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 Health IT Governance and the Affordable Care Act

Health IT Governance and the Affordable Care Act

You are required to reply to 2 classmates’ threads, identifying at least 1 strength and 1 weakness in each classmate’s reasoning. Each reply must be at least 450 words. Each thread and reply must include at least 1 biblical integration and 2 peer-reviewed source citations in current APA format in addition to the textbooks.

Discussion Board Forum 3

Eric Samuel

School of Business, Liberty University

October 1, 2020

Health IT Governance and the Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) became law in 2010, and aimed to increase health care access for Americans by reforming the insurance market, expanding Medicaid and influencing the healthcare system into changing certain practices for long term success (Silvers, 2013). The job of enacting the changes called for by the ACA, monitoring the program objectives and compliance, and evaluating the results became the job of dedicated health IT governance officials within several federal and state agencies.

Meeting and Implementing the ACA Objectives

In Exodus 18:21, Moses’s father in law defined leadership as capable individuals who fear God and do not accept bribes.  He continues on and states that these are the people worthy of officiating over groups of thousands (New International Version, 2014). The words of Exodus still hold true today. The lesson to apply here is that leadership requires that the leader empower the other members to accomplish their goals through teamwork and shared understanding. In the case of the ACA, the nation’s leaders created a framework through teamwork and a shared vision to ensure that the uninsured American people could receive the services and support they needed. Within the healthcare community, the term health IT governance refers to the leadership, structure and processes used to meet organizational goals. The Center of Consumer Information and Insurance Oversight (CCIIO) was created as the primary Health IT governing body to oversee the ACA reform programs.  This organization works directly with state insurance exchange groups, government regulators, and consumers to ensure that uninsured and under insured individuals and families have access to health insurance options (Rosenbaum, 2011). Each state is responsible for implementing and operating their own insurance exchange to offer several insurance options to individuals and families. These insurance options are based on federal income and poverty guidelines, and in some cases can heavily subsidized by the government, or even free of charge (Kominski et. al., 2017).

Monitoring and Maintaining the ACA Objectives

At the federal level, the ACA programs are monitored by both the Department for Health and Human Services and The Centers for Medicare and Medicaid Services. The Center for Medicare and Medicaid Services is responsible for monitoring and auditing the ACA programs for improper payments, medical record billing and coding and Medicare fraud (Centers for Medicare and Medicaid, n.d.). Additionally, the Center for Medicare and Medicaid Services also creates monthly health IT reports detailing the trends within enrolled patients and organizations, such as provider utilization, cost analysis and patient satisfaction. These functions are critical to the long term success of the ACA and its programs. Without consistent monitoring and analysis of the program, it would be not be possible to tailor the system to meet the needs of the nation and consumers. The maintenance of the ACA and its programs is accomplished by a variety of federal programs and agencies.  For example, the MyHealthEData initiatives provided an update to the ACA and its programs in 2020 that improved interoperability between federal and state agencies, and also removed barriers to allow easier patient access to their health information (Centers for Medicare and Medicaid, n.d.). Maintenance is also conducted at the state level by officials responsible for maintaining the health insurance marketplaces.  These examples of ongoing maintenance activities help ensure that the ACA and its programs continue to function as intended into the foreseeable future.

References

Centers for Medicare and Medicaid. (n.d.). Affordable Care Act Research, Statistics, Data and Systems.  Retrieved 30 September, 2020 from https://www.cms.gov/cciio/index

New International Version Bible. (2014). Bible Online.  Https://biblehub.com

Silvers J. B. (2013). The Affordable Care Act: Objectives and Likely Results in an Imperfect World. Annals of Family Medicine, 11(5), 402–405. https://doi.org/10.1370/afm.1567

Rosenbaum S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public health reports (Washington, D.C. : 1974), 126(1), 130–135. https://doi.org/10.1177/003335491112600118

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual review of public health, 38, 489–505. https://doi.org/10.1146/annurev-publhealth-031816-044555

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Health IT Governance and the Affordable Care Act
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