Analysis of The Healthcare Reform (Essay Sample)

Healthcare Reform
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Healthcare Reform
Healthcare reforms are targeted at expanding the coverage of healthcare services and increasing the beneficiaries of the services. The idea is that the traditional mechanism used is insufficient, hence modifying operations and approaches to broaden the population that receives the services through the private sector or public insurance programs. The Affordable Care Act and Value-based care are major healthcare reforms that have increased accessibility to healthcare services even though the former is costly to implement while the latter reduces revenues for hospitals.
Analysis of Healthcare Reforms
Healthcare reforms have been implemented in the US to increase citizens' access to healthcare services. The Affordable Care Act (ACA) is the most profound healthcare reform in the US. Formally, the citizens were covered under the Medicaid and Medicare programs, which, according to Willison and Singer (2017), had limited membership, considering that those eligible for these programs were the elderly and individuals from low-income households. ACA has led to the expansion of Medicaid eligibility leading to an expanded membership. Also, businesses are required under the Act to provide health insurance cover to their workers especially those employed permanently (Willison & Singer, 2017). The passage of ACA has allowed several people to access healthcare services.
The shift from fee-for-service to value-based care is another reform in the healthcare sector. Initially, the healthcare facilities used the fee-for-service reimbursement model. Hospitals charged clients based on the number of services, operations, and medical procedures they received upon visiting hospitals (Bhatia, Tobey & Hochman, 2017). Also, the medical practitioners were remunerated based on the number of patients served and procedures performed. The approach was costly for the patients considering that some were subjected to unnecessary medical procedures to make them pay more for the benefit of the healthcare facilities and the practitioners (Bolz & Iorio, 2016). The value-based payment model is the new reimbursement approach in which the insurance companies pay the hospitals’ financial claims based on the quality of services offered and patient satisfaction instead of the number of medical procedures performed on the clients (Bolz & Iorio, 2016). The payment model has reduced the costs of healthcare services in hospitals.
Benefits and Limitations of Healthcare Reforms
There are some benefits associated with the analyzed healthcare reforms. The ACA, for instance, has increased the number of Americans accessing insured healthcare services. According to Willison and Singer (2017), more than 16,000 beneficiaries enrolled in the program in the first 5 years of its implementation. The other benefit is that individuals with pre-existing conditions are no longer denied coverage. Originally, individuals with chronic diseases such as asthma, diabetes, and high blood pressure were not covered under insurance, forcing them to use out-of-pocket means to seek related medical services (Toseef et al., 2020). Fortunately, the ACA has eliminated the exclusions with such conditions being covered under the new reform. However, the major limitation of ACA is that it has increased taxation by the government (Toseef et al., 2020). Implementing the program is costly and has forced the government to increase its tax to collect more revenues to support the reform. Also, the passage of ACA has led to the loss of job security, considering that some companies opt to employ staff temporarily to evade paying the health insurance costs as required by the ACA (Willison & Singer, 2017). Therefore, the reform has both benefits and limitations.
The value-based payment model has had profound benefits to the health sector in the US. First, it has reduced the cost of care, considering that the physicians no longer conduct unnecessary medical procedures that were too costly to the patients (Bhatia et al., 2017). Also, the reform has led to accessibility to healthcare services, considering that most of the services offered in both private and public facilities are now affordable to most of the citizens. Finally, the reimbursement model has increased the quality of the services provided since the hospitals are reimbursed based on the quality of care offered and not on the number of services rendered (Bhatia et al., 2017). However, the reform has reduced healthcare facilities' revenues, especially those that do not meet the clients' quality standards or those rated low. In return, the facilities have been forced to close or reduce their staff, thus comprising their overall smooth running.
The Situation of Healthcare Services in Florida
Even though the US is known for its robust healthcare system, some states face challenges in the health sector. Florida is one of the states whose healthcare sector is low performing, calling for reforms. Currently, the state has limited coverage of its Medicaid program and has been ranked as the second-lowest in adult access to healthcare services (Freeman, 2018). Freeman (2018), states that only 53% of individuals aged 18 to 64 have health insurance cover while the rest remain uninsured. The state has a 92% child insurance rate, becoming the fourth lowest in the US. The quality of services does not also meet the required standards. At least15% of the patients being discharged in Florida, hospitals state that they are not given health care plans, while 36% state that the facility did not provide patient-centered care (Freeman, 2018). Based on child health, 33% of Florida children lack immunizations, while only 62% have a good checkup with doctors (Freeman, 2018). These statistics reveal that the current healthcare situation in the state is worse hence the need for reforms.
Roles of Advanced Practice Nurses
Advanced Practice Nurse (APN) are primary care providers and, therefore, at the frontline of providing health services in their respective healthcare centers. The first role of the APNs is to diagnose patients to und