The Affordable Care Act and Primary Care Essay Example for Free

The cheap C atomic number 18 carry and primitive Care EssayThe purpose of this paper is to discuss the importance of providing increase access to unproblematic quill superintend and the judge impact of the 2010 Affordable Care action on the delivery of primary assist in the fall in States, extending current trends through the year 2023. Addressed topics will include a brief overview of the Affordable Care constitute, current state of primary headache and the impact of the Affordable Care spell upon primary tutorship patients, providers and payers. The Affordable Care twistIn March 2010, President Obama signed comprehensive wellness reform, the Patient resistance and Affordable Care Act (ACA) into equity. This law makes preventive charge, including primary dread, family planning and other services more than accessible and affordable for many Americans.According to the spirit on Budget an Policy Priorities , the ACA would expand wellness care coverage to 32 million citizens who are currently uninsurable. Expanded coverage of Medicaid and Medicare allows for increased inclusion body of individuals who previously were not eligible for state and federal health amends policy programs. The Medicaid expansion is 100% federally funded for the first three years (2014-2016) and at least(prenominal) 90% federally funded through 2022 and beyond (CBO, 2013).Included in the law is health indemnity policy reform that makes illegal preexisting condition clauses in health insurance coverage and provides coverage for young adults under a family health insurance plan.Affordable Care Act and Primary Care 3The uninsured and self employed would be able to purchase health insurance through state-based exchanges. Subsidies would be available to those who cannot afford to purchase insurance if they meet income requirements. Primary Care in the United StatesIn the United States medical convention was not regulated until the 20th Century. Medical care was provided by a prepare who may or may not admit been trained at a medical school. Many doctors received no formal training, learning as appr entices. These early practitioners provided a multitude of medical services to an entire family including delivering babies, setting fractures, surgeries, diagnosing and dispensing medications. Through organizations such as the American Medical Association the practice of medicine became regulated.These early pioneers were the early practitioners of primary care. Influenced by American ideals and desire for technology and wealth, the number of medical students choosing a path in primary care diminished in favor of specialty practice such as surgery, cardiology, radiology, etc. For several years there has been a decline in the United States primary care workforce. Primary care providers include general practitioners, general internal medicine practitioners, family physicians, physician assistants and nurse practitioners.The United States he althcare system has been go about a decline in its primary care Affordable Care Act and Primary Care 4workforce, infrastructure and access to primary care services for several years. According to research (Petterson,2013) a number of factors, including poor reimbursements to primary care providers, low comparative income, and poor fibre of work vitality due to high patient loads, have contributed to more providers choosing to train and practice in specialty medicine. This trend has led to a shortage of primary care providers across the country, likely contributing to fragmented care, inappropriate use of specialists, and less emphasis on prevention. PatientsPeople who have access to a regular primary care physician are more likelythan those who do not, to receive recommended preventive services and timely care for medical conditions before they become more serious and more costly to treat by visiting the emergency room instead of a primary care provider (Abrams, 2011). Patients a re more likely to adhere to physician recommendations when seen by a primary care provider. Among low-income patients, access to primary care is associated with better preventive care, better management of degenerative conditions, and trendd mortality.Preventing illness is as much a part of primary care as is the diagnosis and treatment of health conditions. The Affordable Care Act provides positive incentives to encourage people to obtain preventive primary care services. Through provisions in the act, applying to Medicare and Medicaid beneficiaries, as well as the privately insured, the law eliminates coinsurance, deductibles, and co payments for approved preventive services Affordable Care Act and Primary Care 5and tests, such as blood-pressure and cancer screenings, mammograms and Pap tests, and immunizations.Studies have shown full coverage of preventive services with no patient cost, increases use of preventive screening services over time (Abrams, 2011). In a look at of lo w-income patients, researchers found that even small incremental changes in co-payments had a substantial impact on the affordability and utilization of care. Included in the ACA is the thought of a patient medical home.This is a primary care site that provides patients with timely access to care, including availability of appointments after regular office hours with patients to manage health conditions and prevent complications, coordinates all care, and engages in continuous quality improvement (Abrams, 2011). Primary care providers will be the coordinators of the medical home. These medical homes will also underwrite greater coordination amongst the primary care site and local emergency departments. Primary Care ProvidersWith the ACA the total number of primary care office visits is expected to increase from the 462 million visits in 2008, to 565 million in 2015. Alsoexpected is the need for an additional 52,000 primary care providers by 2025 due to insurance coverage expansio n (Hofer, 2011).The ACA will entice primary care providers to accept more of the newly covered by increasing Medicare and Medicaid payments for primary care services. There are two Affordable Care Act and Primary Care 6provisions in the ACA that augment payments to primary care providers, one provides a allowance to providers whom participate in Medicare, the second increases reimbursements for Medicaid participation. The goal of these financial incentives is to stabilize and expand the existing primary care workforce. The Affordable Care Act invests an estimated $3.5 billion in the primary care provider bonus program from 2011 to 2016. As a result, Medicaid primary care physicians are estimated to gain an additional $8.3 billion in reimbursement between 2013 and 2019 (Abrams, 2011).To address this growing shortage of primary care providers, the Affordable Care Act provides support of education and training for primary care providers and community health centers. The Affordable Car e Act includes $1.5 billion authorized over 2011 to 2015 for the National health Service Corps to provide scholarships and loan forgiveness for primary care physicians, nurse practitioners, and physician assistants practicing in health professional shortage areas (Abrams, 2011).Other provisions that offer financial support for training new primary care physicians include more favorable loan repayment requirements for the federally supported Primary Care Loan Program and a loan repayment program for pediatric sub specialists and child or adolescent mental or behavioral health providers working in underserved areas. The necessary midlevel primary care practitioner is recognized through scholarships, loans, and loan repayment programs, as well as through the creation and expansion of training opportunities.Affordable Care Act and Primary Care 7PayerThe Affordable Care Act brings an unprecedented level of scrutiny and transparency to health insurance companies. The concept of an insura nce exchange is a major component of the federal Affordable Care Act. An important component of the federal law is that individuals must have health insurance with federal subsidies to help them pay for it.To improve access and protect patient rights, ACA introduces new commercial insurance standards, such as the removal of medical underwriting, voiding of lifetime limits, prohibition of pre-existing condition exclusions, and removal of cost-sharing for preventive services. Insurance plans will be required to cover essential health benefits which are delimit under the ACA (Rosenbaum, 2011). Insurance companies expect significant changes in enrollment, demographics, and plan types.Economic, behavioral, political, and strategic influences are expected to shape the changing insurance coverage landscape, according to a Department of health and Human Services Report. Implications for insurance industry stakeholders are considerable, due to being regulated by state and federal governme nt. Insurance companies and insurance trade publications are stating they will be forced to raise premiums due to ACA requirements, fess and taxes forced upon them ( DHHS,2013).The ACA imposes an annual fee or come upon tax on most businesses that provide health insurance, starting in 2014. The fee will be raised proportionately each year among Affordable Care Act and Primary Care 8insurance providers based on their share of the health insurance market (DHHS, 2013). Certain insurers are exempt from federal excise tax, including public charities and social welfare organizations. In addition, nonprofit insurers that receive more than 80 percent of their gross revenue from government programs that target low-income individuals, seniors, and people with disabilities (including Medicare, Medicaid, and the Childrens health Insurance Program) are not subject to the tax.Supply and demand will determine how the excise tax is ultimately split between insurance companies and purchasers. Insu rers have recently turned in strong financial results and thus are well positioned to bear some of the tax (DHHS, 2013). It is speculated they will pass a portion on to consumers. The Joint Committee on Taxation estimates that premiums subject to the fee will be 2 to 2 percent higher than they would differently be.The Congressional Budget Office estimates that ACA will slightly reduce premiums for employer-sponsored health insurance in the near future. For employers with more than 50 workers, CBO estimates that the law will reduce average premiums by up to 3 percent in 2016. For small employers, the estimated change in premiums ranges from an increase of 1 percent to a reduction of 2 percent .It is important to note that the health insurance industry will gain millions of new enrollees in the next few years as a result of ACA. Insurance plans providing preventative health coverage will benefit financially by providing less expensive care for treatable Affordable Care Act and Primar y Care 9chronic conditions and early diagnosis on other medical conditions. SummaryWith the oncoming implementation of the Affordable Care Act the benefits of the plan encourage the active role of the primary care provider. The uninsured patient now has access to health care that will afford him a better quality of life and address the financial implications of a poorly managed health care system in the United States. The ACA provides a means to entice more into the field of primary care.While it is in the early stages of scrutiny, the health insurance industry is a growing industry and is positioned to be profitable as a result of ACA, even with increased regulation. ConclusionWith the implementation of the Affordable Care Act, the United States is positioned to provide a more sustainable and stronger health care system, due in part to the primary care provisions provided with the ACA. The health care system outlined would provide expanded service for patients, improveoutcomes and quality and reduce future health care spending for the nation.ReferencesAbrams, M., Nuzum, R., Mika, S. and Lawlor, G. (2011, January). Realizing Health Reforms Potential. The Commonwealth Fund. 1, 1-8. http//www.commonwealthfund.org/Publications/Issue-Briefs/2011/Jan/Strengthen-Primary-Care.aspxCenter on Budget and Policy Priorities. (2013, July). Status of the ACA Medicaid refinement After Supreme Court Ruling. Retrieved from http//www.cbpp.orgCongressional Budget Office. (2013). CBOs Estimate of the Net Budgetary Impact of the Affordable care Acts Health Insurance Coverage Provisions Has Not Changed Much Over Time. (CBO Publication No. 144176). Washington, D.C. U.S. Government Printing Office. http//www.cbo.gov/publication/44176.Department of Health and Human Services. (2013, February). Health Insurance Premium Increases in the Individual Market Since the Passage of the Affordable Care Act.(DHHS. Research Brief). Washington, D.C. http//aspe.hhs.gov/health/reports/2013/RateIncrea seIndvMkt/rb.cfmHofer, A., Abraham, J., Moscovice, I. (2011, March). Expansion of Coverage under the Patient protective covering and Affordable Care Act and Primary Care Utilization. Milbank Quarterly. 89(1) 69-89. http//www.milbank.org/publications/the-milbank-quarterlyPatient Protection and Affordable Care Act, 42 U.S.C. 18001 (2010).Petterson, S., Liaw, W., Phillips, R., Rabin, D., Meyers, D. and Bazemore, A. (2013). Projecting US Primary Care medico Workforce Needs 2010-2025. Annuals ofMedicine. 6, 503-509. http//annfammed.org/content/10/6/503.fullRosenbaum, Sara. (2013, February). The Patient Protection and Affordable Care Act Implications for Public Health Policy and Practice. Public Health Reports. 126, 130-135. http//www.publichealthreports.org/