Affordable Care Act (ACA) Essay

For this Assignment, you will examine the stakeholders impacted by the implementation of the Affordable Care Act (ACA). Your paper must include the following topics: Differentiate between at least three groups of stakeholders impacted by the ACA. Examine the financial impact of the ACA on each group of stakeholders. Summarize benefits of the ACA on each group of stakeholders. Summarize drawbacks of the ACA on each group of stakeholders. The word count for your paper, excluding the title page and references page, will be 800-1200 words. You must include a minimum of (5) different scholarly references. Assignment Requirements Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above); consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and utilize spelling and grammar check to minimize errors. Your writing Assignment should: follow the conventions of Standard English (correct grammar, punctuation, etc.); be well ordered, logical, and unified, as well as original and insightful; display superior content, organization, style, and mechanics; and use APA formatting and citation style. Submit your Assignment to the Competency Assessment Dropbox. Save a copy of your work. Confirm that your Assignment file uploaded correctly. Minimum Submission Requirements This Assessment should be a Microsoft Word document. Respond to the questions in a thorough manner, providing specific examples of concepts, topics, definitions, and other elements asked for in the questions. Your paper should be highly organized, logical, and focused. Your paper must be written in Standard English and demonstrate exceptional content, organization, style, and grammar and mechanics. Your paper should provide a clearly established and sustained viewpoint and purpose. Your writing should be well ordered, logical and unified, as well as original and insightful. A separate page at the end of your research paper should contain a list of references, in APA format. Use your textbook, the Library, and the internet for research. Be sure to cite both in-text and reference list citations were appropriate and reference all sources. Your sources and content should follow proper APA citation style. Review the APA formatting and citation style found in the Writing Center. To access the Writing Center, select this link. (It should include a cover sheet, paper is double spaced, in Times New Roman 12-point font, correct citations, Standard English with no spelling or punctuation errors, and correct references at the bottom of the last page.) If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned without being scored. Plagiarism Plagiarism is an act of academic dishonesty. It violates the University Honor Code, and the offense is subject to disciplinary action. You are expected to be the sole author of your work. Use of another person\’s work or ideas must be accompanied by specific citations and references. Whether the action is intentional or not, it still constitutes plagiarism. Affordable Care Act (ACA) Essay

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The stakeholders impacted by the implementation of the Affordable Care Act (ACA).

Three  groups of stakeholders impacted by the ACA

Health care consumers, providers, and insurers are three groups of stakeholders impacted by the implementation by the ACA. A major goal of ACA is to improve the health of populations through lessening obstacles that made consumers unable to access care along with increasing health insurance coverage, affordability, and quality. The ACA precisely targets consumers that have has historically uninsured because they do not meet Medicaid eligibility criteria. According to McKenna et al (2018), the ACA sought to expand affordable coverage to people by expanding coverage to the individual below or at 133 percent of the federal poverty level (FPL), offering tax credits to lessen the costs of insurance premiums for individuals whose income is between 100-400 of FPL and cost-sharing subsidies to lessen out-of-pocket expenditures for individuals whose income is between 100-250 percent of the FPL.Affordable Care Act (ACA) Essay

The ACA has significantly reshaped private insurers. It established consumer protections, notably, by prohibiting insurers from discriminating consumers based on their health status. Insurers were forbidden from charging higher premiums to individuals with preexisting conditions or refusing to cover (McIntyre & Song, 2019). The ACA has programs aimed at controlling costs and improving quality.  Greater care coordination across settings and providers will improve outcomes, quality care, and lessen spending, particularly attributed to avoidable hospitalization, avoidable utilization of emergency department, repeated diagnostic testing, adverse drug interactions, and multiple prescriptions. Providers, including nurses, are required to lead the transformative changes occurring in health care by working as interprofessional teams to provide quality, affordable, and seamless care (Salmond & Echevarria, 2017).

The financial impact of the ACA on each group of stakeholders

The increase in coverage of more individuals initially had a positive financial impact on insurers. A huge number of participating insurance firms created a strong competition off and on the ACA marketplace exchanges. However, individual market insurers have been experiencing financial troubles in the recent past.  There has been an increase in premium rates more than anticipated, and numerous newly create insurers that concentrated on the individual market have either collapsed or experiencing financial difficulties (Hall & McCue, 2016).

The ACA sought to safeguard consumers from high healthcare expenditures by reducing underinsurance and expending health insurance via numerous schemes. The implementation of the ACA has decease out of pocket spending and reduced barriers to health care for individuals qualified for marketplace subsidies and also those affected by state Medicaid expansions (Liu et al., 2020). The ACA increased the number of individuals with health insurance, resulting in increased demand for providers, including nurses. With a high volume of patients, providers get money for the services they provide.  Providers are required to provide care in numerous health care settings, including community care centers, schools, and senior centers (Potter et al., 2017).Affordable Care Act (ACA) Essay

Benefits of the ACA on each group of stakeholders

The ACA financially impacted insurers by expanding the insurance market and increasing the number of individuals who could health insurance coverage. According to Hall and McCue (2016), the ACA reformed individual health insurance market by altering the way insurers sold insurance and by providing subsidies for millions of Americans to enable them to purchase insurance. The ACA also provided insurers with more customers by offering considerable subsidies for millions of individuals to buy individual coverage, the majority of who never had insurance in their life, and forming an exchange structure that enables consumers to compare prices when purchasing insurance.

The ACA is beneficial to providers in that it has rebuilt the primary care workforce by using incentives to expand the number of physician assistants, physicians, nurses, primary care doctors, and also alternative health clinicians and healthcare managers via the funding of loans, grants, and scholarships. The law’s incentivizing process also targets Medicaid through increasing the payments made to physicians as Medicaid providers get ready to cover an increased number of patients (Talbert et al., 2018).

The ACA is beneficial to consumers in that it provided subsidies and tax credits which enable more people to purchase insurance. The Act also created exchanges at the state level to enable individuals to compare identical coverage options and select plans based on price and quality  The law also protected consumers, especially those with preexisting conditions by forbidding insurers from denying them coverage or charging them higher premiums (McIntyre & Song, 2019).

Drawbacks of the ACA on each group of stakeholders

The implementation of the ACA has led to insurers providing a variety of benefits and covering individuals with preexisting conditions. This has resulted in a rise in the cost of premiums for millions of individuals who were already insured. As indicated by Komiski et al (2017), regardless of the provision of cost-sharing reductions and subsidies, the dependence on the ACA on exchanges might raise the cost of accessing coverage and also pose inadvertent access p barriers, especially for low-income individuals. These barriers might emerge in two ways. Firstly, the most known method is via the formation of narrow networks, when insurers provide policies and plans with fewer hospitals and doctors to keep premiums competitive. The second scheme that exchanges might create inadvertent barriers to care access is via the presence of Bronze plans which are highly deductible.

The ACA has generated a considerable impact on the expenses of health insurance forms. Insurers have been required to spend more now that they are required to manage healthcare costs for individuals with preexisting conditions and also cover the entire preventive services costs. While the health reform law has assisted alleviate disparities in healthcare among citizens of the United States, the federal and state insurance exchanges have burdened payers (Corlette et al., 2020). Affordable Care Act (ACA) Essay

The law requires providers to move away from volume to value-based care.   Insures reimburse providers based on the value of care they provide rather than the number of services to deliver. Additionally, providers are required to submit quality reporting yearly.   The ACA has modified the provider payments with providers who provide higher quality care getting higher reimbursements compared to those who offer several health care services which are of low quality (Talbert et al., 2018).

References

Corlette, S., Blumberg, L. J., & Lucia, K. (2020). The ACA’s Effect On The Individual Insurance Market. Health Aff (Millwood), 39(3), 436-444. doi: 10.1377/hlthaff.2019.01363.

Hall, M. A, & McCue, M. J. (2016). How Has the Affordable Care Act Affected Health Insurers’ financial performance? Issue Brief (Commonw Fund) 18, 1-14.

Komisnki, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual Review Public Health, 38, 489-505. doi: 10.1146/annurev-publhealth-031816-044555

Liu, C., Tsugawa, Y., Weiser, T. G., Scott, J. W., Spain, D. A., & Maggard-Gibbons, M. (2020). Association of the Us Affordable Care Act with Out-of-Pocket Spending and Catastrophic Health Expenditures Among Adult Patients with Traumatic Injury. JAMA Network Open, 3(2), e200157. doi: 10.1001/jamanetworkopen.2020.0157

McKenna, R. M., Langellier, B. A., Alcala, H. E., Roby, D. H., Grande, D. T, & Ortega, A. N. (2018). The Affordable Care Act Attenuates Financial Strain According to Poverty Level. Inquiry 55: 0046958018790164. doi: 10.1177/0046958018790164

Mclntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and Directions at the close of a decade. PLoS Medicine, 16(2), e1002752. doi: 10.1371/journal.pmed.1002752

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2017). Fundamentals of Nursing -E-BooK.  New York: Elsevier Health Sciences.

Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic Nursing, 36(1), 12-25. doi: 10.1097/NOR.0000000000000308

Talbert, P. Y., Martin, L. J., Frazier, M., & Byas, D. (2018). Benefits and Challenges of the Affordable Care Act: What should be the Future of the ACA in 2018? Acta Scientific Medical Sciences, 2(5), 9-16. Affordable Care Act (ACA) Essay