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NYCCT Having Access to Health Insurance Discussion Responses

NYCCT Having Access to Health Insurance Discussion Responses


please answer each post:

1.I think the Patient Protection and Affordable Care Act knowns as the Affordable Care Act or Obamacare, which deals with the landmark health reform legislation passed by the 111th Congress and signed into law by President Barack Obama in March 2010. It deals with a long list of health-related provisions that began taking effect in 2010, the bulk of the law had been implemented by 2014 (HealthInsurance, 2023). I think that 90% of Americans will have healthcare coverage as a bill, which deals with also see a 31 million decrease in the number of uninsured people and a 15 million increase in Medicaid and 24 million individuals will continue to be uninsured. The Act deals with 10 distinct legislative titles, and the main goal to control the universal coverage and so on and there must be shared accountability between the government, citizens, and companies. Commerical insurance deals with the protection for companies and organizations and build to protect the company, the workers, and the owners and also it comes with different forms, sizes, and hues because there are so many kinds of companies’ requirements, rules, and regulations. The traditional Medicare Program deals with the traditional of fee-for-service Medicare and the medical treatments are covered in full by the government. Medicare is divided into four parts: Parts A, B, C, and D. Part A deals with hospital and impatient coverage is offered. Part B deals with the outpatient and medical coverage. Part C deals with a different method of receiving the Medicare benefits and Part D deals with Prescription drugs. The Medicare treatment are picked by the fee for service program controlled by the government to keep Part A and B benefits. 

The different funding types impact the strategic management of the facility deals with the objectives and they will try to improve the areas and move it to public health affordability and the main goal would be cover as many people as possible.


Professor Jack McCaffery

Compare and contrast approval/payment from the Patient Protection and Affordable Care Act (PPACA), commercial insurance, and the traditional Medicare program (not a Medicare health maintenance organization [HMO]) available to these types of facilities.

PPACA- The Patient Protection and Affordable Care Act utilizes the pay for performance (a.k.a value-based) payment method to create pressure on the medical providers, this creates a relationship between performance that affects patient outcomes, encourages best practices, and overall content patients (Nix, 2013). The aim is to standardize payments with value and caliber of an organization. Yet this article I read suggests that this particular program should be arranged as a market-based payment system; this would be in an effort to guide providers to mirror quality more naturally instead of preserving a faulty payment structure. The current system influences providers to perform more tests and engage in more processes to receive greater pay. In perusing the textbook, I found that PPACA necessitates that no more than 20% of insurer installment payments is to be spent on administrative expenditures. It is also stated that 80% of the installments is to be spent on patient care and developing metrics aimed at improving quality of care (Ginter, et al., 2018).

Commercial Insurance- Commercial insurance is offered by private entities and is opposite from government-issued insurance, like the Affordable Care Act, the insured person must enroll and pay premiums to cover any expenses accrued that are associated with care given in a healthcare facility. It is also known as private insurance and it is divided into three groups; large, small, and individually purchased markets. Those who do have commercial insurance are typically offered the plans through their place of employment. The majority of the commercial plans are HMO or PPO, the HMOs are usually associated with a small set of facilities and providers assigned to these enrollees. The PPOs offer a wider set of providers, but they are accompanied by a greater cost sharing that enrollees must pay to maintain their coverage. It is more common for the commercial plans to have high deductibles and lesser premiums are proffered if the plan that is chosen necessitates that the enrollee is to pay a few thousand dollars toward their care costs for them to be covered.    

Traditional Medicare program- requires the enrollee to have met 40 quarters of employment that pays into Social Security; accordingly, the enrollee will be eligible for Part A (hospital care) of the program. The enrollee who applies for Medicare for the first time is also automatically enrolled to the traditional Medicare program, yet this person can opt to enroll in the private version of Medicare known as Medicare Advantage. The enrollee will be required to pay a monthly installment for their access to Part B of Medicare; there may also be fees associated with deductibles, coinsurance, and copays (Center for Medicare Advocacy, 2013). Additionally, the traditional form of Medicare does not have out of pocket caps on what the enrollee can spend on care. Another element is that the enrollee will have to purchase the prescription package known as Part D of Medicare if they choose to or need to.

How do the different funding types impact the strategic management of the facility?

Within strategic management there are three stages that need to be fulfilled to achieve a point of managing an organization effectively, and they are the thinking, planning, and momentum aspects. The three stages create a space for improvement of performance for the various funding types, there is a foundation with specific goals and the organization is guided by congruent decision making. The administrators are given insight into better comprehending their present and future circumstances and they learn to look for signs that are suggesting changes be made. There are also the advantages of the administration to view and communicate both vertically and horizontally to enhance their overall integrations.   

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