Health Care Provided By Primary Care Providers

The U.S. health care system faces challenges that indicate that the people urgently need to be reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps even for those with access to insurance coverage.

Health System Reform in the United States: Impact of Rising Premiums and Opportunities for System Improvements to Enhance Access to Healthcare Services

The aim of the ACA is to provide affordable health care to all Americans, but it still leaves some issues unaddressed that will impact the access to health care. Covino (n.d.), “Though the intentions of the legislation are good, the Affordable Care Act does little to improve the actual health care delivery system” (para.1, page 2). According to the American Medical Association, we are facing an increasing Physician shortage. As of 2010 we faced a shortfall of 13,700 physicians, the estimate is that number will increase to 62,900 by 2015, 91,500 by 2020, and 130,600 by 2025 (Krupa, n.d.), with primary care taking the largest impact. Health Care coverage will be of no benefit if there are no doctors to treat the patients. An example of this occurred in 2002 when Thailand’s’ “30 Bhat Scheme” added (CNN n.d.) “14 million people to the country’s health care system, resulting in long waits and subpar service” (Your health is covered, but who is going to treat you?) Several factors contribute to the physician shortage. Many physicians are reaching the age of retirement, the Association of American Medical Colleges estimates nearly 15 million physicians will be eligible for Medicare in the coming years (CNN n.d.). The increasing cost of malpractice insurance also deters many from pursuing a career in medicine, and is forcing some doctors to retire. Also contributing to the physician shortage is a lack of spots in residency programs. “In 2011, more than 7,000 were left

Department of Health & Human Services, 2015). These provisions were aimed at providing new protections for health insurance consumers, lowering the cost and improving the quality of health care, and increasing access to health insurance and affordable care. While many of the ACA’s provisions had implications for community health centers, the ones that impacted them most directly were the expansion of Medicaid and availability of subsidized health insurance through exchanges and the creation of the Community Health Center Fund, which allocated $11 billion in new funding through fiscal year 2015 for operations, capital projects, and expansion of services to enable community health centers to serve an anticipated 20 million newly insured patients (National Association of Community Health Centers, n.d.; “Valley Community Healthcare,” 2015).

In a survey conducted in 2003, it highlighted that the recurrent problem is the reimbursement rate from Medicaid to the physician (O’Shea, 2007). The Center for Studying Health System Change (HSC) show that 21% of physicians that state they accept Medicaid have reported they will not accept a new Medicaid patient in 2004-2005(O’Shea, 2007). This number would only logically be assumed to have risen in 2013 A survey conducted by the U.S. National Health reported that researchers have found two standout trends among Medicaid beneficiaries: they have more difficulty getting primary care and specialty care and they visit hospital emergency departments more often than those with private insurance (Seaberg, 2012). The lack of primary and specialty care access is mostly contributed to the following barriers; unable to reach the MD by phone, not having a timely appointment with the MD and lastly unable to find a specialty MD that will accept Medicaid. In a recent report released by the Partnership to Fight Chronic Disease, it stated that about 30% of Medicaid patients experience “extreme uncoordinated care”, there is a strong correlation between this situation and higher Medicaid spending and less quality of care given (Bush, 2012). After January 1st 2013, healthcare providers have experienced a 2% reduction in payments for Medicaid beneficiary, this will only create more of a problem for these patients to seek the

The new federal health-care law has raised the stakes for hospitals and schools already struggling to train more doctors. Evidence suggests there won’t be enough number of doctors to treat the newly insured millions under the ACA. At current graduation and training rates, America faces a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The greatest demand will be for primary-care physicians. Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more with longer wait times under the new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER

The Issue is that physician payments in Medicare and Medicaid, are already well below the prevailing rates in the private sector. On the average, physicians who take Medicare are paid 81 percent of private payment. Doctors who take Medicaid are paid 56 percent of private payment. This type of payment plan (Obamacare) has resulted in access problems for Medicare patients, and the even lower Medicaid payments have already caused serious access problems for lower-income people and made hospital emergency room overcrowded. During recent research study on the The Affordable Care Act they found that 67 percent of primary care physicians said that under current laws and conditions new Medicaid enrollees will not be able to find “suitable primary care

The Affordable Healthcare Act is expected to increase medical coverage to include an additional 30 million people. What has become clearer is that just because coverage was expanded does not mean an expansion of actual care. “When Congress enacted the national health law, it unleashed a potential tsunami of newly insured patients, flooding a delivery system that was already strained and fragile. The American health care infrastructure has had workforce shortages for decades and is not prepared to meet such a vast influx of patients effectively or efficiently” (Anderson, 2014). It takes years to train nurse and doctors of which the healthcare act does not take into consideration. What ends up happening is

The primary care safety net, which is the first-line of defense, is provided by these 3 cohorts, and while 2/3 of their patients are uninsured – it only represents 8% of the total uninsured population in the area. Expansion is a huge need here.

Health care in the United States is driven by a patchwork of services and financing. Americans access health care services in a variety of ways — from private physicians’ offices, to public hospitals, to safety-net providers. This diverse network of health care providers is supported by an equally diverse set of funding streams. The United States spends almost twice as much on health care as any other country, topping $2 trillion each year. (WHO.INT 2000) However, even with overall spending amounting to more than $7,400 per person, millions of individuals cannot access the health care services they need.(Foundation 2009) So when the Patient Protection and Affordable Care Act (a.k.a the Affordable Care Act or ACA) was passed in the summer

In the wake of the 2016 presidential election, concerns have been raised regarding the Republicans’ desire to repeal the Affordable Care Act, informally referred to as Obamacare. The ACA was originally enacted into law in 2010 and has been annually provisioned to expand its ability to not only improve the nation’s access to health care, but also to reform the health care delivery system. Through the ACA, private and public insurance has become more available and affordable, new health care delivery models have improved quality of care, and several workforce policies have made primary care a more desirable profession for medical students.

The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination.

Eliminating the barriers to access of care starts with the extended health insurance coverage offered through the ACA. The Shortage of healthcare providers in areas- opens a window of

One of the major challenges facing the health delivery system today is governmental policies; the availability of doctors for the increasing number of patients. Currently the United States spends approximately $2.2 trillion on healthcare (Sayles, 2013). Healthcare has become multifaceted, this includes more specialists for chronic health care issues and the inclusion on technologies in the delivery of healthcare (DeVry University, 2015). The Affordable Care Act was developed to improve people’s access to health insurance and healthcare in the United States. However, this policy change enables millions more individual to get healthcare without and an immediate increase in the number of physicians and specialists. 2.8 million more healthcare

The American Academy of Family Physicians suggests that there is no single definition that can completely define primary care. Primary care has several definitions because it is a multi layered approach and network of services experienced in the early stages of an individual’s entry into the health care system. Primary care involves primary care practices, primary care physicians, non-primary care physicians, and non-physician primary care providers (1). They fall under the scope of providing individuals with first contact care and entry into the complex world of health care. There are three levels of care, which are comprised of primary, secondary, and tertiary care. They are are ranked not only