If you've lived in the United States, there is no way the topic of Affordable Care Act(ACA) could be evaded. Its on the news, its on the streets, its everywhere! For the general public the ACA stands for complete health coverage and cheaper insurance premiums. For the healthcare Industry however, whether Hospitals, Health care delivery models, Insurance Companies, Pharmaceutical and Biotech Industries, the ACA poises a huge reform in the delivery of services and products. The ACA or commonly known as Obamacare or the Patient Protection and Affordable Care Act(PPACA) hopes to improve accessibility and quality while reducing costs.
Value Based Purchasing
The existing reimbursement models in healthcare has failed in many different ways. The pay for service had negatively incentivised physicians to prescribe unneeded tests and procedures. The per diem or the pay per day reimbursement system had encouraged hospitals to keep the patients for longer periods. The DRGs or the Diagnostics Related Groups which pays for each diagnosis(disease) had resulted in physicians choosing the cheapest way of treating patients and turned out to be the least effective.
Affordable Care Act brings in a new system of reimbursement model called the value based purchasing (VBP). To address the threats of lesser quality, lesser accessibility and higher cost which constitutes the focus of the ‘Triple Aim,’ VBP brings in a solution by financially incentivising hospitals to provide better care. The hospitals are reimbursed based on patient satisfaction and quality performance. While most countries break even through volume rather than cost, the US uses big bucks to break even. To give an example, while...
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... say that the accountable care organisations and value based purchasing will financially impact the industry. The shift from fee for service to a value based model will increase the sales of evidence based medicines and decrease the sales for new drugs.
One of the major stakeholders of the healthcare industry is the general public as everyone would need healthcare at some point of their time. The ACA concentrates on making it easier for the public. ACA promises to increase the insured by
A global survey from Deloitte has found out that 7% of the surveyed population agreed that they spent lesser than the previous year for healthcare products and services in the United States.The 7% in the USA was much higher than the other countries that were surveyed. The study which was done right after the implementation of ACA summarises the effect on the public.
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