The implications of the 2010 patient protection and affordable care act and the health care and education reconciliation act on cancer care delivery

Overview: The Affordable Care Act (ACA) contains many provisions that affect cancer care. The provisions of health care reform aim to improve access to quality cancer care, particularly among the most vulnerable Americans. However, health care reform also offers many challenges and opportunities that affect every stakeholder in oncology. This article summarizes the ACA provisions relevant to oncology, discusses the ethical implications for the oncology caregiver, and describes the effects on specific oncology stakeholders.

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Working With Older Adults: Impact of the Affordable Care Act and Other Trends in Health Care

Perspectives on Gerontology ◽

10.1044/gero16.1.10 ◽

2011 ◽

Vol 16 (1) ◽

pp. 10-17

Author(s):

Amy Hasselkus

Keyword(s):

Older Adults ◽

Health Care ◽

Affordable Care Act ◽

Care Delivery ◽

Speech Language Pathology ◽

Policy Changes ◽

Patient Protection ◽

Language Pathology ◽

The Impact ◽

Over Time

Rapidly increasing numbers in our aging population coupled with anticipated changes in reimbursement and health-care delivery have led to policy changes that will be implemented over time. This article will review the Patient Protection and Affordable Care Act of 2010 (ACA) and the Health Care and Education Reconciliation Act and will discuss the impact of health care changes on speech-language pathology practice with older adults.

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Potentially Ineffective Care: Time for Earnest Reexamination

Critical Care Research and Practice ◽

10.1155/2014/134198 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

William L. Jackson ◽

Joseph F. Sales

Keyword(s):

Health Care ◽

Critical Care ◽

Affordable Care Act ◽

Outcome Measure ◽

Care Delivery ◽

Health Care Administrators ◽

American Health Care System ◽

Patient Protection ◽

Significant Interest ◽

American Health Care

The rising costs and suboptimal quality throughout the American health care system continue to invite critical inquiry, and practice in the intensive care unit setting is no exception. Due to their relatively large impact, outcomes and costs in critical care are of significant interest to policymakers and health care administrators. Measurement of potentially ineffective care has been proposed as an outcome measure to evaluate critical care delivery, and the Patient Protection and Affordable Care Act affords the opportunity to reshape the care of the critically ill. Given the impetus of the PPACA, systematic formal measurement of potentially ineffective care and its clinical, economic, and societal impact merits timely reconsideration.

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American Society of Clinical Oncology Policy Statement: Opportunities in the Patient Protection and Affordable Care Act to Reduce Cancer Care Disparities

Journal of Clinical Oncology ◽

10.1200/jco.2011.35.8903 ◽

2011 ◽

Vol 29 (28) ◽

pp. 3816-3824 ◽

Cited By ~ 94

Author(s):

Beverly Moy ◽

Blase N. Polite ◽

Michael T. Halpern ◽

Steven K. Stranne ◽

Eric P. Winer ◽

...

Keyword(s):

Health Care ◽

Access To Care ◽

Clinical Oncology ◽

Affordable Care Act ◽

Cancer Care ◽

Cancer Disparities ◽

Policy Statement ◽

Insurance Reform ◽

Patient Protection ◽

American Society

Patients in specific vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. The Patient Protection and Affordable Care Act provides both opportunities and challenges for addressing cancer care disparities and access to care. The American Society of Clinical Oncology (ASCO) advocates for policies that ensure access to cancer care for the underserved. Such policies include insurance reform and the reduction of economic barriers to quality health care. Building on ASCO's prior statement on disparities in cancer care (2009), this article summarizes elements of the health care law that are relevant to cancer disparities and provides recommendations for addressing major provisions in the law. It outlines specific strategies to address insurance reform, access to care, quality of care, prevention and wellness, research on health care disparities, and diversity in the health care workforce. ASCO is committed to leading efforts toward the improvement of cancer care among the most vulnerable patients.

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Hospital costs and profitability related to the Patient Protection and Affordable Care Act

Journal of Hospital Administration ◽

10.5430/jha.v3n3p100 ◽

2014 ◽

Vol 3 (3) ◽

pp. 100

Author(s):

William Robert Pratt ◽

Jerry D. Belloit

Keyword(s):

Health Care ◽

Health Care Delivery ◽

Affordable Care Act ◽

Care Delivery ◽

Hospital Costs ◽

Supreme Court Decision ◽

The United States ◽

Cost Shifting ◽

Patient Protection ◽

The Individual

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). This law was one of the most controversial and transforming pieces of legislation impacting health care delivery in recent history. The legislation was created in response to rising health care costs and the belief that, in part, cost shifting of indigent uninsured care to paying patients would reduce the overall costs of health care. The recent Supreme Court decision upholding the individual mandate portion of the law is expected to significantly reduce the number of uninsured. Using operational data from 212 hospitals in California, this study examines the anticipated impact on hospital costs, profitability, and some patient outcome benchmarks from the restructuring of health care delivery in the United States by the PPACA.

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Assessing Individual Health Insurance Coverage and Utilization Before and After the Patient Protection and Affordable Care Act

International Journal of Strategic Decision Sciences ◽

10.4018/ijsds.2016100105 ◽

2016 ◽

Vol 7 (4) ◽

pp. 55-70

Author(s):

Theresa Jefferson ◽

Gloria Phillips-Wren ◽

Phoebe D. Sharkey

Keyword(s):

Health Care ◽

Health Insurance ◽

Affordable Care Act ◽

Care Delivery ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Health Care Delivery System ◽

Patient Protection ◽

Before And After ◽

Using Data

The adoption of the Patient Protection and Affordable Care Act (PPACA) in 2010 with the intent to improve the U.S. health care delivery system by expanding health insurance coverage and controlling health care costs has generated intense debate regarding its implementation. Marketplaces known as insurance exchanges have been established to provide coverage for Americans who otherwise could not get affordable health care benefits. These exchanges have been plagued with financial losses and other challenges leading to several large insurance providers discontinuing participation in the program. There are many possible remedies under consideration to make the program work better. This research seeks to support program evaluation as well as potential modifications to the law by providing baseline data to compare access and costs in states with state-based exchanges compared to states with federal exchanges. The authors perform an analysis by state for the years 2012 and 2013 (pre-PPACA implementation) using data from the Current Population Survey (U.S. Census) as well as de-identified claims data from Inovalon, Inc.

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The Patient Protection and Affordable Care Act: The impact on urologic cancer care

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2012.01.007 ◽

2013 ◽

Vol 31 (7) ◽

pp. 980-984 ◽

Cited By ~ 13

Author(s):

Kirk A. Keegan ◽

David F. Penson

Keyword(s):

Affordable Care Act ◽

Cancer Care ◽

Patient Protection ◽

Urologic Cancer ◽

The Impact

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Financial Toxicity of Cancer Care: An Analysis of Financial Burden in Three Distinct Health Care Systems

JCO Oncology Practice ◽

10.1200/op.20.00890 ◽

2021 ◽

pp. OP.20.00890

Author(s):

Divya A. Parikh ◽

Meera Ragavan ◽

Ritika Dutta ◽

Jeffrey Garnet Edwards ◽

James Dickerson ◽

...

Keyword(s):

Health Care ◽

Cancer Care ◽

Care Delivery ◽

Medical Center ◽

Financial Burden ◽

Financial Toxicity ◽

Cross Sectional Survey ◽

Factors Associated ◽

Care Systems ◽

Comprehensive Score

PURPOSE: The financial toxicity of cancer care is a source of significant distress for patients with cancer. The purpose of this study is to understand factors associated with financial toxicity in three distinct care systems. METHODS: We conducted a cross-sectional survey of patients in three care systems, Stanford Cancer Institute (SCI), VA Palo Alto Health Care System (VAPAHCS), and Santa Clara Valley Medical Center (SCVMC), from October 2017 to May 2019. We assessed demographic factors, employment status, and out-of-pocket costs (OOPCs) and administered the validated COmprehensive Score for financial Toxicity tool. We calculated descriptive statistics and conducted linear regression models to analyze factors associated with financial toxicity. RESULTS: Four hundred forty-four of 578 patients (77%) completed the entire COmprehensive Score for financial Toxicity tool and were included in the analysis. Most respondents at SCI were White, with annual household income (AHI) > $50,000 USD and Medicare insurance. At the VAPAHCS, most were White, with AHI ≤ $50,000 USD and insured by the Veterans Administration. At SCVMC, most were Asian and/or Pacific Islander, with AHI ≤ $25,000 USD and Medicaid insurance. Low AHI ( P < .0001), high OOPCs ( P = .003), and employment changes as a result of cancer diagnosis ( P < .0001) were associated with financial toxicity in the pooled analysis. There was variation in factors associated with financial toxicity by site, with employment changes significant at SCI, OOPCs at SCVMC, and no significant factors at the VAPAHCS. CONCLUSION: Low AHI, high OOPCs, and employment changes contribute to financial toxicity; however, there are variations based on site of care. Future studies should tailor financial toxicity interventions within care delivery systems.

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Achieving a Deeper Understanding of the Implemented Provisions of the Affordable Care Act

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2014.34.e472 ◽

2014 ◽

pp. e472-e477 ◽

Cited By ~ 5

Author(s):

Shuang Qin Zhang ◽

Blase N. Polite

Keyword(s):

Health Care ◽

Affordable Care Act ◽

Medicare Part D ◽

Payment Reform ◽

Part D ◽

Patient Protection ◽

Current Implementation ◽

Donut Hole ◽

Insurance Exchanges ◽

Review Current

The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

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