Health Care Economics and Finance for Advance Practice Nursing



Health Care Economics and Finance for Advance Practice Nursing

What are the issues with the current Medicare system?

The major issues in the current Medicare system are that it involves high cost of healthcare for old people who cannot afford the treatments of diseases they face during their old age. This system operates according to the Affordable Care Act. Apart from high cost for government, the quality of healthcare services provided to the patients is recorded as poor due to lack of quality measurement and employees' performance evaluation. The guidelines provided by the policy of the Medicare system is not being effectively implemented and the system is not following proper directions of the guidelines provided by the president of the state (Radnofsky, 2011).

What are your thoughts on the WSJ articles?

The articles of WSJ critically analyzed and elaborate the current issues of Medicare system and the implications of the policies of the government regarding healthcare system of the state. Apart from this, the issues concerning doctors and patients are updated in different scenarios. Moreover, the political scenario is also presented explaining the viewpoints and opinions of policy maker and the criteria of Affordable Care Act.

What are your thoughts on the ACO model?

The major purpose of ACO model is to focus on improving the current Medicare System of the state by ensuring that healthcare providers and suppliers of services are effectively implementing the healthcare services with superior quality services and on time delivery. The goal of ACO is to provide high quality health care services to Medicare beneficiary and ensure that the actual quality is aligning with standard quality. The ACO would be the patient-centered organization where patients and providers together form the committee to make effective care decisions.

The most effective program of ACO is Shared Savings Program which aimed at evaluating cost of Medicare system. The program duration is three years in which all Medicare patients and doctors are encouraged to participate in order to receive payment under the policies of Original Medicare Fee-For-Service. The act also requires ACO to develop a governing body that will represent ACO providers of the suppliers, services and Medicare beneficiaries. The ACO will be responsible for controlling and reporting of the care it provides. The plan of the system consists of recording and analyzing particular quality and financial data, analyze specific claims and developing quarterly and annual combined reports by taking site visits and conducting beneficiary surveys (What Providers Need to Know: Accountable Care Organizations, 2011).

How will ACOs affect quality?

In the year 2011, Medicare and Medicaid services (CMS) centers, proposed the new rules and guidelines under the Affordable Care Act. The purpose of making these guidelines and rules was to support doctors, healthcare providers and hospitals to provide coordinate healthcare services to Medicare patients through ACO. The entire proposal was made in collaboration with the Department of Health and Human Services (HHS) to improve healthcare system of the ...