Question

Sharing your thoughts: 1)Why IS IT IMPORTANT To achieve quality and affordable health care for all, health care reform must include concrete steps to reduce health disparities

Answer 1

Ans) The Affordable Care Act (ACA) has the potential to dramatically improve rates of health insurance coverage for low-income Americans, including many vulnerable populations. In states that are opting to expand Medicaid, people with incomes up to 138 percent of poverty may enroll with little or no cost sharing.

- The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care.

ACA:

- Expanded insurance coverage (Access)
- Improve quality of care (demonstration projects → financial and clinical accountability)
- Enhance prevention + health promotion + partnerships + accountable coordinated care
= Risk sharing & shared savings: We are going to give you a flat fee (full capitation, bundled payment, etc), but in exch you need to meet these quality metrics" "The more you're not meeting those quality metrics. You need to meet certain quality metrics and if you don't they penalize you and take a chunk back" Met quality objectives → can receive an award at the end of the year.
= No cost sharing for prevention/wellness: Cost sharing is copays, deductibles, etc; you can't make patients share in the cost of their preventative care and wellness. It was basically ACA's way of saying preventative care is a right and it must be completely covered by private insurers.
= Medicaid expansions for adults
- Prevention and Public Health Fund: Funding stream dedicated to preventing chronic diseases.

- The ACA impacted the availability of health care and reduced the number of uninsured Americans by 5.4 million in the first year of implementation. A neighborhood's crime rate is a part of the physical environment and is not addressed by the ACA. A patient's physical environment is not addressed by the ACA; however, it does impact a patient's health status. A patient's educational background is not impacted by the ACA.

Steps to reduce health disparities:

Improve interpersonal skills.

The first step in reducing health disparities is to improve interpersonal skills, because it is important to provide culturally competent care to patients. The nurse can inform the patient about health care services after improving interpersonal skills. The nurse can advocate for insurance coverage and ask about the financial status of patients after improving interpersonal skills in order to reduce health disparities.

- By allowing the patient to attain his or her health potential.

Health equity refers to the study of differences in the quality of health and health care across different populations. Health equity can be achieved when everyone has the opportunity to attain his or her health potential and no one is disadvantaged. Folk healing is a cultural factor that affects health. Transcultural nursing involves discovering culturally relevant facts to guide the nurse in providing culturally appropriate care. Understanding the cause of health disparities is not sufficient to achieve health equity.

- Health literacy assists the patient in making appropriate health decisions.

Health literacy is defined as the degree to which individuals have the capacity to understand basic health information and make appropriate health decisions. Low health literacy is associated with more hospitalization. Health literacy includes the ability to weigh risks and benefits and the ability to analyze health information.