Uncategorized

Health Care Utilization Essay

Health Care Utilization Paper HCS/235: Health Care Delivery in the U. S. Health Care Reform The Patient Protection and Affordable Care Act of 2010 (PPACA) was designed to decrease health care costs and require health care access to all U. S. citizens. The Act has the potential for reducing the cost of health care in the United States; however, with many risks which could possibly strain the health care system, increase debt, and decrease the quality of care many are concerned. Access to Care The PPACA was enacted in 2010; however, the Act was not completely implemented right away. Hcs 235:Health Care Utilization Essay Paper

The health care reform has been dispersing provisions as the years progressed. Provisions such as simply investing in new resources to fight against fraud, waste, and abuse in government sponsored programs such as Medicare and Medicaid will strengthen the quality of the programs and also protect taxpayer’s money. Under the Affordable Care Act—young adults are allowed to continue in their parents’ health insurance plans until they reach twenty –six years of age, unless the young adult has health care insurance under their own employer.

In the past, medical health insurance companies have denied payments for patients who got sick. Incidents where breast cancer patients were found to have lost medical coverage from their insurance companies after diagnosed with the major disease. The Act makes this action illegal for insurance companies to rescind medical benefits. The purpose of the PPACA is to provide health care services to all Americans, whether through government programs or employer–offered health insurance plans. The Act provides small businesses and some large businesses with tax credits for providing health care benefits to their employees. Hcs 235:Health Care Utilization Essay Paper

Huge investments are placed into prevention. Preventing diseases and illnesses with free preventative care to individuals will impact the costs of emergency room claims from individuals who wait until their diseases or sickness is unbearable. Emergency room claims are far more expensive than preventative care. Keeping previously uninsured individuals healthy before they join Medicare reduces the cost burdens of taxpayer dollars for uninsured patients receiving care at hospitals which go unpaid and drive the cost of health care. Utilization

Utilization management has taken a key role in the health reform act because it evaluates the need, appropriateness, and the efficiency of the health care services which will be used by the covered individual. Health insurance plans are pressured to find ways to reduce plan costs and improve the quality of care provided to their members. Utilization management efforts have reduced inappropriate services and high medical costs just by taking some time to review pre-authorizations instead of providing clinically inappropriate, out-of-network services which prevents the accurate care for patient and increases cost for plans.Hcs 235:Health Care Utilization Essay Paper