Since its formation, the main aim of the Affordable Care Act (ACA) has revolved around decreasing the healthcare expenditure in the United States. In a bid to achieve this objective, the Centers for Medicare and Medicaid Services (CMS) has engaged in the experimentation of various reimbursement methods in an attempt to enhance efficiency and the reduction of costs in the reimbursement methods. In 2014 alone, the US spent 17.5% of its gross domestic product (GDP) on healthcare. The CMS further documented that the Medicare and Medicaid expenditures were at $618.7 billion and $495.8 billion, respectively (Bowling et al., 2008). Other than the reduction of the healthcare expenditure, the ACA had an essential role in guaranteeing a higher-value and efficient healthcare delivery system. Therefore, several strategies must be put in place to decrease the cost of healthcare heading into the future (Hospital Reimbursements and the ACA).
The first solution lies in enhancing a reformed provider payment. Although it will have a slow impact, it will reduce the fee-for-service (FFS) payments. The ACA has put in place mechanisms that move away from the traditional volume-based reimbursements. On the contrary, it is more focused on linking government payments to the performance of the health provider (CMS Strategy: The Road Forward On the Centers for Medicare and Medicaid Services Website). The ACA has played a fundamental role in asking the CMS to create a value-based payment model that would be used by a select group of health workers such as physicians. The value-based system seeks to reward only the physicians performing quality work at an affordable price. Also, it seeks to penalize the physicians who do not provide the much-required affordable care.
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The changes made in CMS are meant to achieve quality and reduce cost. In tandem with the provisions of the ACA, the changes will ensure that every person receives the care they deserve. In general, it seeks to increase health insurance coverage, especially among the underserved communities.
References
Bowling, B., Newman, D., White, C., Wood, A., & Coustasse, A. (2018). Provider Reimbursement Following the Affordable Care Act. The Health Care Manager, 1. doi:10.1097/hcm.0000000000000205
CMS Strategy: The Road Forward On the Centers for Medicare and Medicaid Services Website at Http://Www.Cms.Gov/About-CMS/Agency-Information/CMS-Strategy/Downloads/CMS-Strategy.Pdf .
Hospital Reimbursements and the ACA https://www.hpae.org/issues/healthcare-reform/hospital-reimbursements-and-the-aca/
