Introduction
The Patient Protection and Affordable Care Act can restructure the health care systems by increasing the accessibility of health cover. The Act also controls coverage and streamlines the delivery mechanisms to the population. This also includes payment of these services. The Act seeks to cut down the number of uninsured citizens. The Act aims to tackle this goal by introducing legislation that would enable Medicaid accessible to all persons, making less than one hundred and thirty-three percent of the poverty line as constituted by the federal state. It will also be accessible to persons who make less than fourteen thousand, five hundred dollars annually and twenty-nine thousand, five hundred for families constituting of four family members. The service will also be improved for recipients (Barr,2009).
The bill tries to increase the number of the uncovered by forming government controlled insurance exchanges which are essentially open markets for the purchasing of insurance schemes. All the above mentioned mechanisms incorporate self directive and the fee paid for by an employer, this is done in order to augment insurance to the number of the non covered. The bill also introduces strict guidelines that will set standards of control for the first time. It also develops health care and restricts the cost burden. The bill does not extend coverage to unrecognized migrants. The COB Office approximates that around eight million such individuals would stay without insurance (Focus on Health Reform, 2010). Furthermore, it limits insurance coverage to abortion services in the Health Benefits Exchanges and more so, for individuals collecting federal financial support.
Benefits
Numerous benefits will be accrued from the act; they include:
- Border state wage index protections. From the financial year 2011, hospital institutions in Border States are obliged to provisions such as wage indexes of one or greater than one. Derived from recent U.S. Census annual population estimations: fifty-one IPPS hospital institutions have reached that criteria for protection, this could also be valid to the index for the medical institution outpatient provisions (Caralyn, 2010).
- Supplementary spending for hospital institution with minimum per-enrolee Medicare expenditure. The act grants four hundred million dollars in these supplementary payments, for the financial year of 2011 and 2012. This applies to licensed hospital institutions situated in counties positioned in the least quartile of per-enrolee Medicare expenditure. In the additional regulation, the Centres for Medicare and Medicaid Services recommends a technique for deciding the hospital institutions that are eligible and how much each institution should anticipate being given.
- Momentary broadened qualification for the small-volume institution amendments. The act decreases eligibility requests for the financial Year in 2011 and 2012, to hospital institutions within fifteen miles of other hospital institutions and fewer than one thousand, six hundred discharges of Part A recipients. The Centres for Medicare and Medicaid Services also recommends espousing a linear sliding payment method to establish the compensation add-on the hospital institutions will obtain, ranging from twenty-five percent for hospital institutions with two hundred or less Medicare discharges to approximately 1.6667 percent for institutions with 1,501 one thousand five hundred and one to around one thousand six hundred Medicare discharges.
IPPS
The anticipated inpatient prospective payment system compensation integrates a two point four percent market basket revision for inflation, which signifies a diffident augmentation over the financial year 2010 inflation rate. Nonetheless, Centres for Medicare and Medicaid Services in addition will also include, negative adjustment of approximately two point nine percent that will allow Medicare to recover cumulative overpayment made in the past two financial years. The Centres for Medicare and Medicaid Services is mandated to recover the full amounts in the form of overpayment made in the last two financial years.
References
Barr, D. (2009). Introduction to U.S. Health Policy. New York. The John Hopkins University Press.
Caralyn, D. Medicare: CMS starts to spell out PPACA impact on hospital pay. 2010. Fierce Health Finance. Web.
Summary of the New Health Reform Law. Focus on Health Reform. The Henry J. Kaiser Family Foundation. Web.