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Healthcare Reform

The Facts About Healthcare Reform

The Patient Protection and Affordable Care Act, or the ACA, was signed into law by President Obama on March 23, 2010. With this sweeping legislation, the United States is focused on redesigning a three trillion healthcare industry. The primary goals of the ACA are to:

  1. Expand coverage to an estimated 32 million Americans who have no health insurance
  2. Reform the delivery system to improve quality
  3. Lower the overall costs of providing healthcare

To accomplish the goal of expanding coverage, the legislation mandates that Americans maintain a minimum level of health coverage. Individuals may access health coverage through their employer, the insurance marketplace or the Medicaid program[1]. If individuals have no healthcare coverage, they will likely be assessed a penalty based on their income effective 2015.                   

The legislation also implements a number of insurance market reforms, including a ban on exclusions for preexisting conditions, premium rate restrictions and extension of dependent coverage through the age of 26.

The ACA has also activated several programs to yield improved quality and outcomes for patients. Patients may now access vital preventive services at no or low cost through their health plan. Healthcare leaders are charged with better coordinating care and services for patients in an effort to prevent unnecessary hospital readmissions and other health complications.

The cost of healthcare remains a significant challenge for the nation. The ACA attempts to slow the rise of healthcare costs by addressing healthcare fraud, waste and abuse with the Medicare and Medicaid programs. The ACA also calls for healthcare provider payments to be reduced over a defined period of time. 

Overall the ACA affects everyone — from insurance companies and healthcare providers to individuals and employers. The law is significantly impacting how healthcare is accessed, delivered, financed and regulated. Summa Health System is complying with the ACA by implementing innovative care delivery and payment reforms on a local level.

Summa Health System is committed to transforming healthcare and, as a result, supports many of the provisions of healthcare reform which deliver better value at a lower cost to patients and employers.

[1] In June 2012 the United States Supreme Court ruled that the federal government could not mandate that Medicaid be expanded in all 50 states. The decision to expand Medicaid is a state right. Each state decides if it will or will not expand Medicaid. The state of Ohio decided to expand its Medicaid program effective January 2014.