scholarly journals Potentially Ineffective Care: Time for Earnest Reexamination

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
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.

scholarly journals The Implementation and Evaluation of the United States Affordable Care Act

2019 ◽  
Vol 12 (1) ◽  
pp. 17-38
Author(s):  
David Schultz
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Health Care Outcomes ◽  
The Us ◽  
American Health Care

In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

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

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.

The Politics of Native American Health Care and the Affordable Care Act

2016 ◽  
Vol 41 (1) ◽  
pp. 41-71 ◽  
Author(s):  
Daniel Skinner
Keyword(s):  
Health Care ◽  
Native American ◽  
Native Americans ◽  
Affordable Care Act ◽  
Health Care Policy ◽  
Care Policy ◽  
Patient Protection ◽  
Long Run ◽  
American Health Care ◽  
Native American Health

Abstract This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms—private marketplaces, Medicaid expansion, and accommodations for Native Americans—are best read as potential “supplements” to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform—especially “affordability”—which is critical for understanding what is required from and appropriate to future Native American health care policy making.

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

Cancer ◽  
2010 ◽  
Vol 117 (8) ◽  
pp. 1564-1574 ◽  
Author(s):  
Heidi W. Albright ◽  
Mark Moreno ◽  
Thomas W. Feeley ◽  
Ronald Walters ◽  
Marc Samuels ◽  
...  
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Cancer Care ◽  
Care Delivery ◽  
Patient Protection

scholarly journals Athletic Trainers' Knowledge Regarding Health Care Delivery Systems and Administration in the American Health Care System

2020 ◽  
Vol 15 (4) ◽  
pp. 295-307
Author(s):  
Lindsey E. Eberman ◽  
Zachary K. Winkelmann ◽  
Jessica R. Edler ◽  
Elizabeth R. Neil
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Athletic Trainers ◽  
Delivery Systems ◽  
Knowledge Assessment ◽  
Perceived Knowledge ◽  
American Health Care System ◽  
American Health Care ◽  
Health Care Delivery Systems

Context The American health care system is dynamic and ever evolving. As athletic training continues to advance, our understanding of and the ability to integrate best practices in policy construction and implementation, documentation, and basic business practices is critical to promoting optimal patient care. Objective To identify and compare knowledge gaps of clinicians and educators regarding health care delivery systems and administration. Design and Setting Cross-sectional, Web-based survey. Patients or Other Participants Athletic trainers (N = 485), representative of the national demographic of the profession (age = 37 ± 12 years, experience = 14 ± 11 years). Intervention(s) We used a multi-part assessment including a perceived knowledge questionnaire, validated knowledge assessment (21 items: knowledge retrieval [11 items], knowledge utilization [10 items]), and self-efficacy scales. Main Outcome Measure(s) We calculated the knowledge assessment total score and compared educators (n = 41) and clinicians (n = 444). We calculated the knowledge gap with a Spearman ρ correlation to determine the relationship between perceived knowledge mean and the knowledge retrieval subscore. We calculated the practice gap with a Spearman ρ correlation to determine the relationship between self-efficacy mean and the knowledge utilization subscore. Results Athletic trainers scored less than 50% on a knowledge assessment (mean = 10.27 ± 2.41 of 21) about health care delivery systems and administration. We identified that educators scored approximately 1 point higher (11.65 ± 0.4) than clinicians (10.14 ± 0.11), equivalent to 7% to 10% higher on the knowledge assessment. We identified, relative to health care delivery systems and administration, a knowledge gap (Spearman ρ = .161, P < .001) between perceived knowledge and knowledge retrieval and a practice gap (Spearman ρ = .095, P = .037) between self-efficacy and knowledge utilization. Conclusions Athletic trainers demonstrated knowledge and practice gaps related to health care delivery systems and administration. To meet the expectations of the practice analysis and the needs of patients in today's American health care system, we must engage in professional development in this domain of practice.

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

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.

Defining a High-Performance ICU System for the 21st Century: A Position Paper

1998 ◽  
Vol 13 (4) ◽  
pp. 195-205 ◽  
Author(s):  
Daniel Teres ◽  
Thomas Higgins ◽  
Jay Steingrub ◽  
Laurie Loiacono ◽  
William Mcgee ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Quality Improvement ◽  
Care Delivery ◽  
Severity Of Illness ◽  
Improve Patient Care ◽  
High Quality ◽  
American Health Care System ◽  
Improvement Programs ◽  
Care System

In the fall of 1997 George D. Lundberg and John E. Wennberg wrote an editorial in JAMA calling for comprehensive quality improvement programs to become the driver of the American health care system. The suggestion came during the Second European Forum on Quality Improvement in Health Care held in Paris, France, in April 1997 and was based on comments made by Donald Berwick. The concept was to focus on an organized response to problem identification and proposed solutions to improve patient care and protect the health of the public. Critical care medicine represents a large segment of health care and is undergoing dramatic changes during our managed care revolution. General ICU severity of illness models have been developed, tested, and shown to provide a useful estimate of hospital mortality for populations of critically ill patients. These systems have captured the imagination of clinical researchers and have become an integral component of a large number of publications as well as a part of many ICU databases. These risk adjustment severity models are remarkably robust for heterogeneous patient populations but the models have not been shown to validate well in new settings. We feel that by focusing on the episode of critical illness rather than each individual ICU admission and by going beyond the traditional acute hospital discharge to determine whether the patient lives or dies, we can better evaluate critical care system performance and cost-effectiveness. The incentives for high quality/low cost should favor integrated comprehensive critical care delivery systems. Programs that score well should be identified as high quality and be honored as medallion level 1 ICUs. We challenge national and international critical care societies to evaluate and then debate the described definitions and recommendations as a call to action.

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