1 Health Law, Policy, and Regulation Paper Allison M. Wood HCS/545 September 5, 2016 Professor Kathleen Cross
2 Health Law, Policy, and Regulation Paper Health care organizations and providers have been trusted with providing quality care to patients in the United States for many years. The government and regulating agencies have created strict rules and regulations that organizations and providers must follow. Americans have witnessed a decline in care with increasing costs. According to Santilli and Vogenberg (2015), it has been “ reported by many sources since 2010, the United States spends more on healthcare than any other industrialized country; however, the US healthcare system is not better, and its quality is inconsistent.” Many believed that the reason for this was that the health care system operated on a fee for service (FFS) model of care in which “ providers receive payment for each service rendered, leading to incentives to provide more, not better, services” (Santilli and Vogenberg, 2015). Health law, policy, and regulation in health care organizations serves as a means controlling the quality and costs of care that a practitioner provides to the public. The government and other regulating bodies oversee policies and procedures in order to improve patient care in hospitals, clinics, and private physician practices while reducing costs. There are many regulatory bodies that govern the health care industry. Regulations apply to physicians, financiers, pharmaceutical and insurance companies, health care institutions, public health organizations, and health research companies. Today, health care is the most regulated industry in America (Anderson, 2014). This paper will explore the Affordable Care Act and its impact on health care organizational policies. The Affordable Care Act The Affordable Care Act (ACA) was created as a means for health care reform in the United States. The ACA was “passed by congress and then signed into law by President Obama
3 on March 23, 2010” to improve health care coverage, lower health care costs, and grant health care access to patients who have not had health coverage in the past (U.S. Department of Health and Human Services, 2016). The ACA requires all citizens to have health care access and coverage regardless of race, social class, or economic class. Any person who chooses not to have coverage is subject to a tax fine. Under the ACA, patients cannot be refused coverage for having a health condition prior to the start of coverage. Another valuable piece of this legislation is that insurance carriers cannot limit benefits for customers. Patients with conditions such as cancer have exhausted benefits in the past. This is no longer an option for insurance companies. The Affordable Care Act also offers coverage for some preventative care services. Patients may get screenings such as
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