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Healthcare reform in the United States has been a major discussion amongst politicians for a long time. Healthcare reform proposes a change in the healthcare system’s current processes by enhancing the quality of care, containing costs, and improving accessibility (Nikolai, 2017). Insurance coverage, the health system, patient outcomes[CR1], and financing health efforts significantly impact health reform. Certain criteria should be analyzed such as expanded insurance coverage that includes pre-existing medical conditions, trends in the healthcare system’s costs and quality, alternative payment methods that hold health care organizations responsible for patient outcomes and broadening the focus of payment based on successful patient outcomes (Obama, 2016).
Nikolai. (2017). Healthcare reform: what it is and why we need it. Retrieved from https://www.nihp.org/healthcare-reform-what-it-is-and-why-we-need-it/
Obama B. (2016). The United States Health Care Reform: Progress to Date and Next Steps. JAMA, 316(5), 525–532. doi:10.1001/jama.2016.9797
The Patient Protection and Affordable Care Act was put into law in 2010 when President Obama was in office. The goals of the PPACA were to provide affordable health coverage to all Americans, choice of health plans, disease prevention and wellness initiatives, provide better healthcare quality and patient safety, as well as lower healthcare costs and improving productivity (Tetielbaum, n.d.)
The criteria that is needed to be used to evaluate or analyze the reforms impact on insurance coverage would be the amount of Americans who are actually insured now compared to before the reform (Teitelbaum, n.d.). The other criteria that should be used is the change in whether an insurance company can determine to cover a patient on pre-existing conditions (Teitelbaum, n.d.). After the reform was established health insurances were no longer allowed to choose to cover a patient based on pre-existing conditions (Teitelbaum, n.d.). Also the expansion of Medicaid in each state that is willing to participate in the expansion (Tetielbaum, n.d.)
The criteria that should be used to evaluate or analyze the impact of healthcare reform on hospital systems and patient outcome is the development of the National Strategy for Quality Improvement and the New Patient-Centered Outcomes Research Institute or PCORI (Teitelbaum, n.d.). The PCORI was developed to improve healthcare quality, improve delivery of healthcare services, patient outcomes, and public health (Teitelbaum, n.d.). PCORI was also created to improve the effectiveness of medical treatments so that patients can have the best possible outcome (Teitelbaum, n.d.).
The criteria that should be used to evaluate or analyze the impact of healthcare reform on finance success or failure is the taxing on health insurance plans that are employer-based when total expenses are over $10,200 for individual coverage or $27,500 for family coverage (Teitelbaum, n.d.). The other criteria is edit taxes and fees on healthcare industries (Teitelbaum, n.d.). As well as some changes on income taxes (Teitelbaum, n.d.)
Teitelbaum, J. B. Essentials of Health Policy and Law. [Purdue University Global Bookshelf]. Retrieved from https://purdueuniversityglobal.vitalsource.com/#/books/9781284158793/