Case Assignment
The health care reform debate is not a new one. The plan for a national system was a Hillary Clinton platform when she was First Lady. The notion lost steam and was placed on the back shelf until the election of President Obama. During President Obama’s presidency, the debate for the need of a national plan has heated up considerably. It is incumbent on us all to become as informed about health care reform as possible because it affects us, our family, and loved ones.
- List and briefly describe 3 of the recommendations for health care reform from experts, interest groups, etc.
- Discuss how the Patient Protection and Affordable Care Act (PPACA) fits (or does not fit) with the recommendations.
Length: Submit a 3-page paper
Required Reading
Auerbach, J. (2015). Creating incentives to move upstream: Developing a diversified portfolio of population health measures within payment and health care reform. American Journal of Public Health, 105(3), 427-431.
Geisel, J. (2015). Health care reform law’s auto-enrollment rule repealed. Business Insurance, 49(23), 3.
Ogundipe, B., Alam, F., Gazula, L., Olagbemiro, Y., Osiezagha, K., Bailey, R., & Richie, W., (2015). Remaking the American health care system: A positive reflection on the Affordable Care Act with emphasis on mental health care. Journal of Health Care for the Poor and Underserved, 26(1), 49-61.
Pai, R.K., Kennedy, M., & Hahn, P. (2016). Health care reform—12 steps to recovery. Physician Leadership Journal, 3(3), 52-54.
Perez, K. (2016). Healthcare reform and the presidential election campaign. Healthcare Financial Management, 70(4), 102-103.
Presidential candidate’s comments on Medicare reform spark debate. (2015, July 28). Washington: The Advisory Board Company.
Reiboldt, M. (2016). Presidential election and healthcare policy: The last time we discuss this (for a while, at least). The Journal of Medical Practice Management: MPM, 31(5), 261-262.
Expert Solution Preview
Introduction:
As the debate for a national health care plan heats up, it becomes imperative for medical college students to become informed about health care reform as it affects them and their loved ones. In this regard, a case assignment has been given to list and briefly describe three recommendations for health care reform from experts and interest groups, followed by a discussion of how the Patient Protection and Affordable Care Act (PPACA) fits with the recommendations.
1. List and briefly describe three recommendations for health care reform from experts, interest groups, etc.
– Expanding health insurance coverage: Experts and interest groups recommend expansion of health insurance coverage to more Americans as a way of providing access to affordable healthcare for all. This can be done through the expansion of Medicaid or the use of tax incentives to encourage uninsured individuals to purchase health insurance.
– Cost control reforms: Health care expenditure has been identified as the major driver of healthcare inflation. Experts recommend cost control measures to reduce healthcare expenditure. Cost control measures include adopting preventive healthcare measures, reducing hospital readmissions, promoting the use of electronic medical records, and reducing administrative costs.
– Payment reforms: The traditional fee-for-service reimbursement model has been identified as a major contributor to healthcare inflation. Experts recommend payment reforms that reward value rather than volume. Implementation of such payment reforms would increase hospital efficiency and improve the quality of healthcare provided to patients.
2. Discuss how the Patient Protection and Affordable Care Act (PPACA) fits (or does not fit) with the recommendations.
The Patient Protection and Affordable Care Act (PPACA) was enacted in 2010 to provide affordable health insurance to Americans. The act introduced several reforms, including the expansion of Medicaid coverage to low-income Americans, provisions that allowed young people to remain on their parents’ healthcare insurance until 26 years old, and the introduction of subsidies to help low- to middle-income Americans purchase health insurance. These reforms align with the recommendation of expanding health insurance coverage.
The PPACA also introduced a cost-control measure in the form of the Medicare Shared Savings Program (MSSP). The MSSP is a payment reform model that incentivizes healthcare providers to reduce Medicare spending while improving patient outcomes. MSSP aligns with the recommendation of payment reforms to reward value over volume.
However, the PPACA has faced criticism from some experts and interest groups who argue that the act did not do enough to control healthcare expenditure. Despite the introduction of healthcare cost-control measures such as the MSSP, healthcare expenditure continues to rise. In conclusion, the PPACA fits with some recommendations for health care reform but falls short in some areas.
