Affordable Care Act (ACA)

In the national context

There are several trends that have an impact on the healthcare sector. The Affordable Care Act (ACA), which was passed into law in 2010, is one of the laws that strives to give uninsured individuals access to insurance coverage. In order to reduce reimbursements while boosting their competitiveness, Trinity Hospital must reassess their operations and implement the ACA’s standards.

Value-based payment

Value-based payment, which is another trend influenced by the Affordable Care Act, has an impact on the standard of care provided to patients. One aspect of the base rate rise in compensation is the performance of Trinity Hospital in particular on quality criteria. As such, the amount and performance are tied, thus pushing the institution to focus on the quality of services and care for the patients they serve.

The Readmission Reduction Program

The Readmission Reduction Program, based on the ACA, is a trend in the healthcare sector developed to reduce the costs incurred by patients due to readmissions in the hospital (Krumholz, Hsieh, Dreyer, Welsh, Desai, & Dharmarajan, 2016). For 30 days, Trinity Community Hospital must ensure the patients they treat are not readmitted. Otherwise, they will face lower reimbursement for the same. As such, it is imperative for Trinity Community Hospital to reduce the cases of readmission and alleviate the challenge of meeting penalties toed to readmission of patients.

Impact

One of the impacts based on the trends in healthcare reforms is that the orthopedic service line will need to have many physicians to serve the needs of the community, keeping in mind that quality is expected to be at par while the cost is to be minimum. As such, Trinity will have to recruit more physicians to cover the anticipated increase in demand for orthopedic services primarily due to the rise in the aging population. These staff members will coordinate and efficiently provide quality services to not only improve the performance of the hospital but also to increase the compensation for services they offer.

The same strategy will be utilized for both the oncology and cardiology service line for Trinity Hospital.

It is expected that these two service lines will obtain additional staff members to meet the population increase and needs for services they offer. Abiding by the regulations and quality requirements of the ACA is mandatory to avoid fines imposed by the same especially on the readmission rate of the patients back to the hospital. The success of these service lines will depend on the quality of services provided to the patients and the timeline for delivery of these services.

Legislation

Trinity must ensure to meet the requirements of the ACA especially in the increase in quality of services offered and decrease in the expenses incurred by the patients. The staff, therefore, is expected to efficiently collaborate with the regulations and meet the required standards of care for the patients. According to Aoughsten, Johnson, Kuruvilla, & Bionat, (2015), it is expected that the readmission rate will significantly reduce in Trinity Hospital, thus alleviating the risk of facing hefty fines on the same. However, it is recommended that the hospital can utilize the staff and offer home-based services to patients soon after they are released from the institution to reduce the chances of readmission back into the hospital. Thus, the orthopedic, oncology and cardiology service lines will be satisfied if they adhere to the regulations of the ACA and abide by all the requirements of the same.

References

Aoughsten, J., Johnson, S., Kuruvilla, M., & Bionat, S. (2015). The Effect of the Affordable Care Act on Medicare: Opportunities for Advanced Practice Nursing. Nurse Leader, 1349-53. doi: 10.1016/j.mnl.2014.07.018

Krumholz, H. M., Hsieh, A., Dreyer, R. P., Welsh, J., Desai, N. R., & Dharmarajan, K. (2016). Trajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. Plos ONE, 11(10), 1-14. doi: 10.1371/journal.pone.0160492