and policy makers can take advantage of. Such as prevention and health center funding. Prevention centers are vital to local communities and needed they would have to demonstrate how useful they would be the same as nonprofit hospitals. The Implication for the Appeal of the Affordable Care Act The ACA had many provisions that would affect how Medicaid and the many elderly people who relied on Medicaid for health insurance coverage. The ACA really helped to compensate hospitals for providing care to lower income families. Repealing the ACA's sustained reductions in provider payments would be expected to increase Part A and Part B spending (Cubanski, Neuman, Jacobson, & Boccuti, 2016). Repealing the provisions would increase payments to providers and some hospitals. It would also help with deductible and copayment which is paid by the beneficiary. Prior to the ACA federal payments to Medicare Advantage plans per enrollee were 14 percent higher than the cost of covering similar beneficiaries under the traditional Medicare program, according the Medicare Payment Advisory Commission [MedPAC] (Cubanski et al, 2016). Repealing this would also increase the total Medicare spending and improve the out of pocket cost for each beneficiary that is enrolled in the Medicare Advantage plans. The ACA helped to improve preventive benefits for screenings such as breast, diabetes, and cardiovascular to name a few. By having the preventative services physicians could determine early signs and start treatment early or prevent it. The ACA gives the individual permission to file an appeal if they feel they were wrongly denied. The insurance company must notify the patient in writing the reason why the claim was denied, and that the individual has the right to file an appeal and request an external review (Harrington, 2016, p.
Running head: AFFORDABLE CARE ACT 5 106). The appeal helps patients to get a second opinion on their case. A lot of times patients rely on the help to cover medical expenses. Financial Theories in the Healthcare Industry Understanding and overcoming barriers is crucial to implementing effective improvements. The government itself now is finding themselves faced with constraints on healthcare spending capacity while the demands and expectations are increasing. Across health care systems there are powerful pressures on local decisions makers to improve outcomes whilst reducing expenditures (Willias, Brown, & Healy, 2018). The health care industry has a huge impact in the United States economy. Health care spending is at an all-time high for the overall economy. The ACA has made insurance more affordable for low income families but at the same time those who are high earners, employers, and health care providers affects them by paying more taxes. Many individuals have gain access to affordable insurance since the ACA and many incentives were given. Some may argue that the ACA has introduced more insured patients into the health market and has created a system overload for a shortage of healthcare professionals.
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- Spring '18