Healthcare has a set of regulations, rules, and legislation that have been established to govern clinical practice and shape the delivery of care. Health policy covers an array of issues including emerging medicines, preventive health care, financing of health care, long-term care, chronic illness, and public health at large. The healthcare policy succeeds in federal, state and local legislation by managing the terms of healthcare services since the industry is undeniably vital in maintaining a healthy state of individuals.
For example, the affordable care act (ACA) transformed the role of practitioners by implementing new roles including care coordination, primary care partners, and informatics specialist. The goal of the act is to adjust the availability, quality, and affordability of healthcare practices. Chinese medicine has evolved in the prevention of health problems. This essay discusses how health policy affects practitioners in their practice, highlights the advantages and disadvantages of health policy, and finally, the essay gives insights on the action plan based on the legislation.
The Affordable Care Act (ACA) or Obamacare is a notable health reform legislation signed into law in 2010. The legislation provision is to cover uninsured citizens, as well as implement intervention for affordable health care services and improve efficiency in the US healthcare system (Miller, 2017). To achieve this, the law incorporates cost-sharing subsidies and premium subsidies to lower coverage costs. The act diversified into Medicaid (healthcare program for individuals and families with low income) to provide coverage for citizens near the poverty line. Additionally, ACA fosters the innovative medical care delivery approaches that are developed to generally lower the cost of health care.
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ACA empowers practitioners’ clinical practice since it gives them control over treatment decisions by removing the coverage exclusions for the patient pre-existing condition, as well as patient access to preventive care. Practitioners were facing multiple challenges due to strict regulations and rules from insurance companies, now since the signing of the bill, there have been remarkable changes such as dependent insurance coverage. The act substantially improved patient access to care and initiated value-based care. This empowered patients and caused an increase in patient consumerism. ACA transformed the healthcare revenue cycle by lowering reimbursement rates and refocusing the healthcare revenue cycle in an effort to maximize profits. As a result, health care providers have lower reimbursement rates under ACA legislation by reducing wasteful spending in the organization and reforming practitioners pay for delivering care.
ACA advocated for non-discriminatory health coverage by the insurance companies, therefore, initiating integrative treatment such as complementary medicine (Reddy, 2013). Notably, the integrative treatment approach was a significant breakthrough for the practice of acupuncture (stimulating body points using pre-sterilized using needles). With a setting like this, ACA provided an ultimate opportunity for consumers to access acupuncturists, naturopathic doctors, massage therapist, and chiropractors that are licensed (Reddy, 2013). Now healthcare professionals could easily refer to complementary medicine since patients would not be required to pay cash.
Prior to ACA legislation, 15% of Americans were uninsured. However, the law significantly reduced the uninsured population to 9.1% (Miller, 2017). Health insurance has become more affordable for Americans. There are many advantages of ACA. First, it lowers the health care costs through vast insurance coverage and free preventive care. Second, insurance companies cannot deny coverage for preexisting conditions for anyone (cannot raise premiums). Third, it eliminated coverage limits, as well as children, are under the health insurance plan of their parent up to age 26 (Miller, 2017). Despite the benefits, people had to pay higher premiums since the insurance companies started to cover preexisting conditions.
The Joint Commission on Accreditation of Health Care Organization (JACHO) rulings is focused in ascertaining that healthcare organization delivers quality patient care (Ameringer, 2018). The body evaluates healthcare organizations looking for accreditation, Medicaid reimbursement and licensing. JACHO designs performance regulations and standards addressing essential elements of healthcare operations including consumer rights, infection control, medication safety, and patient care.
JACHO rulings promote integrative treatments. It gave a clarified standard for non-pharmacological treatments in the healthcare system. The ruling elevated the use of emerging integrative treatments such as relaxation therapy, osteopathy, massage therapy, acupuncture therapy, and chiropractic therapy (Weeks, 2015). The ruling supports the use of acupuncture in its pain management standards. This would also mean that JACHO licenses independent practitioners that offer non-pharmacological pain modalities such as acupuncture. However, the JACHO ruling on integrative treatment cautions practitioners to consider both the positive and negative implications of opioids in medical decision making.
Acupuncture is beneficial in the following ways, first, relieving physical pain since it initiates the healing process, decrease muscle spasms and promotes relaxation (Leggit, 2018). Second, the procedure relives tension, therefore, allowing an extended range of motion and increases flexibility. Third, it enhances faster recovery since the needle aid in the removal of metabolic waste such as lactic acid that accumulated in muscle tissue.
JACHO rulings enhanced practitioners’ decision making and innovation in promoting quality patient care to align with their guidelines, as well as enhance the professional development of the interprofessional team. The rulings gave clinicians guidance in their clinical practice to continually enhance the institution performance and collaboratively work with the interprofessional team to deliver quality care. JACHO on-site survey is patient-centered and evaluates actual care process to ensure that patients receive quality care from competently trained practitioners. Finally, JACHO auditing and evaluation of the adherence to its ruling are acknowledged by the Centers for Medicare and Medicaid services. This would mean that JACHO plays an integral role in Medicare reimbursement. However, offering acupuncture without the state license is prohibited.
JACHO ruling strongly focuses on patient quality care, development of strategies to curb healthcare injury and reinforces practitioners best practice. Its standards encourage evidence-based decision making. JACHO reinforces the community confidence in the safety and quality care since its regulations are patient-centered, improves healthcare management and risk reduction by concentrating on state-of-state performance initiatives for an organization to improve safety, it gives professional guidance and advice to increase efficiency in the organization and, it improves practitioners’ recruitment and educational development (Ameringer, 2018). However, despite JACHO being the most comprehensive coverage, its programs and standards are relatively expensive due to training and qualification levels required to achieve accreditation.
Even with the enactment of ACA, US healthcare still requires revitalization and reform. In this context, the action plan is the adoption of marketing principles (patient-consumer empowerment). The goal of the practical market-based reform is to provide all US citizens with access to affordable quality care. In this consumer-driven insurance plan, all Americans will have continuous insurance coverage. Also, the Medicaid program has experienced a rapid rise in costs despite not adequately covering the health needs of lower-income households. There is a need for reform by changing how the US government pays for its total share. Finally, Health Saving Accounts (HSA) should be an integral component in the US healthcare system. With a setting like this, the account will provide incentives for healthcare purchases and high medical expenses.
Healthcare legislation such as ACA expand the sustainability and quality of patient care in an effort to realize healthcare goals in society. The government plays a key role since it is responsible for legislating all aspects of the healthcare system. The government shapes healthcare legislation that governs the practitioner’s clinical practice. This implies that health care providers play a central role in the implementation of the policy. JACHO rulings and accreditation of non-pharmacologic treatment revolutionized the use of contemporary chinese medicine mainly acupuncture for the use of pain treatment. In the end, I believe healthcare policy should be based on both the needs of US citizen and the state economy for the well-being of the community at large.
References
- Ameringer, C. F. (2018). US health policy and health care delivery: Doctors, reformers, and entrepreneurs. Cambridge: Cambridge University Press
- Leggit, J. C. (January 01, 2018). Musculoskeletal Therapies: Acupuncture, Dry Needling, Cupping. Fp Essentials, 470, 27-31. Management, A. I. R. (2018). Healthcare Policy and Reform. Hershey: IGI Global.
- Miller, E. A. (2017). The Affordable Care Act: Advancing long-term care policy in the United States. New York: Routledge.
- Reddy, B. (2013). A Closer Look at the Affordable Care Act. How it will affect Your Practice. Retrieved from https://www.acupuncturetoday.com/mpacms/at/article.php?id=32794
- Weeks, J. (2015). The Joint Commission Moves Integrative Approach Ahead of Pharmaceuticals for Pain Management… plus more. Integrative Medicine: A Clinician’s Journal, 14(2), 14. Retrieved From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566474/
