an increase in the number of people who can access healthcare services through its affordable health coverage model (Mulcahy et al., 2018). Due to an increase in patients, more physicians would be needed to meet the demand while still providing high-quality treatment. Furthermore, hospital managers who have become reliant on the present price structure for acute care services will have to balance the quest for cost reductions in the inpatient environment with the development of capabilities that will enable them to serve more patients. Since outside commercial insurance companies and the government pay the majority of doctor’s visit charges, patients usually are unaware of or unconcerned about the cost, which is, to some extent, the cause of our rising human services costs.
