HCA 675 What are your thoughts about the emerging accountable care organizations?

Grand Canyon University HCA 675 What are your thoughts about the emerging accountable care organizations?-Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University HCA 675 What are your thoughts about the emerging accountable care organizations? assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for HCA 675 What are your thoughts about the emerging accountable care organizations?                            

Whether one passes or fails an academic assignment such as the Grand Canyon University HCA 675 What are your thoughts about the emerging accountable care organizations?  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for HCA 675 What are your thoughts about the emerging accountable care organizations?                          

The introduction for the Grand Canyon University HCA 675 What are your thoughts about the emerging accountable care organizations?  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for HCA 675 What are your thoughts about the emerging accountable care organizations?                          

After the introduction, move into the main part of the HCA 675 What are your thoughts about the emerging accountable care organizations?  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for HCA 675 What are your thoughts about the emerging accountable care organizations?                          

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for HCA 675 What are your thoughts about the emerging accountable care organizations?                            

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for HCA 675 What are your thoughts about the emerging accountable care organizations? 

Re: Topic 8 DQ 2

The new accountable care organizations or ACOs as they are commonly called came about as the health system in the U.S began to restructure and redesign (Babyar, 2016). Under the Affordable Care Act (ACA) there were proposed as new policies to facilitate better coordination of care between health care providers and health systems (Babyar, 2016). Especially for those who are insured through Medicare provisions (Babyar, 2016). ACOs require that there be voluntary participation from the health systems and providers to help improve the quality of care and the lower the healthcare costs (Babyar, 2016).

With my work in health insurance, I get to work alongside the ACOs who manage some of our networks and members. They are extremely helpful in managing the care, cost, and networks of those under their care. I know that the insurance company I work for has also seen a great reduction in cost since implementing the ACOs. They were created based upon the “promise of reducing costs and improving the quality of care by realigning payment incentives to focus on health outcomes instead of service volume” (Fullerton, Henke, Crable, Hohlbauch & Cummings, 2016, p.1257). One of the areas that they are key in managing the care and services for members are those that have mental health issues (Fullerton et al., 2016). For years there has always been notoriety in mental health that the patients tend to not be compliant, and facilities are overwhelmed and lack available beds for treatment. ACOs have been key in helping to streamline the coordination of treatment for these people with mental health issues (Fullerton et al., 2016). I get to see it with my own eyes at work as they work to coordinate available treatments, providers, facilities, and network exceptions in order to promote uninterrupted care for these members. Most of my work with them has been for out of network exceptions related to members who are experiencing access to care issues. Having the support of the ACOs has been integral in finding providers and services and negotiating with them in order to provide the most benefit to our members.

ACOs are already affecting the current health care delivery system because of their coordinating and collaborating efforts, they have improved the ease for people to find providers and services. The practice patterns of primary care physicians will be more focused on quality care measures, and less cost. Another great way they are making an impact is that the ACOs are now presenting new opportunities to address the gaps in healthcare often experienced by those in rural areas of our country (Ortiz, Bushy, Zhou & Zhang, 2013). These populations are most notably at risk of having suboptimal care because of their location and the scarcity of providers associated with their remote location. Many do not even have established primary care providers so often underlying health issues are never treated and result in more serious consequences down the road. Thus, with ACOs working alongside organizations such as the Rural Health Clinic management or RHC puts the focus back on patients getting set up with steady primary care providers who can focus on the patients and improve their health outcomes (Ortiz et al., 2013).

Lastly, as with any system, it is impossible to have it be perfect and not exert any ill effects. One of the negatives of ACOs specific to their effects on primary care practices is that they exclude some physicians. This happens because the very nature of the ACOs can make it extremely difficult for “small, independent, physicians to get involved, and that drives independent physicians’ wariness of ACOs” (Becker’s Hospital Review,2013, para.1). There is a perpetuating belief that with independent physicians versus their counterparts working for larger health systems switching to an ACO will not truly improve the quality of their care (BHR, 2013). Rather they feel that is more likely that joining an ACO will have a negative impact on their small practice particularly in the aspect of their profitability (BHR, 2013). Mainly because of the fact that participating with an ACO will require more time and effort for the physicians to spend on “reporting metrics and filling out more paperwork—putting a damper on the time-independent physicians spend seeing patients” (BHR, 2013, para.2). A burden that they cannot financially bear and thus it hinders their desire to participate openly with an ACO (BHR, 2013).

Becker’s Hospital Review. (2013). 2 of the largest problems with ACOs. Retrieved from https://www.beckershospitalreview.com/accountable-care-organizations/2-of-the-largest-problems-with-acos.html

Ortiz, J., Bushy, A., Zhou, Y., & Zhang, H. (2013). Accountable Care Organizations: Benefits and barriers as perceived by Rural Health Clinic management. Rural and Remote Health, 13(2), 2417-2436. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761377/

Fullerton, C., Henke, R., Crable, E., Hohlbauch, A., & Cummings, N. (2016). The impact of Medicare ACOs on improving integration and coordination of physical and behavioral health care. Health Affairs, 35(7), 1257-1265. Retrieved from https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2016.0019

Babyar, J. (2016). Opportunities and Accountable Care Organizations. Journal of Medical Systems, 40(11), 248–250. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118700353&site=ehost-live&scope=site

Sample Answer 2 for HCA 675 What are your thoughts about the emerging accountable care organizations? 

Accountable care organizations (ACOs) keep emerging throughout the United States. According to McWilliams, Hatfield, Chernew, Landon, & Schwartz (2016), in 2015, there were about 838 accountable care organizations, however, by the beginning of 2016, there were additional of about 1200 ACOs. More than 28 million Americans receive medical care through accountable care organizations. The ACOs will improve coordination between hospitals, providers, and payers. These organizations will also ensure that patients receive quality care while reducing the cost associated with healthcare (McWilliams et al., 2016). The Affordable Care Act positioned the development of the ACOs.  The experts believed that the biggest benefit of the ACOs would be reducing the cost of care.

The practice patterns of primary care physicians will change greatly under the ACOS. These healthcare providers focus on the provision of quality care rather than quantity of services or the number of tests and procedures delivered (Lewis, D’Aunno, Murray, Shortell, & Colla, 2018). Doctors under the ACOs work together to coordinate care through the use of health information technology, enhanced communication, care coordination staff, and other initiatives. The ACO payment for healthcare providers is connected to value and quality rather than volume (Lewis et al., 2018). The outcome-focused payment enables the ACOs to deliver high-quality care and meet quality improvement goals.

There are some problems arising from this practice pattern. For instance, the operational challenges associated with the measurement do not necessarily reflect the complexity of caring for patients with multiple conditions (Kaufman, Spivack, Stearns, Song, & O’Brien, 2019). Additionally, rigid measures and standards make providers to focus on patients who might show better outcomes to make them avoid penalties. Those with complex conditions and non-compliant ones are avoided by the primary care physicians.

References

Kaufman, B. G., Spivack, B. S., Stearns, S. C., Song, P. H., & O’Brien, E. C. (2019). Impact of accountable care organizations on utilization, care, and outcomes: a systematic review. Medical Care Research and Review, 76(3), 255-290. doi: 10.1177/1077558717745916.

Lewis, V. A., D’Aunno, T., Murray, G. F., Shortell, S. M., & Colla, C. H. (2018). The hidden roles that management partners play in accountable care organizations. Health Affairs, 37(2), 292-298. doi: 10.1377/hlthaff.2017.1025.

McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016). Early performance of accountable care organizations in Medicare. New England Journal of Medicine, 374(24), 2357-2366. doi: 10.1056/NEJMsa1600142.

HCA 675 Topic 8 PPACA Paper FINAL 

Rising expenditures on medical care is a worldwide problem that limits access to health services especially among populations with meager incomes. The United States of America as one of the affluent countries also grapples with increasing costs on medical care as it reports high expenditure on health services. Due to an increased burden on care, America introduced a healthcare policy called the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare or ACA, to improve access to health facilities (French et al., 2016). The reform aimed to expand access to healthcare through improved coverage and quality of services by lowering the cost to improve consumer protections. Moreover, since its establishment, PPACA has improved consumer protections through eliminating most awful practices of third-party payers such as charging exorbitant prices or denying coverage to individuals with pre-existing health conditions. With the policy, approximately 20 million Americans gained coverage in 2016 (Oberlander, 2020). However, despite this milestone in patient protection, large proportions of Americans lack health insurance coverage and the cost of care continue to soar at an unsustainable rate. The premise cast debate on whether the policy is an improvement or a liability to the American healthcare delivery system.  

The PPACA as an Improvement or Liability 

           According to Chernew, Conway, and Frakt (2020), PPACA is a breaking point in the American public health policy. As of 2019, the policy increased coverage to 32 million Americans. The most defining measures of the policy are to expand coverage to up to 133% of the populations below the poverty line. Besides, the policy limits insurance exclusions and also prevents the use of lifetime caps or any other mechanism to deny insurance coverage to Americans. The policy has also seen increased coverage to people with preexisting or chronic conditions and has also allowed coverage for children up to age 26 enrolled on parental plans. Based on this context, the PPACA has tremendously reduced the cost of care to all populations enrolled in the program.  

           With the enactment of the policy, individuals were expected to purchase health insurance policies at the beginning of 2014. The mandatory law to have the policy had irredeemable consequences to those not able to buy the coverage. In other words, a fine of $95 or alternatively 1% of the taxable income (Chernew, Conway & Frakt, 2020) was imposed to defaulters. The penalties, however, increased to $695 or 2.5% of income in 2016 for individuals and people with families were charged three times more from the personal fines. Through these amendments, the policy emerged to be a liability especially to those with scanty incomes. The government, on the other hand, anticipated to collect a substantial revenue to pay for it, but this came at the expense of consumers. The policy, therefore, emerged to be a burden to consumers rather than a reprieve to the irredeemably rising cost in care.  

Pros and Cons 

           Oberlander (2020) indicates that PPACA has had a host of challenges to third-party payers (the insurance industry). According to the author, the profits for these payers have largely decreased since these companies have to take care of healthcare costs for individuals with pre-existing medical conditions and also provide coverage to preventive services associated with these illnesses. With this, the state and federal insurance exchanges have charged high prices to enable people to purchase coverage for these preexisting conditions. On a negative flip-side, the legislation has increased costs burden for healthier people and younger adults. These populations are more likely to assume the tax burden of purchasing health insurance exchanges for a pool of older people as well as sicker populations suffering from pre-existing or degenerating illnesses (French et al., 2016). Guided by this argument, it is clear that alleviating the health disparities among populations in America is still a major challenge and these compounds to ever-rising cost in healthcare. Besides, due to the high costs of health insurance exchanges, some states have not yet expanded Medicaid programs to citizens and this limits the possibility of PPACA in bridging the health disparity gap which overall leaves millions of Americans with limited options on coverage.  

           French et al. (2016) postulate that the PPACA has made health insurance companies operate through an exchange program where they serve a more expensive client base than earlier predicted by the policy. When compared to previous years, the insurers assume more health costs while receiving high premiums from healthy populations. Seeking broader enrollment of populations to the already overburden populations has been a daunting task to the health insurance companies. The premise has seen health insurers such as Aetna to reduce the health insurance exchanges offered in different counties in America. For instance, the company reduced selling health plans from 778 counties in 2016 to 242 counties in 2017 as a result of a $200 million loss recorded in the second quarter of 2016 (Chernew, Conway & Frakt, 2020). Due to such challenges, payers increased their premiums to address the volatilities in the health insurance environment.  

Patients also respond to these inherent challenges by opting for payers who provide the lowest possible premiums. However, despite the availability of reduced costs on monthly premiums, patients still face a challenge of higher out-of-pocket deductible charges when they seek care. Nonetheless, as patients aim to strike a balance on quality of care, they tend to incur additional out-of-pocket expenditures and this has made the overall cost on care expensive. The primary intention of the PPACA was to enhance low deductible and low co-pay health insurance to cushion American citizens from high expenditures on care (Oberlander, 2020). At the moment, the policy has led to high-deductible costs and forced people to incur additional expenditure as they seek quality health services. The trend cast doubt on the sustainability of the PPACA and the survival of the payers in the current health insurance ecosystem.  

           Even though the PPACA has made Medicaid services more inclusive for many people enrolled in the programs, coverage has been low for a majority of uninsured U.S. citizens (Oberlander, 2020). Since its rollout, shopping for coverage has been complicated due to confusion emanating from limited periods of enrollment. Besides, difficulties with websites on its online platform have made enrollment complicated to a majority of citizens who yearn for the highly publicized benefits of the policy (French et al., 2016). With these difficulties in shopping for coverage, some citizens have perceived PPACA as a liability and contemplated exiting the old methods of health payments with others resorting to out-of-pocket expenditures.  

Conclusion 

           Despite having good health insurance policies, Americans suffer from rising medical costs on care. The PPACA as the highly debated landmark health policy has consistently failed to address the exceedingly high medical cost. Young adults, as well as healthier populations, are compelled to pay high premiums to cater to the demands of the older populations. Besides, the policy does not consolidate the low monthly health premiums paid and the quality of services delivered to patients. Due to the disequilibrium, patients have resorted to out-of-pocket expenditures in seeking quality health services making the policy a liability. 

References 

Chernew, M. E., Conway, P. H., & Frakt, A. B. (2020). Transforming medicare’s payment systems: progress shaped by the ACA: A narrative review of Affordable Care Act payment reforms. Health Affairs, 39(3), 413-420. 

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key provisions of the Patient Protection and Affordable Care Act (ACA): A systematic review and presentation of early research findings. Health services research, 51(5), 1735-1771. 

Oberlander, J. (2020). The ten years’ war: Politics, Partisanship, and the ACA: An exploration of why the Affordable Care Act has been so divisive despite the law’s considerable accomplishments. Health Affairs, 39(3), 471-478.