Group: Taxpayers (against reform)

Re: Patients

The Patient Protection and Affordable Care Act (ACA) sounds like a great way for all Americans to have access to healthcare with reduced fragmentation of services and it will have an ability to maintain costs. Sounds great when you say it but in reality it just is not true. The older adult may suffer under this new program and be denied access to care simply due to the fact that our bodies develop multiple conditions of frailty as we age. In October 2013 Medicare is implementing its Hospital Readmission Reduction Program which will penalize hospitals for rehospitilizations within 30 days of discharge. Under the Affordable Care Act within two years they will require quality improvement programs through patient safety organizations, “The researchers warn that because some frail older adults have multiple conditions and therefore have a higher possibility of being readmitted hospitals could respond by limiting access to this population.” (Affordable Care Could Have Unintended Consequences, 2012) Although it does state that the ACA will require that hospitals pay a penalty for rehospitalizations this may not offset the potential earnings from the rehospitalizations themselves, therefore better healthcare practices may not be encouraged.

Bundled payments are being introduced as a way to encourage healthcare service collaboration for preventative care and better patient care outcome. This is to lower costs. However under the National Pilot Program on Payment Bundling the researchers note, “The pilot program excludes long-term services and support as part of the ‘bundle,’ so …providers may simply withhold services to this group past the bundled payment period to realize savings.” (Naylor MD & Grabowski, 2012)

Although all age groups are to be served under the ACA, the older adult may suffer due to loopholes within the Act. The hope within medical insurance programs is that young healthy premiums will help displace the older adult’s increased medical costs.

References:

Affordable Care Could Have Unintended Consequences. (2012). PT in Motion, 4(8), p. 10.

Naylor MD, K. E., & Grabowski, D. e. (2012, September 28). Unintended consequences of steps to cut readmissions and reform payment may threaten care of vulnerable older adults. Health Affairs. doi:10.1377/hlthaff.2012.0110.