Outcomes and Quality: Key Characteristics of a Successful SLP Value Journey

2015 ◽  
Vol 25 (3) ◽  
pp. 94-106 ◽  
Author(s):  
Paul R. Rao
Keyword(s):  
Affordable Care Act ◽  
Healthcare Reform ◽  
The United States ◽  
Levels Of Care ◽  
National Healthcare ◽  
Patient Protection ◽  
Key Characteristics ◽  
The Supreme Court ◽  
Insurance Rates ◽  
Roll Back

We are living in a challenging era of healthcare reform marked by dramatic change and unprecedented political and legal turmoil surrounding this reform. Healthcare reform in the name of the Patient Protection and Affordable Care Act (PPACA, 2010) is becoming “hardwired” over the five years since its inception, yet as recently as March of 2015, the Supreme Court of the United States heard arguments to roll back subsidies for the Federal Health Exchanges which if approved could increase insurance rates by nearly 75% on over 8 million subscribers. The national healthcare landscape including reforms, changes, wins, and losses to date will be described. The “secret sauce” for meeting these challenges is to embrace value in healthcare which can be defined as outcomes over cost. In the context of our current levels of care, an inexorable movement away from volume to value will be described focusing on outcomes. The challenges we face especially in reporting outcomes and shifting from volume to value are described. Finally, arguments and illustrations are provided for how speech-language pathologists (SLPs) can continue to espouse value in becoming critical players in the value-based healthcare economy.

Interpretative theories as roadmaps to constitutional identity: The case of the United States

2015 ◽  
Vol 4 (3) ◽  
pp. 289-327 ◽  
Author(s):  
OR BASSOK
Keyword(s):  
United States ◽  
National Identity ◽  
Affordable Care Act ◽  
Focal Point ◽  
The United States ◽  
American Identity ◽  
American Constitution ◽  
Patient Protection ◽  
American National Identity ◽  
Constitutional Identity

AbstractAs long as the American Constitution serves as the focal point of American identity, many constitutional interpretative theories also serve as roadmaps to various visions of American constitutional identity. Using the debate over the constitutionality of the Patient Protection and Affordable Care Act, I expose the identity dimension of various interpretative theories and analyse the differences between the roadmaps offered by them. I argue that according to each of these roadmaps, courts’ authority to review legislation is required in order to protect a certain vision of American constitutional identity even at the price of thwarting Americans’ freedom to pursue their current desires. The conventional framing of interpretative theories as merely techniques to decipher the constitutional text or justifications for the Supreme Court’s countermajoritarian authority to review legislation and the disregard of their identity function is perplexing in view of the centrality of the Constitution to American national identity. I argue that this conventional framing is a result of the current understanding of American constitutional identity in terms of neutrality toward the question of the good. This reading of the Constitution as lacking any form of ideology at its core makes majority preferences the best take of current American identity, leaving constitutional theorists with the mission to justify the Court’s authority to diverge from majority preferences.

Are You Covered? Associations Between Patient Protection and Affordable Care Act Knowledge and Preventive Reproductive Service Use

2017 ◽  
Vol 32 (4) ◽  
pp. 906-915 ◽  
Author(s):  
Ashlee N. Sawyer ◽  
Melissa A. Kwitowski ◽  
Eric G. Benotsch
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Affordable Care Act ◽  
Service Use ◽  
The United States ◽  
Amazon Mechanical Turk ◽  
Insurance Status ◽  
Patient Protection ◽  
Health Care Legislation

Purpose: Sexual and reproductive health conditions (eg, infections, cancers) represent public health concerns for American women. The present study examined how knowledge of the Patient Protection and Affordable Care Act (PPACA) relates to receipt of preventive reproductive health services among women. Design: Cross-sectional online survey. Setting: Online questionnaires were completed via Amazon Mechanical Turk, a crowdsourcing website where individuals complete web-based tasks for compensation. Participants: Cisgendered women aged 18 to 44 years (N = 1083) from across the United States. Measures: Participants completed online questionnaires assessing demographics, insurance status, preventive service use, and knowledge of PPACA provisions. Analysis: Chi-squares showed that receipt of well-woman, pelvic, and breast examinations, as well as pap smears, was related to insurance coverage, with those not having coverage at all during the previous year having significantly lower rates of use. Hierarchical logistic regressions determined the independent relationship between PPACA knowledge and use of health services after controlling for demographic factors and insurance status. Results: Knowledge of PPACA provisions was associated with receiving well-woman, pelvic, and breast examinations, human papillomavirus vaccination, and sexually transmitted infections testing, after controlling for these factors. Results indicate that expanding knowledge about health-care legislation may be beneficial in increasing preventive reproductive health service use among women. Conclusion: Current findings provide support for increasing resources for outreach and education of the general population about the provisions and benefits of health-care legislation, as well as personal health coverage plans.

scholarly journals A FEW FOR-PROFIT BUSINESSES’ BATTLE OVER THE AFFORDABLE CARE ACT’S PREVENTATIVE SERVICES MANDATE

2014 ◽  
Vol 32 (2) ◽  
pp. 381-400
Author(s):  
Leigh Argentieri Coogan
Keyword(s):  
Affordable Care Act ◽  
Cost Sharing ◽  
Religious Organizations ◽  
District Court ◽  
Health Plans ◽  
For Profit ◽  
Patient Protection ◽  
The Supreme Court ◽  
Regulation Changes ◽  
Preventative Services

Under the Patient Protection and Affordable Care Act (ACA), employers are required to provide employees with health plans, which must include FDA, approved contraceptives with no cost sharing. While Health and Humans Services (HHS) revised the regulation to allow for a compromise among religious organizations and non-profits run by religious organizations, private for profit businesses must comply with the ACA even if the business asserts to be founded on religious principles. Several for profit business have sued in district court for an injunction against the requirements. However, a circuit split exists among courts granting preliminary injunctions against the ACA pending a granting of appeal. This note will focus on whether the federal government can compel secular, for profit organizations to provide employee health plans that include contraceptives, the morning after pill and sterilization under the Religious Freedom Restoration Act. Unless the statute or regulation changes, the Supreme Court will likely need to grant certiorari to resolve the issue.

scholarly journals The impact of the Patient Protection and Affordable Care Act on insurance coverage and cancer‐directed treatment in HIV‐infected patients with cancer in the United States

Cancer ◽  
2019 ◽  
Vol 126 (3) ◽  
pp. 559-566 ◽  
Author(s):  
Kelsey L. Corrigan ◽  
Leticia Nogueira ◽  
K. Robin Yabroff ◽  
Chun Chieh Lin ◽  
Xuesong Han ◽  
...  
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
The United States ◽  
Patients With Cancer ◽  
Patient Protection ◽  
The Impact

Key Opinion Leaders and the Corruption of Medical Knowledge: What the Sunshine Act Will and Won’t Cast Light on

2013 ◽  
Vol 41 (3) ◽  
pp. 635-643 ◽  
Author(s):  
Sergio Sismondo
Keyword(s):  
Affordable Care Act ◽  
Medical Knowledge ◽  
The United States ◽  
Opinion Leaders ◽  
Pharmaceutical Companies ◽  
United States Congress ◽  
Physician Payment ◽  
Patient Protection ◽  
Medical Supplies ◽  
Key Opinion Leaders

In 2010, in connection with the Patient Protection and Affordable Care Act (Obamacare), the United States Congress passed the Physician Payment Sunshine Act. This legislation requires pharmaceutical companies, medical device companies, and other manufacturers of medical supplies to collect information on their payments to physicians, beginning on August 1, 2013, and to annually report this information to the Centers for Medicare and Medicaid Services (CMS), beginning on March 31, 2014. All payments of over $10 are to be reported and aggregate payments of more than $100 to a single physician in a single year must also be reported.

Comparative Effectiveness Research under the Patient Protection and Affordable Care Act: Can New Bottles Accommodate Old Wine?

2011 ◽  
Vol 37 (4) ◽  
pp. 522-566 ◽  
Author(s):  
Eleanor D. Kinney
Keyword(s):  
Affordable Care Act ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Health Sector ◽  
The United States ◽  
Healthcare Sector ◽  
Cost Curve ◽  
Effectiveness Research ◽  
Patient Protection ◽  
Research Initiative

The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act of 2010, initiated comprehensive health reform for the healthcare sector of the United States. PPACA includes strategies to make the American healthcare sector more efficient and effective. PPACA's comparative effectiveness research initiative and the establishment of the Patient-Centered Outcomes Research Institute are major strategies in this regard. PPACA's comparative effectiveness research initiative is one in a long line of federal initiatives to address the rising costs of healthcare as well as to obtain better value for healthcare expenditures. The key question is whether the governance and design features of the institute that will oversee the initiative will enable it to succeed where other federal efforts have faltered. This Article analyzes the federal government's quest to ensure value for money expended in publically funded healthcare programs and the health sector generally. This Article will also analyze what factors contribute to the possible success or failure of the comparative effectiveness research initiative. Success can be defined as the use of the findings of comparative effectiveness to make medical practice less costly, more efficient and effective, and ultimately, to bend the cost curve.

Better Than Nothing: Participant Experiences in Using a County Health Plan

2012 ◽  
Vol 34 (4) ◽  
pp. 13-18 ◽  
Author(s):  
Kimberly Rovin ◽  
Rebecca Stone ◽  
Linda Gordon ◽  
Emilia Boffi ◽  
Linda Hunt
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Affordable Care Act ◽  
The United States ◽  
United States Government ◽  
Patient Protection ◽  
Access To Health ◽  
History Of ◽  
Better Than

The United States health care system has reached a crisis point, with 49.9 million Americans now living without health insurance (DeNavas-Walt, Proctor, and Smith 2011). The United States government has responded to this crisis in a variety of ways, perhaps the most visible being the enactment of the Patient Protection and Affordable Care Act (ACA) in March 2010. With a goal of expanding access to health insurance to 32 million Americans by 2019, the ACA marks an important moment in the history of United States health care reform with the potential to drastically change the United States health insurance landscape (Connors and Gostin 2010). The law delineates only general categories of required benefits and leaves it to each state to decide the specific benefits that will be provided by the insurers in their state (Pear 2011).

scholarly journals Privilege, Oppression and the Affordable Care Act: Cultural Implications for Health Educators

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Chandra Story ◽  
Hugh Crethar ◽  
Tayler Hall
Keyword(s):  
United States ◽  
Health Disparities ◽  
Preventive Care ◽  
Affordable Care Act ◽  
Quality Care ◽  
The United States ◽  
Health Educators ◽  
Culturally Competent ◽  
Patient Protection ◽  
Cultural Implications

 The United States Patient Protection and Affordable Care Act (ACA) provides an opportunity for more equitable healthcare. Preventive care provisions under the ACA have the potential to address persistent health disparities. However, many health disparities are fueled by issues of privilege and oppression in our society, which lead to inequitable access. Those in positions of privilege may have greater access to quality care, even in light of the ACA. Health educators are equipped to address underpinning issues of oppression and privilege through equitable participation and culturally competent programming.

scholarly journals Evolution of Physician-Centric Business Models Under the Patient Protection and Affordable Care Act

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Tanya Nix ◽  
Lynn Szostek
Keyword(s):  
United States ◽  
Medical Care ◽  
Affordable Care Act ◽  
Business Models ◽  
Healthcare Delivery ◽  
The United States ◽  
New Paradigm ◽  
Medical Specialties ◽  
Patient Protection ◽  
The Cost

For decades, the cost of medical care in the United States has increased exponentially. United States citizens spend twice as much as their European counterparts on medical care. Congress enacted the Patient Protection and Affordable Care Act (PPACA) to ensure affordable healthcare to the citizens of the United States. PPACA legislation is creating a new paradigm in healthcare delivery and provider business models. The purpose of this case study was to explore physicians’ perspectives regarding physician-centric business models evolving under the requirements of the PPACA legislation. Data were gathered through semistructured interviews and questionnaires with a purposive sample of 75 participants across 20 medical specialties within the United States. Three universal themes emerged including (a) use of midlevel practitioners, (b) changes to provider practices, and (c) enhanced business education. Healthcare leaders may use the findings to advance the evolution of physician business models that meet the needs of healthcare stakeholders.

scholarly journals Wpływ reformy zdrowotnej w Stanach Zjednoczonych ObamaCare na biznes ubezpieczeniowy

Ekonomia ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 9-25
Author(s):  
Łukasz Jasiński ◽  
Marta Makowska
Keyword(s):  
United States ◽  
Healthcare Reform ◽  
The United States ◽  
Public Institutions ◽  
Insurance Companies ◽  
Patient Protection ◽  
Insurance Business

Impact of the Healthcare Reform in the United States ObamaCare on the Insurance Business The main aim of this article is to present the most significant changes for the insurance business that are the result of the reform made by Patient Protection and Affrodable Care Act commonly known as ObamaCare. The article analyses the specific changes that were introduced into insurance companies activity in order to conform to the requirements of ObamaCare. Moreover, it presents the effects of the changes on the insurers, patients and public institutions.

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