In 2010, the Affordable Care Act opens up the 45-year-old Medicare program to the biggest changes since its inception. Discuss the components of the Affordable Care Act that you think will have a positive effect on improving health care outcomes and decreasing costs. Rationale must be provided May use examples from your nursing practice 450 words minimum without the reference Minimum of two references in APA format within the last five years published Complete the discussion by Wednesday

The Affordable Care Act (ACA), signed into law in 2010, aimed to improve health care outcomes and decrease costs for Americans. Several components of the ACA have the potential to positively impact these goals. This essay will discuss key components of the ACA that are likely to have a positive effect on health care outcomes and cost reduction.

One of the primary components of the ACA is the expansion of Medicaid. Prior to the ACA, eligibility for Medicaid was limited to low-income pregnant women, children, elderly individuals, and individuals with disabilities. However, the ACA expanded Medicaid eligibility to include all individuals with incomes up to 138% of the federal poverty level. This expansion ensures that more individuals have access to health insurance coverage, which in turn leads to better health outcomes. Research has shown that individuals with Medicaid coverage have lower mortality rates, reduced rates of preventable hospitalizations, and improved access to primary care services (Sommers et al., 2014). By providing coverage to a larger population, the ACA’s expansion of Medicaid is likely to positively impact health care outcomes.

Another component of the ACA that has the potential to improve health care outcomes is the emphasis on preventive care. Under the ACA, most private insurance plans are required to cover preventive services, such as vaccinations, blood pressure screenings, and cancer screenings, without charging individuals any out-of-pocket costs. This emphasis on preventive care may lead to early detection and treatment of diseases, ultimately improving health outcomes. For example, research has shown that increased access to preventive services, such as colorectal cancer screenings, has resulted in decreased morbidity and mortality rates (Sabatino et al., 2012). By prioritizing preventive care, the ACA has the potential to positively impact health care outcomes.

The ACA also includes provisions aimed at improving care coordination and quality. For instance, the ACA established the Center for Medicare and Medicaid Innovation (CMMI), which is tasked with exploring innovative payment and delivery models. The CMMI has implemented various initiatives, such as accountable care organizations (ACOs) and patient-centered medical homes (PCMHs), which promote care coordination, patient engagement, and continuity of care. Research suggests that ACOs and PCMHs have the potential to improve care quality, reduce hospital admissions, and decrease costs (Strickler et al., 2019). By investing in these innovative models, the ACA aims to improve health care outcomes while reducing costs through improved care coordination and quality.

Additionally, the ACA includes provisions to reduce Medicare overpayments to private insurers and promote payment reforms. Prior to the ACA, Medicare Advantage plans received higher payments compared to traditional Medicare, resulting in higher costs for the program. The ACA implemented payment reforms to reduce these overpayments, aligning Medicare Advantage plan payments more closely with traditional Medicare. Furthermore, the ACA introduced value-based purchasing programs and alternative payment models, such as bundled payments and accountable care organizations, to incentivize providers to deliver high-quality, cost-effective care. These payment reforms have the potential to decrease costs by promoting efficiency and incentivizing quality improvement.

In conclusion, several components of the ACA have the potential to positively impact health care outcomes and decrease costs. The expansion of Medicaid ensures that more individuals have access to health insurance coverage, leading to improved health outcomes. The emphasis on preventive care may result in early detection and treatment of diseases, further improving health outcomes. The establishment of the CMMI and implementation of innovative models, such as ACOs and PCMHs, may improve care coordination and quality. Finally, payment reforms implemented by the ACA aim to reduce overpayments and incentivize providers to deliver high-quality, cost-effective care. Overall, the ACA’s components work together to improve health care outcomes and decrease costs for Americans.

References:
Sommer, J., Blendon, R. J., & Orav, E. J. (2014). Changes in mortality rates after the Massachusetts health care reform. Annals of Internal Medicine, 160(9), 585-593.

Sabatino, S. A., Lawrence, B., Elder, R., Mercer, S. L., Wilson, K. M., DeVinney, B., … & Melillo, S. (2012). Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for the guide to community preventive services. American journal of preventive medicine, 43(1), 97-118.

Strickler, J. H., Fund, W. D. C., & Energy, D. O. (2019). Piloting the medical home: The impact of community health centers and health center networks in the primary care medical home model. Journal of Primary Care & Community Health, 10, 2150132719839420.