Week 9: Trends & Issues in Executive Management for Health care Administrators
The Affordable Care Act
The implementation of the Patient Protection and Affordable Care Act (PPACA, or ACA) was signed into law in 2010 to provide affordable health care insurance to Americans and rules for insurance companies regarding how they provide insurance. As a health care executive, you will be intimately involved with many of the provisions of the ACA, necessitating an understanding of how they are executed within your particular state. Each state was given the opportunity to choose whether or not to enact Medicaid expansion and how they would offer enrollment in ACA health insurance.
The ACA is also intertwined with the new payment methodologies that you examined in Weeks 4 and 5, which are reflective of supporting population health. Previously, hospitals were responsible for caring for patients in the hospital bed; however, with changes from the Center for Medicare and Medicaid (CMS) focusing on penalties for re-hospitalizations, hospitals now need to focus on patient care across the continuum. The ACA furthered this focus through encompassing population health, the outcomes of the health of the population, through expanded insurance coverage, improving quality of care and enhancing health promotion and prevention as well as the implementation of community-based activities.
1. This week you examine how the ACA has been enacted in your state, including how this may impact costs and benefits. You also compare the ACA with other states and study the connection between the ACA and population health.
· Compare Affordable Care Act costs and benefits for states
· Evaluate how the Affordable Care Act impacts health care executives in managing health care organizations
· Evaluate population health strategies in relation to the Affordable Care Act for hospitals
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
DiMichele, T. (2016). Obamacare facts: Facts on the Affordable Care Act. Retrieved from http://obamacarefacts.com/obamacare-facts/.
Hardcastle, L. E., Record, K. L., Jacobson, P. D., & Gostin, L. O. (2011). Improving the population’s health: The Affordable Care Act and the importance of integration. Retrieved from http://scholarship.law.georgetown.edu/cgi/viewcontent.cgi?article=1032&context=ois_papers.
Huelskoetter, T. (2015). 2014 census data confirm dramatic impact of the Affordable Care Act. Retrieved from https://www.americanprogress.org/issues/healthcare/news/2015/09/16/121094/2014-census-data-confirm-dramatic-impact-of-the-affordable-care-act/.
Kliff, S. (2013). The cost of Obamacare varies wildly by state. Retrieved from https://www.washingtonpost.com/news/wonk/wp/2013/10/13/the-cost-of-obamacare-varies-wildly-by-state/.
Robert Wood Johnson Foundation. (2015). Reform by the numbers. Retrieved from http://www.rwjf.org/en/library/features/reform-by-the-numbers.html.
Shaw, F.E., Asomugha, C.N., Conway, P.H., & Rein, A.S. (2014). The patient protection and Affordable Care Act: Opportunities for prevention and public health. The Lancet, 384(9937), 75-82.
Stoto, M. A. (2013). Population health in the Affordable Care Act era. Retrieved from https://www.academyhealth.org/files/AH2013pophealth.pdf.
Urban, J. (2013, September 23). How the Affordable Care Act (ACA) varies by state [Blog post]. Retrieved from http://www.zanebenefits.com/blog/bid/317011/How-the-Affordable-Care-Act-ACA-Varies-by-State.
U.S. Department of Health and Human Services. (2015a). The Affordable Care Act is working. Retrieved from http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/aca-is-working/index.html.
The Affordable Care Act: Variability by State
The costs of implementing provisions called for under the PPACA, and the benefits from the legislation, vary from one state to another. The degree to which your health care organization must adhere to guidelines of the ACA may affect the extent of the type of health care services offered, the types of patients served by your facility, and how health care costs are maintained. As a current or future health care executive, you must consider how to balance operations of your health care organization within the context of the ACA and in providing high-quality, low-cost health care.
1. For this Discussion, review the resources for this week. Search for the cost of implementing the ACA for a health care organization in your state. Reflect on the benefits of implementing the ACA for a health care organization in your state. How might your health care organization, or one with which you are familiar, be affected by ACA mandates?
By Day 3
2. Post a description of the costs of implementing ACA provisions in your state. Then, explain the benefits of the ACA in your state. Explain how the costs and benefits of the ACA may impact you as a current or future health care executive and your health care organization or one with which you are familiar. Be specific and provide examples.
By Day 5
Continue the Discussion and respond to one of your colleagues and comparing the cost of the ACA in his or her state with the cost in your state. Then, compare the benefits of the ACA in his or her state with the benefits of the ACA to your state.
Submission and Grading Information
To access your rubric:
Week 9 Discussion 1 Rubric
Post by Day 3 and Respond by Day 5
To participate in this Discussion: Week 9 Discussion 1
Discussion Part 2
Population Health and the Affordable Care Act
Earlier in this course you examined how health care organizations are beginning to look at value-based care, which often encompasses care across the continuum of health care services. You also considered how this was associated with new payment methodologies. Care across the continuum links to population health, which describes the outcomes of the health of the population, and to new payment methods through the ACA.
1. As a health care executive for a hospital, you have been responsible for caring for the patient in your hospital bed. In the last couple of years, your role has likely expanded to include determining how to keep patients from being re-hospitalized. With the implementation of the ACA, your role is expanding further to encompass population health.
2. For this Discussion, review the resources for this week and reflect on your role as a health care executive in implementing ACA provisions related to population health strategies. Reflect on the considerations you should keep in mind to fully comply with and enact population health strategies in light of ACA legislation.
By Day 4
3. Post an explanation of how you as a hospital chief executive officer (CEO) might create a population health strategy based on ACA foci. Be specific and provide examples.
By Day 6
Continue the Discussion and respond to one of your colleagues, providing feedback regarding the feasibility of his or her strategy and recommendations for improvements.
Submission and Grading Information
To access your rubric:
Week 9 Discussion 2 Rubric
Post by Day 4 and Respond by Day 6
To participate in this Discussion: Week 9 Discussion 2