Future Direction in Healthcare in America

In 2010, the United States created The Affordable Care Act (ACA). The objective was to share the responsibility of costs between the government, individuals, and employers to provide affordable access to quality health insurance. “However, health coverage remains fragmented, with numerous private and public sources, as well as wide gaps in insured rates across the U.S. population.” (“United States: International Health Care System Profiles,” n.d.). Each individual state within the US, generally has control over private insurance.

One dominant economic feature of the healthcare industry is the growing need for both basic and specialized healthcare due to the continued aging of the “Baby Boomer” generation. This generation consists of over 79,000,000 individuals born in the US between 1946 and 1964. As this generation has aged, the need for healthcare has increased dramatically. Let us take a look at some statistics:

The main economic challenge for the healthcare system in the United State will be the rising expenses associated with Medicare and Medicaid. The Governments share of healthcare spending is predicted to rise to 31 percent by the year 2020 (Keehan, Sisko, Truffer, Poisal, Cuckler, Madison, Lizonitz, and Smith, 2011). This may jeopardize the economic stability and financial security of the nation.

Hospitals have put in place widespread security and privacy measures to protect patient health information. However, there are still errors being made in data security through the IT standpoint. Some of these errors or issues include:

The Medicare and Medicaid federal programs were put in place as a way to help the less fortunate. Individuals with severe disabilities or over the age of 65 qualify for Medicare. This program helps them with health coverage, so the disabled and elderly who have Medicare do not have to worry about their medical bills and not going to the hospital when they are sick. Medicaid is a similar program, however, it only applies to low income families who cannot provide for their children. Similar to Medicare, this program covers any health related problems and takes away the worry and troubles that come with hospital bills.

Over the recent years, healthcare in the United States has drastically changed. The industry has experienced continuous growth, due to an array of events. The introduction and passing of Affordable Care Act, the increase of Baby Boomers (individuals born between 1946-1960) reaching the age of retirement, and potential passing of immigration inclusion laws has impacted and will continue to impact America’s healthcare landscape. Numerous factors associated with the political, economic, social, technological, environmental, and legal aspects are key indicators into the potential success of the industry.

In 2014, the US entered into the force sensational health care reform of the protection of patients in the United States, which is called The Patient Protection and Affordable Care Act. Under this reform, all the citizens and residents of the country are required to have health insurance. It has also caused many discussions and opinions among people. Supporters of it say that this is a significant step forward, since there is no company that can refuse a person in the insurance policy. However, opponents believe that this reform will only worsen the condition of the Americans. The current health care reform has its drawbacks, such as increased fees for insurance, and the impossibility of choice, therefore, it is necessary for change.

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

Medicaid is a medical assistance program for low-income Americans. It is funded partially by the federal government and partially by the state and local governments. The federal government requires that certain services be provided and sets specific eligibility requirements. Medicaid covers the following benefits required by the federal government; early and periodic screening, diagnosis, and treatment services, rural health clinic services, family planning services, SNF and home health services for persons over 21 years old, physicians’ services, laboratory and x-ray services, outpatient hospital care, and inpatient hospital care. Because Medicaid is also partially run by the state and local government individual states sometimes cover services

One of the greatest changes in healthcare in the past ten years has been the rise of managed care, much to the displeasure of many patients and physicians alike. Managed care arose out of concern about spiraling healthcare costs and was designed to encourage physicians to give patients treatments that were cost-effective out of their own financial interests. "The consumer strategy was directed at imposing some barriers to use by levying various forms of co-insurance. The most common approaches used either deductibles (where the consumer paid the first portion of the bill a technique familiar in other types of insurance) or co-payments (where the consumer paid a portion of the bill and the insurance company the rest) or a combination of both' (Kane et al 1994). Managed care has given health insurance companies an increasingly significant voice in how treatment is administered and allocated. Managed care has proliferated in the past decade despite considerable criticism of the practice of 'nickel and diming' patients as well as the considerable bureaucratic red tape it is has generated. Also, research indicates that healthy, well-insured patients tend to over-consume care without meaningful co-pays but poorer, sicker patients can be deterred even by moderate co-payments and suffer negative health consequences (Kane et al 1994). However, managed care has not gone away and is a reality that all healthcare

The Medicaid program differs by state. There are dozens of ways to qualify for this state and federally funded health insurance program. There are Medicaid programs for the low-income, disabled, elderly, children, and long-term care. “Since its inception in 1965, the Medicaid program has evolved to become the largest single source of health coverage in the United States” (Crowley & Golden, 2014). From its beginnings the goal of single payer health care is on a slow roll for all citizens. Some

Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).

Medicaid is a government program that effects millions of people in the united states by providing health care. These individuals that receive these benefits include low-income adults, children, pregnant woman, the elderly, and people with disabilities (medicaid.gov). Because of the many different types of people that this program serves, it has the ability to effect many people across America. In the United States, each individual state administers and makes decision about their own medicaid program. There are certain services that the states are required to provide to a pateint with medicaid. A few, but not all, of these services are home health services, in and outpatient hospital services, X-ray services, family planning services,

The Medicaid program is a state and federally funded entitlement program that pays for medical services to qualified “low income adults, children, pregnant women, elderly adults and people with disabilities” (Medicaid, n.d.). Through Medicaid, health care coverage is made available to individuals and families who meet certain eligibility criteria. The purpose of Medicaid programs is to ensure that vital health care services are made available to those who otherwise do not have the financial means to obtain them. Medicaid programs are established and administered by individual states to “determine the type, amount, duration, and scope of services within broad federal guidelines” (Medicaid, n.d.). A list of mandatory and optional benefits can

The future and direction of health care has been the topic of discussion amongst politician and U.S citizens today. There are several challenges surrounding the future and strategic direction in which health care should be heading. Accreditation, quality of health care and organization’s compliance; access to health care, maintaining a skilled workforce, information technology and pay for performance are some of the challenges that currently presenting itself in healthcare today. If health care is not dealt with appropriately it will have a significant effect an impact on the strategic direction in the future and direction of care.