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ACA Annotated Bibliography

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Introduction The Affordable Care Act (ACA) contained provisions for States to develop demonstration projects for Medicaid Programs. The State of Ohio has had a unique approach. The MyCare Ohio is a program targeting dual eligible Medicare and Medicaid patients. The program in Ohio seems most similar to the Oregon plan for the following reasons: All-payer health claims data program Community-based accountable entities Sponsored collaborative initiatives Consolidation of state purchasing power Conducting ACO pilot programs This annotated bibliography is to inform the executive team of the Governor’s Office of Health Transformation progress toward state compliance with ACA Medicaid payment reform Bibliography The Henry J. Kaiser Family …show more content…

The article discusses the state demographics and heath care disparities. There is a review of the significant proportion of the state budget dedicated to healthcare. There is a review of healthcare coverage in Ohio, the movement to population health and the role of Medicaid expansion. The article articulated Governor Kasich’s plan to move the state Medicaid program to managed care. The article point out 75% of Medicaid patients are already in managed care programs. There is also discussion of Ohio’s cabinet level Medicaid agency. The article also articulates the state’s commitment to support development of Patient Centered Medical Homes as a key to quality care. The states goal is 80-90% of the state’s population in some value-based payment model for …show more content…

The site outlines eligibility and enrollment declines. It also discusses the person-centered nature of the care delivery program. The site provides a list of the medical services to be included in the plan. The services also include behavioral health, community based services, and care management. All of these benefits are presented in an expanded format. The is a discussion of quality measures. A brief review of provider contracting is included.The is a status update of the project. A model of the Integrated Care Delivery System (ICDS) is also presented. This information is relevant to healthcare care provides as it provides information as to the state’s choice of a MCO over the ACO model. The site is part of a comprehensive review of the Office of Health

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2276 Words | 10 Pages

Arizona’s health care system is somewhat more complicated than that of other states. From 1972 to 1981, Arizona was the only state that had not accepted the federal Medicaid program. Instead, Arizona opted for their own system, where each county in the state was responsible for providing some measure of health care to the poor with their own money. The Arizona Health Care Cost Containment System (AHCCCS) was set up by the Health Care Financing Administration (HCFA) in 1981. AHCCCS was deemed to be “experimental” and was significantly different from the Medicaid system.

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769 Words | 4 Pages

Some individuals and families have experienced increased financial strain due to the high cost of insurance plans, even with the subsidies provided under the ACA. This has led to concerns about the affordability of healthcare for certain population segments (McKenna, Carlson, & Green, 2018). Another challenge is the issue of access to healthcare services in rural areas. The ACA's emphasis on expanding insurance coverage did not necessarily guarantee increased provider availability in these regions. Geographic disparities, along with socioeconomic factors, continue to contribute to limited access to healthcare for

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1655 Words | 7 Pages

One of the author’s reasoning for how taking away ACA would affect Medicaid is back in 2016 legislation tried to step away from it, but former President Barack Obama repealed it because could eventually affect the lives of millions of people. The authors also cover how ACA changed Medicaid for the better, for example creating a program for just children’s coverage, inventing a new method to determine eligibility, and even creating new benefit options for families and small businesses. The author describes how the new Presidential administration can repeal or alter Medicaid through Section 1115. The authors main argument is that by repealing ACA would eliminate the Medicaid system which in turn will allow millions of people to be

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769 Words | 4 Pages

First, state taxpayers may experience rising healthcare costs disproportionate to other states (Mahan, 2). Without tailored federal assistance, health care costs may contribute to an unbalanced state budget that burdens the taxpayer. In order to account for this, states may be forced to eliminate certain programs, therefore, leaving some without coverage. Medicaid currently covers almost 70 million Americans, including one in three children, four in 10 births and 70 percent of nursing home residents (Kodjak, 2). With the implementation of block grants, especially without clear guidance and infrastructure, those currently covered by the Affordable Care Act could very well experience reduction or loss of their health coverage.

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627 Words | 3 Pages

The government of some opt out states are looking at alternative options to provide care for their large uninsured populations but this only leads to disparities in the health care options available to their denizens versus the other states (Omolola et.al). One proposal repeatedly made by the current administration is to limit the federal contribution by switching from the current percentage model to a model of block grants or per-capita caps. Under the block grants model, states would be given a fixed amount of Medicaid funding which they would need to manage. Under the per-capita model, Medicaid recipients will be subject to a reimbursement cap.

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555 Words | 3 Pages

Introduction The recent article in the New York Times with the title ‘Making Medicaid a Tool for Moral Education May Let Some Die’ is worth reviewing. President Trump promised Americans that his policies are directed towards making America a great country again. He proposed to repeal the Affordable Care Act and as a result there has been some changes in Medicaid enrollment policy. Kentucky became the first state to impose work requirement to be eligible for Medicaid.

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833 Words | 4 Pages

This will help the part of the community who are unable to afford the pricey health care costs. The federal government provides tax credits based on one’s income in relation to the poverty line by 4 times. While many state’s government expanded Medicaid coverage to people earning up to 133% of the poverty threshold. A new insurance market reform discusses the “medical cost ratio” requiring the insurance agencies to spend a minimum of 80% of premiums collected on patient care. However, if insurance payments result in less than 80%, a rebate must be provided.

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747 Words | 3 Pages

The success of Medicaid expansion, e.g., improved infant and child care, reduced mortality rates, and increased access to doctors’ offices (instead of expensive ER visits), is hard to argue against. Unfortunately, 12 percent of children still have no health insurance, despite expansions in public health insurance. The 800-pound elephant in the public health insurance room is the states’ budgets. With the stroke of a pen, funding cutbacks can derail any positive gains for public health insurance for children. The ACA was one of the most contentious pieces of legislation to come down the pike since the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), and the importance of this piece of legislation is

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3557 Words | 15 Pages

The progression of Medicare and Medicaid show major differences from the start of the services to currently. The progression of the services is due to lawmakers eliminating, improvising, and creating new aspects to Medicare and Medicaid. The lawmakers are the ones that progress the services. “Therefore it is important to carefully consider the policy recommendations of the candidate to understand their vision for the future of Medicare” (Cubanski & Neuman, 2008, p.1). Medicare and Medicaid should be considered when electing lawmakers, candidates, because they are the ones that determine the progression and changes of Medicare and Medicaid.

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1212 Words | 5 Pages

A rising number of hospitals throughout the U.S. are applying a service model known as integrated health care (Kathol, Perez, Cohen 2010). The need for this is center around this area: Integration has made its approach into the health care settings gradually. This can assist in treating one’s medical and behavioral health needs within patient’s primary care provider’s office, recommending a proper evaluation as a whole person (Blout, 2003). Medical clinics have been used for a many years but its recognition is growing nationwide because of its effectiveness. Impact all parties involved, including but not limited to, patients, providers and insurance companies can be very effective.

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582 Words | 3 Pages

Currently the country is experiencing dissatisfaction with health care delivery. (Maurer-Smith, p. 55). Key features of the U.S. health care system include decentralized governance, laissez-faire philosophy, and abundant economic resources. With decentralization, local communities, the states and the federal government all share the responsibilities for the regulation and provision of services to the population;

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743 Words | 3 Pages

States are being pressured to expand Medicaid to families earning up to $30,000 a year, just like the Affordable Care Act permits. While several respected governors have agreed to expand the program, many other governors and state legislators are cautious. These officials do not want to deny Americans their access to health care, however they do want to slow the expansion of a program that will provide them with limited access to quality care while destroying state budgets. One of the strongest arguments that can be made against the expansion of Medicaid is the fact that States simply can not afford it. The appeal to states to expand Medicaid is that the federal government will cover 100% of the cost through 2016 and eventually lowering to

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367 Words | 2 Pages

Many Americans were led to believe that the introduction of the Patient Protection and Affordable Care Act in 2009 would put an end to disparities in health care access. While it did improve the situation for a small percentage of the population there are still many Americans who lack access to good quality health care. Health care access in America is determined by money and those in lower socioeconomic groups frequently tend to miss out on adequate care. In a recent health care report by the national health research foundation Kaiser Family Foundation, it was noted “health care disparities remain a persistent problem in the United States, leading to certain groups being at higher risk of being uninsured, having limited access to care, and experiencing poorer quality of care” (Kaiser Family Foundation). The current health care

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727 Words | 3 Pages

Health care should not be considered a political argument in America; it is a matter of basic human rights. Something that many people seem to forget is that the US is the only industrialized western nation that lacks a universal health care system. The National Health Care Disparities Report, as well as author and health care worker Nicholas Conley and Physicians for a National Health Program (PNHP), strongly suggest that the US needs a universal health care system. The most secure solution for many problems in America, such as wasted spending on a flawed non-universal health care system and 46.8 million Americans being uninsured, is to organize a national health care program in the US that covers all citizens for medical necessities.

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464 Words | 2 Pages

The purpose of this paper is to explain why unlike Medicare, Medicaid eligibility rules and coverage vary between states and to also discuss the advantages and disadvantages of the current state-oriented Medicaid system. Although both health care programs are administered by the U.S. government, there are significant differences in the way these two programs function. The analysis of this paper will reveal the differences and describe the pros and cons attributed by the Medicaid system being administered separately by each state. Although Medicare and Medicaid both provide healthcare for U.S citizens, “Administratively, the biggest difference between Medicaid and Medicare is that states govern a lot of what Medicaid covers, while the federal government runs Medicare” (Caplinger, 2015). The rationale behind these variances is due to Medicaid being based on need and social welfare, whereas Medicare serves people who have reached retirement age or are disabled, regardless of their economic status.

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