The Patient Protection and Affordable Care Act (ACA) was an extremely significant law passed in regards to federal healthcare policy and business strategies that are driven by those policies. This act made health insurance accessible to all Americans regardless of their pre-existing conditions. This piece of the act alone has already affected healthcare business strategies.
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This paper will answer the question in detail and explain how the ways the ACA, in some cases, has already affected healthcare business strategies and will continue to affect healthcare business strategies. The ACA will be explored from its beginning, to passage, to implementation. The advantages and disadvantages of ACA will be discussed in relation to impact on healthcare business strategies.
The Patient Protection and Affordable Care Act is the official name of what many commonly refer to as the Affordable Care Act, or also known as Obamacare. It is the comprehensive healthcare reform law in the United States that was enacted in March 2010. The primary three goals of the law were to: make health insurance affordable and accessible to more people, expand Medicaid, and promote lower cost, innovative health care delivery methods (Affordable Care). These three goals have the greatest impact on healthcare business strategies. The purpose for these goals were to make near-universal coverage possible; strengthen quality and consumer cost for coverage; strengthening value, efficiency and care quality while cutting out waste; increasing accountability across systems; empowering community-based preventive care on a long-term scale (Rosenbaum).
A strategy is plan for moving advantageously from one point to a future point while navigating risk and resistance. In healthcare, strategy focuses on service, growth, quality, financial capital, and human capital. All good strategies begin with goals and objectives. Regarding healthcare strategies, the goals were already determined by the ACA. Implementation is where strategy will be needed for healthcare businesses dealing with ACA objectives (Beckham).
The enactment of ACA added approximately 46 million individuals to the number of people with insurance coverage in America (Rosenbaum). This increase in patients will impact a healthcare business world that is already suffering to obtain and maintain qualified staff (Morrissey). This lack in workforce also strains quality and efficiency, but it creates opportunity for community-based care to become more accessed, (Rosenbaum) which will be discussed later. To counteract the lapse in workforce, the ACA has also provided incentives for those in healthcare to advance their education or obtain continuing education credits (Morrissey). Training strengthens a business’s ability to have a qualified staff. Like many other industries that rely on federal funding, budget cuts in states that did not implement the Medicaid expansions leave shortages unmanaged (How The Affordable).
The ACA extends funding to special populations in an effort to increase preventative health that also lowers the cost of healthcare and eases some of the strain felt from the increase in patients (Rosenbaum). Healthcare care business strategists would do well to collaborate with community organization to receive funding but mainly as an attempt to promote prevention, which is typically more cost effective than treatment (Preventive).
In 2015, the ACA’s Value Based Purchasing (VBP) program replaced Sustainable Growth Rate with the passing of the Medicare Access and CHIP Reauthorization Act (MACRA) (Chee et al.). ACA has in a way pushed the healthcare business industry to be more streamlined and technology focused using proven strategies to run the business side of healthcare and measure quality (CAHPS). The third goal of improving healthcare delivery includes quality, efficiency, and accountability. This is achieved through use of multiple metrics such as patient surveys, readmissions, and quality of life (Lazar et al. 2013). It is through these quality measurements, providers are given incentives for care quality. Prior to passage of the ACA, doctors were paid a fee for the services they provided and no consideration was given to the quality of that service. In essence, a person could go in and receive top-notch service and would pay the same fee to a great physician as they would have paid to a physician who was negligent and careless. Another issue that can affect quality is readmissions for noncompliant patients. Quality scores can also suffer from this (Seaborg).In theory, such a practice is not good business, receiving lackluster work but paying a premium price. After ACA, healthcare providers are now receiving incentives for the quality of their work (How Insurance Changes).
The final way the ACA has impacted healthcare business strategies is through improved technology. This technology is used in every level of healthcare to make improvements to business strategies, operations, and procedures (Nemeth et al.). This part ties in with the training incentives to ensure the workforce and training requirements evolve with the technology (Morrissey). This new technology is used to reduce risk and revenue loss (Wang et. al).
The Affordable Care Act turned the healthcare industry on its ear. The legislation ushered in a multitude of changes that have revamped an outdated medical industry. With any new legislation, there will be resistance, but the legislation has built in protections against such resistance in the form of penalties. An already struggling healthcare industry cannot undertake penalties for resistance, although some states have chosen to do this with opting out. As of now, the country can appreciate the improvements in care implementation, quality care and service, reduction in wasteful spending and fraudulent claims, streamlined, efficient service delivery, and a growing and continuously improving workforce equipped with the latest medical information technology. With the incentives given to individuals within the healthcare industry, it is highly likely the field will soon have a growth spurt to supplement its current workforce shortages. The ACA seems to be successful in all of its goals, but only time will reveal the full impact it will have on health care business strategies.
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