Order ID |
53563633773 |
Type |
Essay |
Writer Level |
Masters |
Style |
APA |
Sources/References |
4 |
Perfect Number of Pages to Order |
5-10 Pages |
Description/Paper Instructions
ACA and Healthcare Outcomes and Costs Paper
ACA, Healthcare, Outcomes, Costs, Paper
Instructions: Response must be at least 350 words written in current APA format with at
least two academic references cite. References must be within the last five years.
Respond by extending, refuting/correcting or adding additional nuance.
All human beings deserve health care coverage, whether they can afford it or not. In
today’s U.S. healthcare system, to have good health care, it is not just about having
health insurance coverage. It must be affordable and accessible. The Affordable Care
Act (ACA), passed in 2010, represents the most extensive reform to the U.S. health
care system since the introduction of Medicare and Medicaid in 1965 (Duggan, Goda &
Jackson, 2019).
The positive effect on improving health care outcomes is ACA’s main components,
which is improving access to care by enabling more Americans to gain health insurance
coverage and containment of healthcare costs (Mason, Dickson, McLemore, and Perez,
2016).
By offering the expansion of Medicaid, changes in private (commercial) insurance
coverage, the establishment of health exchanges, employer requirements for providing
healthcare coverage, and the introduction of the individual mandate (LaFontaine,
Vogenberg & Pizzi, 2019).
ACA includes dozens of provisions to expand health insurance coverage, slow the
growth rate in health care costs, and reform the market for private health insurance.
After implemented many of these provisions in January of 2014, un-insurance rates
among nonelderly adults fell substantially, from 20.1 percent in the fourth quarter of
2013 to 15.1 percent by the fourth quarter of 2014 and 12.6 percent by the fourth
quarter of 2015 (Duggan, Goda & Jackson, 2019).
Also, ACA seeks to contain Medicare costs and pay for coverage expansion by phasing
out extra payments to insurers who offered Medicare Advantage Plans, managed the
care of private plans that the older population can choose instead of traditional Fee-for-
Service (FFS) Medicare. Medicare pays a lower annual increase and pays less for
medical equipment.
Furthermore, by reducing outstanding payment, taxing employers who offer high-cost
private insurance plans, encouraging the development of Accountable Care
Organizations (ACOs) for Medicare recipients, especially those with costly chronic
conditions.
Penalizing hospital by reducing their reimbursement if they have excessive 30-day
readmissions and hospital-acquired infections, implementing
aggressive Medicare/Medicaid fraud and abuse prevention measures, establishing an
Independent Payment Advisory Board (IPAB), implementing administrative
simplification measures, and conducting comparative effectiveness research (Mason,
Dickson, McLemore, and Perez, 2016).
To tackle insurance coverage issues, it is essential for healthcare professionals and
pharmacy and therapeutics (P&T) or related committees in all practice settings to
realize that today’s ACA differs from the original 2010 act. As plan requirements,
government funding, and patient affordability change, so too must the plans offered by
third-party healthcare payers or purchasers (employers, municipalities, and unions).
ACA established new coverage guidelines on plan eligibility and scope that private
insurers must follow. The most well-known policy deriving from the changes prevents
insurers from denying coverage to individuals based on pre-existing medical conditions.
Another part of the rule made it illegal for insurers to charge a greater fee based on a
person’s health status or gender.
Moreover, coverage expanded for young adults, who can claim dependent status on
their parents’ health insurance up to the age of 26, with no restrictions regarding their
living situation, financial independence, or health insurance options offered by their
employer. Insurers are prohibited from imposing lifetime limits on coverage, and this
coverage could not be rescinded.
Furthermore, to encourage wellness checks, the act established mandatory minimum
coverage standards known as “essential health benefits” and instituted zero-dollar co-
payments for many preventive health services (LaFontaine, Vogenberg & Pizzi, 2019).
ACA set out guidelines for employers with more than 50 full-time employees and
instituted financial penalties for those who were unwilling to comply. A highly
controversial aspect of ACA was the individual mandate. In 2010, the act laid the
groundwork for supplementing insurance-risk pools with healthier patients by instituting
an individual mandate for health insurance.
Beginning in 2014 and extending through 2016, patients without insurance coverage
were required to pay an annual tax penalty. Now: On December 20, 2017, the Tax Cuts
and Jobs Act passed by Congress finalized the individual mandate’s permanent repeal,
with the penalty phasing out in 2019.
As conversations about the repeal were heating up in 2017, the Congressional Budget
Office (CBO) estimated what repealing the mandate would cost: the report concluded
that the number of people with health insurance would decrease by four million in 2019
and increase to 13 million by 2027.
To provide patient-centered care in today’s healthcare environment, understanding the
system within which patients and providers function is more critical than ever
(LaFontaine, Vogenberg & Pizzi, 2019).
RUBRIC
QUALITY OF RESPONSE |
NO RESPONSE |
POOR / UNSATISFACTORY |
SATISFACTORY |
GOOD |
EXCELLENT |
Content (worth a maximum of 50% of the total points) |
Zero points: Student failed to submit the final paper. |
20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. |
30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. |
40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. |
50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. |
Use of Sources (worth a maximum of 20% of the total points). |
Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. |
5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. |
10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. |
15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. |
20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. |
Grammar (worth maximum of 20% of total points) |
Zero points: Student failed to submit the final paper. |
5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors |
10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors |
15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. |
20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. |
Structure of the Paper (worth 10% of total points) |
Zero points: Student failed to submit the final paper. |
3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. |
5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper |
7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. |
10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. |
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