Question

What are some features of the ACA that affect healthcare insurance and reimbursement?

Answer 1

	ACA (Affordable care Act) signed by Obama on 23 march 2010.
		Putting Information for Consumers Online	So that consumers can compare health insurance coverage options and pick the coverage that works for them.
		Prohibiting Denying Coverage of Children Based on PreExisting Conditions	The health care law includes new rules to prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition.
		Prohibiting Insurance Companies from Rescinding Coverage	In the past, insurance companies could search for an error, or other technical mistake, on a customer's application and use this error to deny payment for services when he or she got sick. But now this is illegal. After media reports cited incidents of breast cancer patients losing coverage, insurance companies agreed to end this practice immediately.
		Eliminating Lifetime Limits on Insurance Coverage	Insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays.
		Regulating Annual Limits on Insurance Coverage	Insurance companies' use of annual dollar limits on the amount of insurance coverage a patient may receive will be restricted for new plans in the individual market and all group plans. In 2014, the use of annual dollar limits on essential benefits like hospital stays will be banned for new plans in the individual market and all group plans.
		Appealing Insurance Company Decisions	Provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process.
		Establishing Consumer Assistance Programs in the States	States that apply ACA receive federal grants to help set up or expand independent offices to help consumers navigate the private health insurance system. These programs help consumers file complaints and appeals; enroll in health coverage; and get educated about their rights and responsibilities in group health plans or individual health insurance policies. The programs will also collect data on the types of problems consumers have, and file reports with the U.S. Department of Health and Human Services to identify trouble spots that need further oversight.
		Improving Quality and lowering costs	Both this head get amended from time to time so that consumer receive best to best service.
		Increasing Access to Affordable Care
	Hoe ACA Affects Reiumburshment
		Short Term Effects:
		The most immediate expected effect of the ACA for providers is a sudden rise in patient populations. Millions of Americans are expected to obtain coverage under the ACA
		Payers are required to cover more than ever,under the ACA, individual and small group health plans are required to cover 10 essential health benefits
		Long Term Effects:
		Changing payment and care models,biggest changes in healthcare right now are the new fee-for-value payment models that are replacing traditional fee-for-service programs
		Through Medicare and Medicaid, the government has been spurring providers to adopt these new service models - largely through promotion of accountable care organizations (ACOs), patient-centered medical homes (PCMH) and other integrated networks.