Ambulatory Care- the Key for 21st Century Healthcare Industry
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Abstract
The Great Economic Depression of the 21st Century has brought along with it a huge challenge of rising health care cost in the health care industry. To deal with this the Obama Administration came out with a Health Care Reform also known as the Obama Health care plan or The Affordable Care Act. This paper will provide a brief overview of how Ambulatory Care will play a key role for all the health care organizations to survive under this new health care reform. This paper will also throw light on advantages of integrating additional medical services and improved quality in ambulatory care in the looming crisis of healthcare industry.
Ambulatory Care: The Key for 21st Century Health Care Industry
Obama Health Care Plan
The Obama Health Care Plan, also known as the Patient Protection and Affordable Care Act. The Affordable Care Act (ACA) was signed into law by the President Barrack Obama on March 23, 2010. This marks as one of the most important day in the American Healthcare Industry since Medicare and Medicaid (Laxmaiah Manchikanti, 2011). The Affordable Care Act ensure that all Americans will have access to quality health care at a subsidized cost (affordable) and will also create the transformation within the health care system required to contain costs. The Congressional Budget Office (CBO) determined that the Patient Protection and Affordable Care Act is fully paid for, and that the act will provide coverage to more than ninety four percent of Americans and yet stay under the nine hundred billion dollar limit established by the President. However, the act does not fix problems for the one hundred and sixty million people who currently have insurance (Johnston, 2010) (Democratic Policy Committee, 2010).
The Affordable Care Act will be put to effect in two separate phases. Let us now look at the few important changes to be brought about by the Affordable Care Act 2010 in both of these phases;
Phase I (2010-2014) (Democratic Policy Committee, 2010) (Johnston, 2010)
If insurers use too much of the administrative cost or profits, they will be forced to give a part of it back through rebates.
Preventive care like screenings and vaccinations will become free in new privates insurance policies and in Medicare.
Medicare patients will get more assistance with their drug cost.
Young adults (extended dependent coverage) can stay insured under their parents insurance up to age 26.
Small businesses will get tax cuts to aid them in paying for health insurance of their employees.
Lifetime limits on health coverage will be removed.
Illegal for insurance companies to turn-down kids with pre-existing health condition for example asthma and diabetes.
Phase II (2014-2019) (Democratic Policy Committee, 2010) (Johnston, 2010)
Medicaid will be provided to all low-income individuals and families over the nation.
If one looses job or if the employer does not provide insurance, then ax-credit will be offered.
If employer does not provide insurance, then one can buy coverage in Exchange. Which is a type of open market where competition amongst the insurance companies will help make buying insurance affordable.
Insurance companies will no longer be allowed to turn down people or charge extra for being sick.
Large businesses will be asked to pay fines for not insuring employees.
Others who are not eligible for coverage will be provided with; credits, expanded programs and new rules; by the government.
Risk Bearer
Due to the changes brought about by the Affordable Care Act 2010, the risk will now shift from the consumers to the providers (insurance companies and hospital settings). Since the act now mandates that the insurance companies cannot deny care to patients with pre-existing conditions and that the annual limit on the plans will be removed; the risk financial burden (risk) will now move over the time from consumers to the insurance companies. Furthermore under this act, the hospitals will no longer receive payments based on per diem per unit rather the payments will be based on quality of care provided and prospective payment method will be used. All this will shift the risk from consumers (patients) to both insurance companies and hospitals. Hospitals will now be required to finds ways to provide quality care so that the hospital beds are not occupied for prolonged time and thus