Legislations Influence in Health Care & what Changes can be made for the Better?

By: Maile AndrusHCS/440

July 27, 2015Michele Burka

Influence of Legislation on Health Care A Brief Introduction

• Welfare Reform Act of 1996:• also known by the name “The personal Responsibility and Work

Opportunity Reconciliation Act or PRWORA, P.L.104-193” (Valerius, 2014)

• Health Insurance Portability and Accountability Act or (HIPAA) (Valerius, 2014)

• The Affordable Care Act or ACA of 2014:• Better known as Obamacare (Cafasso, 2011).

Common tools to Identify & Address the Economic Challenges

Common Tools• Centers for Disease Control and

Prevention (CDC)– Public Health Economics and Tools

• Analysis of Economic Prevention Benefits

Economic Changes• Centers for Disease Control and Prevention

(CDC)– Public Health Economics and Tools

– There are more families that are considered low-income as medical expenses continue to rise.

– Baby Boomer population living long and is affecting costs because there are those that at are at higher risk.

– There are a growing number of documented and non-documented immigrants

Health Care Reform over the years.What are possible changes?

•Welfare Reform Act

•Health Insurance Portability and Accountability Act (HIPAA)

• Affordable Care Act (ACA)

Effective method(s) or tool(s) that could be used to resolve current economic affected by the influence of legislation.

• Welfare Reform Act– The American population needs to change the way they eat.– Making health choices can change the populations health care needs

• Welfare Reform Act– Stiffer penalties for those that breach HIPAA State and Federal Laws.

• Welfare Reform Act– I think there needs to be a lot more done to fix the technology and

reduce the amount of cost that the public needs to pay for ACA as it is currently not affordable for most of the population it was meant to help.

Identify various payment sources and mechanism used in the health care industry.

• State and Federally funded Health care plans such as – Medicare– Medigap– Medicaid

• Private Insurances– Health maintenance organization

(HMO)– Preferred provider organizations (PPO)– Health savings account – Point-of-service

Which payment source(s) or mechanism(s) are the most effective to resolve the economic The rising costs of Health care?

• There is no insurance that is better than another these days as many insurances companies have raised rate consistently.

• The question is unanswerable, as ACA is still so uncertain and State and Federal Funding in health care continues to decline.

• While this is true, there are a few insurance that are employer/ employee contributor to the health care insurance premiums.

• There are additional health care plans like flex spending • As well as health care Savings accounts

To combat the rising costs of health care and help redefine the ACA so that it is truly

Affordable.

• Reduce the amount of people that are on State and Federally funded health care, for such things as drug abuse, alcohol abuse, and welfare.

• Put a freeze on health care costs until such time there can be sufficient changes made to the health care cost percentages annual increase.

• Make those that are State and Federal funded health care just like welfare have to supply proof that they are looking for work, and that they would be required to take a random drug tests and screenings.

Conclusion • While this is just the start to a long continuing fight Cruz like the

rest of the Nation will have to see what the final numbers hold and if the new legislation will in fact help or hurt the Countries economic health as well as that of the population. Truly only time will tell if the ACA will remain a constant fixture in the legislation or if the next Government leaders will repeal and start over.

• The bottom line is that there needs to be greater accountability from doctors and the insurance companies to help reduce the costs and spending in health care. Accountability starts with making sure there is the right staff for the job. That they are well trained so that there is the less wasted time that will reduce the number of funds it will take to correcting a problem. (Valerius, 2014)

ReferencesBurke, V. (1996-2003). The 1996 Welfare Reform Law. Retrieved from CRS, Welfare Reform Briefing Book: http://royce.house.gov/uploadedfiles/the%201996%20welfare%20reform%20law.pdfCafasso, E. (2011, March 21). How health-reform stakeholders will be affected by recent changes. Retrieved from The Public Relations Strategist: http://www.prsa.org/Intelligence/TheStrategist/Articles/view/9071/1028/How_health_reform_stakeholders_will_be_affected_by#.VBdIXvldWSo

Amanda Honeycutt, L. C. (2006, 3). Guide to Analyzing the Cost-Effectiveness of Community Public Health Prevention Approaches. Austin. A and Wetle, V. (2012). The U.S. Health System. In The U.S. Health Care System (2nd ed.).Healthcare Timeline. (2014). Retrieved from University of Phoenix: http://www.pbs.org/healthcarecrisis/history.htmMark L. Messonnier, P. (2006, 12 22). Economics and Public Health at CDC. (SUP02), pp. 17-19.Valerius, B. N. (2014). Medical Insurance An Integrated Claims Process Approach (6th ed.). McGraw-Hill Higher Education.Wilhelmine Miller, D. R.-E. (2013). A Review and Analysis of Economic Models of Prevention Benefits. ASPE Report.Long Term Growth of Medical Expenditures- Public and Private, ASPE Issue Brief; U.S. Department of Health and Human Services, March 2005 Retrieved from http://aspe.hhs.gov/health/medicalexpenditures/Overview Of Health Care Financing: A Self Study Course U.S. National Library of Medicine August 2014 Retrieved from http://www.nlm.nih.gov/nichsr/edu/healthecon/02_he_01.html

References Continued • Mercuri, R. (2004). The HIPAA-potamus in Health Care Data Security. Security Watch, 47(7), 25-

28.• Balcombe, J. (2010, 8). Impact of Healthcare Legislation on Health Insurance Companies.

Retrieved from http://www.irmi.com: http://www.irmi.com/expert/articles/2010/balcombe08-insurance-agency-company-valuation.aspx

• Greenberg, J. (2013, August 8). Is the health care law hurting the economy? Retrieved from http://www.politifact.com: http://www.politifact.com/truth-o-meter/article/2013/aug/08/ted-cruz-health-care-law-and-legislation-hurts-eco/

• Tomes, J. P. (2007). Management of HIPAA Compliance Takes on Increased Importance with Criminal Enforcement. Journal of Health Care Compliance.