Components of the Patient Protection and Affordable Care Act

Healthcare-Related Programs Associated with Medicare and Medicaid AND Components of the Patient Protection and Affordable Care Act (PPACA)
Access to healthcare is a significant human need. Yet, the cost of healthcare often hinders access to healthcare. According to Beik and Pepper (2021), the cost of healthcare has been on the rise due to an increase in chronic conditions as well as increased demand for healthcare, among others. This has necessitated health insurance to cater to health expenses. In the United States (US), the government has created health policies and programs to enhance access to healthcare through healthcare financing. This essay aims to explore the US public health policy through the lens of Medicare, Medicaid, and the Patient Protection and Affordable Care Act (PPACA).
Healthcare-Related Programs Associated with Medicare and Medicaid
Medicare and Medicaid are programs designed by the US government to enhance the public’s access to healthcare through medical insurance. They were created in 1965 as amendments to the Social Security Act to provide health-related services to particular patient groups (Lusted, 2020). Medicare refers to a social insurance program financed by the federal government to cover medical care for people older than 65 years as well as some people with disabilities (Lusted, 2020). Medicaid is a social welfare program that the federal and state governments jointly run to provide medical coverage to low-income individuals below the age of 65 years (Lusted, 2020). The two programs are managed by the Centers for Medicare and Medicaid Services (CMS). According to Potter et al. (2021), the CMS was created to reduce the programs’ expenditure while ensuring that beneficiaries receive quality care. To this end, several health-related programs are associated with Medicare and Medicaid. They include hospital-acquired condition (HAC) reduction, hospital value-based purchasing, bundled payments for care improvement, and hospital readmission reduction programs (Potter et al., 2021). These healthcare-related programs are targeted at healthcare organizations to facilitate quality care at lower costs.
The CMS created the HAC reduction program to incentivize healthcare organizations to reduce incidences of HACs such as surgical site infections and pressure ulcers. According to Potter et al. (2021), under this program, the CMS provides limited or no funding for treating HACs in healthcare organizations with high incidences of HACs. The goal is to incentivize organizations to reduce HACs and enhance patient safety while reducing the costs associated with the treatment of HACs for beneficiaries of Medicare and Medicaid. The hospital value-based purchasing program links part of the Medicare payments made to a hospital to the hospital’s performance in vital quality measures, while bundled payments for care improvement focus on improving the quality of care for particular medical conditions (Potter et al., 2021). Finally, the hospital readmission reduction program was also created to enhance patient safety and the quality of care. Under this program, healthcare organizations with high patient readmission rates within 30 days of discharging a patient receive limited Medicare payments from the CMS (Potter et al., 2021). These programs have ensured that the CMS can control the cos...