AFA

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Population Affected The Affordable Care Act prevents denial of health insurance related to any pre-existing medical condition. The affected people are individuals with special needs. Individuals who were previously denied insurance coverage can now obtain treatment. Currently, policies cannot be denied or priced at a premium based upon pre-existing conditions. Mental health services and habilitative care are now offered. The requirement of the affordable care act is that all policies offer mental health services and are treated the same as a physical ailment. Habilitative services are also offered to patients that need a capability developed, like speech therapy. Patients with disabilities will now have better access to medical coverage, and community based services. This paper will review…. Organizations point of view The Affordable Care Act will influence the reimbursement for hospitals and doctors. Physicians currently receive reimbursement based on tests and procedures they provide to their patients. The process is considered a fee for service. The Affordable Care Act is stimulating healthcare transformation in a direction toward bundled payments. This system will reimburse physicians a fixed amount of revenue to cover a particular illness. The goal is to reward efficient care. According to Page (2013), the “transition from fee for service to bundled payments will be challenging during the next five years” (p.). One of the benefits for providers is that the insurance company will pay them for preventative services and essential health benefits. Plans are not allowed to deny anyone due to pre-existing medical conditions; therefore there will be an increase in the reimbursement. Reimbursement from Medicare and Medicaid wi... ... middle of paper ... ...tribute to cost containment. Kovner & Knickman, 2011, define the moral hazard argument, as individuals who are removed from the financial risk of a particular activity will change their behavior to take on more of that risk. Patients could manage their health and discontinue unhealthy behavior. Conclusion The goal of the Affordable Care Act is to improve overall health. Many systems are being implemented and changing health care as we know it. The goal for the use of patient centered medical homes are to change the health care delivery system. The transformation will hopefully lead to equitable healthcare to everyone. As nurses, we are committed to our professional standards. According to the American Nurses’ Association (2010), it is our role to “advocate for equitable healthcare” (p.47). Our most vulnerable population deserves to be protected.
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