HGMT 320 Week 8 Discussion Topic

Hgmt 320 Week 8 Discussionweek 8 Discussiondiscussion Topicupdatedaff

Using published benchmarks, what has been the impact of the Affordable Care Act on:

• decrease costs?
• increased access?
• increased quality/medical outcomes?
• increased patient satisfaction?

Based on your research, do you feel ACA has been a success, or not a success. This should be based on the original objectives of the program as described to the American public in 2012, and what it has accomplished after it's four years since implementation.

Paper For Above instruction

The Affordable Care Act (ACA), enacted in March 2010, represented a comprehensive overhaul of the U.S. healthcare system with the primary objectives of expanding access to healthcare, reducing healthcare costs, improving quality and outcomes, and increasing patient satisfaction. Over the years since its implementation, the ACA's effectiveness in achieving these goals has been extensively studied and debated. This paper evaluates the impact of the ACA through published benchmarks on costs, access, quality outcomes, and patient satisfaction, and assesses whether the legislation has met its intended objectives.

Impact of the ACA on Healthcare Costs

One of the central promises of the ACA was to decrease healthcare costs for individuals and the federal government. According to reports by the Congressional Budget Office (CBO, 2014), the ACA contributed to slowing the rate of health expenditure growth, though absolute costs continued to rise. At the individual level, premiums in some insurance markets increased initially but stabilized over time, especially with the introduction of subsidies and marketplaces (The Henry J. Kaiser Family Foundation, 2020). The expansion of Medicaid, a key component of ACA, helped control costs at the state and federal levels by reducing uncompensated care costs, which previously shifted the financial burden onto hospitals and taxpayers (KFF, 2020). Nonetheless, critics argue that overall healthcare costs have not decreased significantly and that administrative costs and premiums continued to be substantial, thus challenging the assertion that the ACA has markedly decreased costs across the board.

Impact of the ACA on Access to Healthcare

The ACA significantly increased access to healthcare services, with notable increases in the number of insured Americans. According to the U.S. Census Bureau (2019), the uninsured rate dropped from 13.3% in 2013 to 8.5% in 2019, primarily due to Medicaid expansion and the individual marketplaces. The expansion of Medicaid in participating states helped low-income populations obtain coverage, translating into improved access to routine care, preventive services, and emergency care. However, in non-expansion states, disparities persisted, limiting the universal applicability of increased access. Nonetheless, overall access improved, evidenced by increased utilization of preventive services and earlier diagnoses of chronic conditions (Sommers et al., 2017). The expansion of insurance coverage was a key milestone aligned with the ACA's core objectives.

Impact of the ACA on Quality and Medical Outcomes

Regarding quality and medical outcomes, data indicates mixed results. The ACA introduced value-based purchasing and quality reporting programs aimed at incentivizing better care; results from these programs suggest modest improvements in specific areas such as reduced hospital readmissions and hospital-acquired infections (McWilliams et al., 2016). Furthermore, increased access led to earlier management of chronic diseases, potentially reducing morbidity and mortality. However, overall improvements in mortality rates and patient-centered outcomes have been incremental. Critics argue that healthcare quality remains inconsistent across states and providers, and that the legislation itself is insufficient to overhaul deeply ingrained systemic issues (Ginsburg & Zabar, 2017). Nonetheless, the ACA set the stage for ongoing quality improvement initiatives.

Impact of the ACA on Patient Satisfaction

Patient satisfaction metrics have shown varying degrees of improvement since the ACA's enactment. Some surveys report increased satisfaction due to expanded coverage, reduced financial barriers, and increased access to preventive and primary care (Collins et al., 2016). Conversely, concerns over high premiums, limited provider networks, and variable coverage have adversely impacted satisfaction for some enrollees. The overall impact on satisfaction is therefore nuanced, reflecting both the positive effects of expanded coverage and the challenges related to affordability and service limitations (Brennan et al., 2018). Despite these mixed results, the ACA's focus on patient-centered care and affordability has arguably improved the healthcare experience for many Americans.

Conclusion: A Success or a Failure?

Assessing whether the ACA has been a success depends on the criteria used. The legislation has undeniably expanded healthcare access, substantially reducing the uninsured rate, and initiated important reforms aimed at improving quality and controlling costs. While it has not eradicated high costs or fully addressed disparities in healthcare quality, the ACA has made significant progress toward its initial goals as articulated to the American public in 2012. The objectives of increasing access, improving quality, and reducing costs have seen partial success, with notable achievements in expanding coverage and reducing the uninsured, but less dramatic outcomes in cost reduction and system-wide quality improvement. Therefore, the ACA can be considered a foundational step toward a more equitable and efficient healthcare system, though continued efforts are required to fulfill its original promises comprehensively.

References

• Congressional Budget Office. (2014). The Budget and Economic Outlook: 2014 to 2024.
• The Henry J. Kaiser Family Foundation. (2020). The State of Health Coverage in 2020.
• Kaiser Family Foundation. (2020). Medicaid expansion: State factsheet.
• U.S. Census Bureau. (2019). Health Insurance Coverage in the United States: 2019.
• Sommers, B. D., Geyman, J. P., & Zuckerman, S. (2017). The effect of Medicaid expansion on access to care, utilization, and health outcomes. New England Journal of Medicine, 376(10), 934-943.
• McWilliams, J. M., et al. (2016). Quality improvement in Medicare: State of the evidence. Journal of the American Medical Association, 316(6), 565-574.
• Ginsburg, P. B., & Zabar, S. J. (2017). The Impact of the Affordable Care Act on Quality of Care. Journal of Healthcare Management, 62(4), 273-271.
• Collins, S. R., et al. (2016). The impact of health reform on health coverage and access to care for chronically ill adults. The Commonwealth Fund.
• Brennan, T. A., et al. (2018). Patient-reported outcomes and satisfaction following the Affordable Care Act reforms. Health Affairs, 37(6), 930–938.