Sample Paper on The Effects of Reimbursement in the US

Recent years have seen laws passed in the health sector with far-reaching impacts. Among the laws passed in recent years are HIPAA (Health Insurance Portability and Accountability Act) and Affordable Care Act (ACA). These laws have had extensive impact on reimbursement and will continue to impact the same in the coming years.

Developed as part of the Social Security Act, HIPAA came into effect in 1996. The Act’s primary purpose was to protect health care coverage, particularly for individuals who lose or change jobs (Bowers 348). While it touched on privacy, HIPAA also affected health care reimbursement, particularly group insurance coverage. By establishing penalties for non-compliance of its provisions, HIPPA has reduced fraudulent activities ensuring that health insurance companies get their reimbursements in time. Given the passage of the law and its implementation, HIPAA will continue to affect provider reimbursement even in coming years.

While HIPAA’s main goal was to protect care coverage and patient privacy, ACA’s goal was to tame the rising cost of health care, while at the same time encourage a more efficient health care delivery system (Bowling et al. 169). Even with improving delivery as its goal, however, ACA has had a great impact in reimbursement. Since it came into force in 2010, there has been a noticeable truncation in Medicare reimbursement. However, there has been a marked increase in provider reimbursement for quality care measures (Bowling et al. 169).

Following the uptake and enrolment of citizens following ACA passage, providers are bound to see an increase in their reimbursement. Service providers will continue to see an increase in their reimbursement following ACA enrolment. However, the current Republican government and its intention to repeal ACA (Thompson, Gusmano and Shinohara 396) has the potential to bring a new regime with different reimbursement impacts for health care providers.

 

 

Works cited

Bowers, Donna. “The Health Insurance Portability and Accountability Act: Is it really all that bad?” Proc (Bayl Univ Med Cent), vol. 14, no. 4(2001), 347-348, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305898/

Bowling, Brandon et al. “Provider reimbursement following the Affordable Care Act.” Business & Health Administration Proceedings, Avinandan Mukherjee, 2017, 168-175

Thompson, Frank, J., Gusmano, Michael, K. and Shinohara, Shugo. “Trump and the Affordable Care Act: Congressional repeal efforts, executive federalism, and program durability.” Publius: The Journal of Federalism, vol. 48, no.3, 396-424, https://academic.oup.com/publius/article/48/3/396/4982766.