Cost in most healthcare systems has been a problem, especially for patients. Managing costs at all levels of a healthcare organization affects the bottom line, which directly affects all aspects of the organization. Therefore, organizational policies play a significant role in helping healthcare providers and patients understand the part of operations in a healthcare setting, ensuring high quality of care across all departments. Affordable Care Act is a crucial policy in a healthcare organization that provides controlled costs, hence maintaining the quality of care across the healthcare system (Eguia et al., 2018). The paper explores the details of the Affordable Care Act policy in a healthcare organization, explaining how the policy impacts the fiscal aspects of the organization, the unintended consequences of the policy, and the impacts of the policy on the quality of patient care.
The healthcare system across the United States comprises reimbursement systems comprising a mixture of public and private third-party coverage. In that regard, employers, individual patients, and the government contribute to healthcare costs, where individuals pay premiums to private insurance companies to cover their medical costs. However, our policy limits private insurance reimbursement to Medicare, which would cut healthcare costs significantly. It is revealed that healthcare spending in the organization increases due to higher prices paid by private health insurers; thus, the policy would limit their reimbursement and ensure the average cost of health costs (Hu et al., 2018). The policy was put in place in 2016 and was adopted system-wide because it involves all members of the healthcare system. The policy addresses essential aspects of cost control aimed at protecting and promoting the health of individuals and the community. Through the policy, government officials can accomplish their objective in the healthcare system in a way that creates respect for human rights, such as rights to privacy, self-determination, and non-discrimination. There are potential impacts of not following the policy at the organizational level, including fines and penalties that may also open the organization to lawsuits. Besides, individuals may suffer fines if non-compliant and increase their costs to settle the suits.
The police impact on fiscal aspects of the organization because it allows employees and patients to choose the health insurance they want. In that regard, the costs and expenditures in the organization are reduced, as there are reduced provider payments, reduced coverage, and higher copayments. The fiscal budget of the organization has to change amid the implementation of the policy to accommodate the new changes in payments and coverage. Besides, the policy limits payment mechanisms with varying effectiveness, thus impacting fiscal aspects. According to Hu et al. (2018), the policy acts as a cost control because prices paid by private insurance are high, thus limiting their reimbursement controls the cost of healthcare provision. Besides, the policy acts as a cost control because it lowers costs by reducing the resources required for care since private insurers do not provide an expensive care plan for patients. Through limits of reimbursement in the healthcare system, our organization applies price setting, fee schedules, reference pricing, and price negotiations, which control the costs of care in the organization.
According to Duggan et al. (2019), the policy significantly impacts patients’ quality of care, aiming to improve healthcare costs and high-quality care. Implementing the policy has led to reforms that promote the coordination of care, encouraging the healthcare organization’s success. Besides, the policy expresses gratitude toward patient care, as it reduces the costs of medical care for low-income earners. According to the policy, all residents within the community are guaranteed adequate, affordable, and accessible care in the organization. It also allows the community health system to emphasize social determinants of health that will improve the overall quality of care. In addition, the policy improves efficiency because it helps to improve the quality and efficacy of care for all patients in the organization, contributing to better health outcomes while reducing costs (Chen & Grabowski, 2019). When the organization implemented the policy, patients expanded their Medicaid eligibility. They broadened the medical drug rebate program, as the policy gave more low-income earners access to healthcare and medical care.
The goal of the policy is to improve the quality of care and reduce the cost of healthcare in the organization. According to Caswell & Waidmann (2019), the police provide that healthcare spending be reduced and lower premiums paid by individuals for medical coverage. Moreover, the policy led to an annual growth rate in organizational expenditure from 6.4 percent to 5.8 percent. However, the policy led to unintended consequences such as a narrow network of healthcare providers, where healthcare facilities and specialists deemed higher costs are excluded from several insurance plans under the policy (Caswell & Waidmann, 2019). Similarly, health insurance deductibles and out-of-pocket costs have increased under the policy, leaving employees to pick up more and more of their health coverage. Besides, the policy has secondary impacts on the organization, as it increases the number of people attending the healthcare organization, thus demanding an increased number of healthcare providers. Although the policy has cut costs in healthcare provision, some alternatives exist, such as private health insurance, faith-based plans, short-term medical, and zero deductible plans. However, the policy is the best way to address the issue of healthcare costs in the organization.
References
Caswell, K. J., & Waidmann, T. A. (2019). The affordable care acts Medicaid expansions and personal finance. Medical Care Research and Review, 76(5), 538-571.
Chen, M., & Grabowski, D. C. (2019). Hospital readmissions reduction program: intended and unintended effects. Medical Care Research and Review, 76(5), 643-660.
Duggan, M., Goda, G. S., & Jackson, E. (2019). The effects of the Affordable Care Act on health insurance coverage and labor market outcomes. National Tax Journal, 72(2), 261-322.
Eguia, E., Cobb, A. N., Kothari, A. N., Molefe, A., Afshar, M., Aranha, G. V., & Kuo, P. C. (2018). Impact of the Affordable Care Act (ACA) Medicaid expansion on cancer admissions and surgeries. Annals of Surgery, 268(4), 584.
Hu, L., Kaestner, R., Mazumder, B., Miller, S., & Wong, A. (2018). The effect of the affordable care act Medicaid expansions on financial well-being. Journal of public economics, 163, 99-112.
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