Mẹo What was the purpose of the Patient Protection and Affordable Care Act quizlet?
Mẹo về What was the purpose of the Patient Protection and Affordable Care Act quizlet? 2022
Dương Khoa Vũ đang tìm kiếm từ khóa What was the purpose of the Patient Protection and Affordable Care Act quizlet? được Update vào lúc : 2022-12-09 21:32:03 . Với phương châm chia sẻ Kinh Nghiệm về trong nội dung bài viết một cách Chi Tiết Mới Nhất. Nếu sau khi đọc Post vẫn ko hiểu thì hoàn toàn có thể lại Comment ở cuối bài để Mình lý giải và hướng dẫn lại nha.Nội dung chính Show
- What is the goal of the Patient Protection and Affordable Care Act quizlet?What is the major focus of the 2010 Patient Protection and Affordable Care Act quizlet?Which of the following is true of the Patient Protection and Affordable Care Act quizlet?
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PHA 4723 - Intro to Public Health in Pharmacy
Terms in this set (111)What is the Affordable Care Act (ACA)?
a law consisting of two pieces of legislation that are collectively referred to as "Healthcare Reform" or "Obamacare"
What are the individual laws that make up the ACA?
1. The Patient Protection and Affordable Care Act (PPACA), enacted on March 23, 2010
2. The Health Care and Education Reconciliation Act (HCERA), enacted on March 30, 2010
What is the main objective of the ACA?
to expand health insurance coverage to an estimated 32 million uninsured Americans and strengthen existing coverage
What does the ACA do?
- increase benefits and lower costs for consumers
- provide new funding for public health and prevention
- bolster health care and public health workforce and infrastructure
- foster innovation and quality in our system
What points encompass the Patient's Bill of Rights?
- Coverage
-
Costs
- Care
What are the main ideals of Coverage?
- ends preexisting condition exclusions for children
- keeps young adults covered
- ends arbitrary withdrawals of insurance coverage
- guarantees the patient's right to appeal
What are the main ideals of Costs?
- ends lifetime limits on Coverage
- reviews premium
increases
- helps patients get the most from their premium dollars
What are the main ideals of Care?
- covers preventive care no cost to patients
- protects the patient's choice of doctors
- removes insurance company barriers to emergency services
What are the 10 essential health benefits?
1. Ambulatory Patient
Services
2. Emergency Services
3. Hospitalization
4. Maternity and Newborn Care
5. Mental Health and Substance Use Disorder Services
6. Prescription Drugs
7. Rehabilitative and Habilitative Services
8. Laboratory Services
9. Preventive and Wellness Services and Chronic Disease Management
10. Pediatric Services
As of April, 2014, how many individuals were eligible to enroll in a Marketplace Plan in the U.S.? Florida?
U.S. = 13,547,592
Florida = 1,603,575
As of April, 2014, how many individuals had selected a Marketplace Plan in the U.S.? Florida?
U.S. = 8,019,763
Florida = 983,775
As of April, 2014, how many individuals could potentially enroll in Marketplace Coverage in the U.S.? Florida?
U.S.
= 28,605,000
Florida = 2,545,000
As of April, 2014, how many uninsured individuals were eligible for Medicaid under the ACA in the U.S.? Florida?
U.S. = 8,748,000 adults & 5,220,000 children
Florida = 94,000 adults & 362,000 children
As of April, 2014, how many adults were in a Coverage Gap in the U.S.? Florida?
U.S.
= 4,831,580
Florida = 763,890
According to the ACA in 2010, insurance companies will no longer be able to do what?
- deny coverage to children with pre-existing illnesses
- rescind coverage due to an error on a customer's application
- impose lifetime dollar limits on essential benefits
- impose annual dollar limits on insurance coverage
What benefits were allowed to consumers by the ACA in 2010?
- consumers had the right to appeal insurance company decisions
- uninsured Americans with preexisting conditions could access insurance coverage
- the establishment of consumer assistance programs
In 2010, what was provided to seniors in the Medicare prescription drug "Donut Hole"?
a $250 rebate check
In 2010, what were tax credits provided to?
small business health insurance
In 2010, what were new plans required to cover?
không lấy phí preventive care
In 2010, the ACA also began focusing efforts on what?
cracking down on healthcare fraud
In 2010, what were the main guarantees of the ACA?
- extending coverage for young adults until age 26
- expanding coverage for early retirees
- rebuilding of the primary care workforce
- insurance companies are held accountable for rate hikers
- Medicaid expansion for states
- increased payments for rural healthcare providers
- strengthening of community health centers
What benefits were guaranteed for senior citizens by the ACA in 2011?
- 50% off for Medicare Part D brand name drugs
- không lấy phí preventive care
- community care transitions program for high Medicare beneficiaries
What was established by the ACA in 2011?
the Center for Medicare & Medicaid Innovation and the Community First Choice Option
What does the Community First Choice Option allow?
states to offer home and community-based services to disabled individuals
In 2011, in what ways were prices reduced for consumers?
- health care premiums were reduced
- overpayments to big insurance companies were stopped
Health Care Premiums were reduced in 2011, but in what way?
least 85% of all premium dollars collected by insurance companies for large employer plans are spent on healthcare quality improvement
How was Medicare Advantage strengthened in 2011?
enrollees were able to receive all guaranteed Medicare benefits while also having bonus payments for high quality care provided for
In what way were payments linked to quality outcomes by the ACA in 2012?
financial incentives were provided to hospitals to improve the quality of care provided to Medicaid patients
How were care organizations for physicians made accountable in 2012?
- they were able to better coordinate and improve patient care and quality
- help prevent disease and illness
- reduce
unnecessary hospital admissions
In 2012, how did the ACA improve the understanding of health disparities?
by collecting and reporting racial, ethnic, and language data
What new ACA policies came into effect in January of 2013?
- new funding to state Medicaid programs covering preventive services
- establishment of a national
pilot program to improve coordination and quality of patient care (runs on a flat fee)
- increased Medicaid payments for primary care doctors
When did open enrollment in the health insurance marketplace begin?
October 1, 2013
What ACA policies were changed in January of 2014?
- discrimination due to preexisting conditions or
gender were prohibited
- annual limits on insurance coverage were eliminated
- individuals participating in clinical trials are ensured
- healthcare was made more affordable for middle class
How was healthcare made more affordable for those in the middle class?
tax credits became available for people with an income between 100% and 400% of the poverty line who were not eligible for other afforable coverage
What was established in 2014?
the Health Insurance Marketplace
What option did a patient have if their employer did not offer them with insurance?
they could buy it directly from the Health Insurance Marketplace
What was increased in 2014?
-
the small business tax credit
- access to Medicaid
How was access to Medicaid increased?
people earning less than 133% of the poverty level (about $14,000 for an individual and $29,000 for a family) were eligible to enroll in Medicaid
What was the goal of the ACA in 2014?
to promote individual responsibility
What will become effective in January of 2015?
physicians will be paid based on value rather than volume based on a new provision
How will the new provision for physician payment work?
physicians who provide higher quality care will receive higher payments than those who provide lower quality care
When did the ACA require most individuals to have health insurance or health coverage by?
January 1, 2014
How can health insurance by obtained?
Through an employer or individual health plan
How can health coverage be obtained?
Through programs such as:
- Medicare, Medicaid, Florida Healthy
Kids
- Tri-Care, federal employee health benefit plans
- Veteran's Health Care, Indian Health Services (IHS)
What were some exceptions to the ACA's healthcare reform deadline?
- individuals or below 100% of the federal property level and eligible for Medicaid Expansion
- individuals for whom coverage would be unaffordable
- under a hardship which prevents the consumer from obtaining health
coverage
- undocumented immigrants
- individuals that are members of the healthcare sharing ministries as well as the Amish, Mennonite, and Indian tribe communities
What was the consequence for people who did not meet the health coverage deadline and were not exempt from the federal requirement?
they were subject to a Shared Responsibility Payment collected by the Internal Revenue Service (IRS)
When would individuals who did not meet the deadline NOT have to make a payment?
- when the coverage was unaffordable for them
- when they spent less than three consecutive months without coverage
- when they qualified for an exemption
What was the total annual tax penalty for the eligible who did not meet the deadline?
the greater
amount of either a flat dollar amount or a percentage of taxable income
- $95 per person or 1% taxable income for 2014
- $326 per person or 2% taxable income for 2015
- $695 per person or 2.5% taxable income for 2022
What happens to the tax penalty after 2022?
it will increase annually based on a cost of living adjustment
How does the ACA affect women and families?
by protecting them from the worst insurance company abuses, making healthcare more affordable, and giving people better access to care (through preventive benefits and coverage for preexisting conditions)
How does the ACA affect young adults?
by expanding affordable options for health insurance and giving hardworking families security (through coverage) and important new benefits (through preventive services)
How does the ACA affect seniors?
will help save them money ensure that people with Medicare can see a doctor that they know and trust
What will the ACA do for seniors?
- provide cheaper prescription drugs
- end limits on care
- provide không lấy phí preventive services
-
better coordinate care
- fight fraud
- protect medicate benefits
How does the ACA affect employers?
makes it easier for businesses to find better coverage options while also building on the employer-based insurance market that is already in place, giving the consumer and business owner more control while making healthcare coverage more afforable
How does the ACA affect healthcare providers?
by holding health insurance companies accountable, protecting providers and patients, while also guaranteeing choice and control (through the provision of opportunities and incentives to coordinate care and by strengthening the workforce)
How does the ACA hold health insurance companies accountable?
by reducing the burden of uncompensated care on physicians and hospitals by making access to care easier and more affordable
How does the ACA affect people with disabilities?
by ending insurance company abuses and discrimination against preexisting conditions, expanding affordable coverage, and through the creation of new long-term and community-based care options
Why do we need the Affordable Care Act?
to help minimize the high uninsured rate, unsustainable spending, poor health outcomes, lack of preventative emphasis, and health disparities
According to the Congressional Budget Office, how many Americans were uninsured in 2012?
about 55 million under the age of 65
(1 in 5 people)
Why do the uninsured usually face higher treatment costs?
they are less likely to receive preventive care and less likely to seek care when they are sick or injured, resulting in higher overall costs
In 2012, how much of the U.S. gross domestic product (GDP) was represented by healthcare?
16.9%
How much is the GDP expected to reach by 2022?
20%
What was life expectancy in the U.S. in 2011?
78.7 years
Where does the U.S. rank among Organization for Economic Cooperation and Development (OECD) countries?
27th
What is the OECD average life expectancy?
80.2 years
How many U.S. deaths are related to preventable diseases (ie. obesity, diabetes, high blood pressure, heart disease, cancer)?
7 in 10
How much of the national healthcare funds are spent towards treating preventable diseases?
75%
How much of the national healthcare funds are spent towards prevention of preventable diseases?
$0.03 of every $1.00
African-American women have the highest death rates from which conditions?
heart disease, breast cancer, lung cancer, stroke, and pregnancy
Which five areas of the Affordable Care Act focus on pharmacy involvement?
1.
Delivery Systems Reform
2. Payment Reform and Quality
3. Comparative Effectiveness Research
4. Workforce Issues
5. 340B Drug Pricing Program
Why was the Marketplace established?
to provide an easier means of shopping and purchasing individual and small group health coverage
How will Florida residents and employers participate in the marketplace?
through a Federally Facilitated Marketplace (FFM)
Why do Floridians have to participate in this slightly altered version of the marketplace?
because Florida did not create a state-based exchange
What are the two types of federal exchanges?
1. Individual Marketplace
2. Small
Business Health Options Program (SHOP)
Why is the Individual Marketplace available?
so that individuals can purchase qualified coverage
Why is the Small Business Health Options Program (SHOP) available?
so that small businesses of 2 to 50 employees can purchase a Qualified Health Plan (QHP)
Will there be any changes to the QHP?
Yes, in 2022 the number of employees required for eligibility will increase to up to 100 employees
How do self-employed individuals participate in the Marketplace?
through the Individual Marketplace
What requirements must be met for health plans to be offered on the Marketplace?
- must receive certification by the HHS
- muse meet certain minimum standards
What are the four coverage tiers?
1. Platinum Plans (90% coverage)
2. Gold Plans (80% coverage)
3. Silver Plans (70% coverage)
4. Bronze Plans (60% coverage)
What are the coverage tiers based on?
the percentage of the total allowed cost of benefit paid by a health plan on average
When is the next enrollment period for 2015 coverage?
from November 15, 2014 through February 15, 2015
When is the enrollment period for 2022 coverage?
October 15, 2015 through December 7, 2015
What is the goal of Medicaid Expansion?
to extend Medicaid coverage to most low-income people
Who did the ACA expanding Medicaid eligibility to in 2014?
138% of the federal poverty line (FPL) for citizens and qualified immigrants
Who is funding the Medicaid Expansion?
- funded 100% by the federal
government for the first 3 years (2014 - 2022)
- funded least 90% by the federal government afterwards
How much Medicaid was provided for individuals in 2014? For a family of 3?
- $15,415 for individuals
- $26,344 for a family of 3 (citizens and qualified immigrants)
How does a coverage gap occur?
as a result of states deciding not to expand Medicaid
How many will fall into the coverage gap?
almost 5 million uninsured adults
What percentage of individuals who fall into the coverage gap live in Florida?
16%
Which states are not expanding Medicaid?
Pennsylvania
(6% coverage gap)
North Carolina (7% coverage gap)
Georgia (9% coverage gap)
Florida (16% coverage gap)
Texas (22% coverage gap)
How many Floridians selected a marketplace plan?
983,775 individuals
Of the Floridians who selected a plan, how many are: female and male?
55% and 45%, respectively
Of the Floridians who selected a plan, how many are: under 35?
31%
Of the Floridians who selected a plan, how many are: between the ages of 18 and 34?
27%
Of the Floridians who selected a plan, how many have: selected a Silver Plan?
73%
Of the Floridians who selected a plan, how many have: selected a Bronze Plan?
13%
Of the Floridians who selected a plan, how many have: selected a plan with financial assistance?
91%
In 2014, what were insurance companies no longer allowed to do under Healthcare Reform?
-
deny adults coverage
- charge adults with higher premiums due to preexisting conditions
How many children in Florida who were diagnosed with conditions that resulted in denials in coverage are now protected?
244,800
Which aspects of insurance company abuses will also be changed with healthcare reformed?
- insurers will no
longer be able to charge higher premiums based on gender or health status
- insurers will be required to spend least a set share of premium dollars on actual medical care
How will the competitive marketplace help uninsured consumers?
by driving down costs, guaranteeing choice, and putting consumers in control through the forced competition between insurance companies
How will people with moderate incomes be able to get health insurance?
through tax credits provided through these new exchanges
How many people were eligible for these new tax credits in 2014?
nearly 2.0 million people
What are the requirements for small businesses to also qualify for tax credits?
-
have less than 25 employees
- average wages less that $50,000
How many Florida businesses qualified for a tax credit in 2011?
222,400
What percentage of the cost of coverage is currently covered by the tax credits for small businesses?
up to 35% previously with an increase to 50% in 2014
How many seniors and people with disabilities who are on Medicare now have access to không lấy phí preventive services in Florida?
3.4 million
How many Floridians received a rebate check for their prescription drugs in 2010?
256,000
By 2022, how much will each Florida household save on healthcare costs on average?
$1,520
What will happen to the ACA each year?
a new aspect will be implemented
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What is the goal of the Patient Protection and Affordable Care Act quizlet?
What was the primary goal of the proponents of the Patient Protection and Affordable Care Act? Extend health insurance coverage to all Americans. Economists argue that in treating patients: both benefits and costs should be taken into account by physicians.What is the major focus of the 2010 Patient Protection and Affordable Care Act quizlet?
The Patient Protection and Affordable Care Act (ACA) was signed by President Obama on March 23, 2010. The focus of the program is three-fold: to expand Medicaid, to preserve both Medicare and employer/job-based insurance coverage, and to promote state control of insurance markets.Which of the following is true of the Patient Protection and Affordable Care Act quizlet?
Which of the following is true of the Patient Protection and Affordable Care Act (PPACA)? It requires individuals not covered by an employer policy to purchase health insurance from a state health care exchange. Tải thêm tài liệu liên quan đến nội dung bài viết What was the purpose of the Patient Protection and Affordable Care Act quizlet?
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