Research topic ideas: Healthcare reform and the Affordable Care Act (ACA)

Interesting research paper topics in the category of healthcare reform include the rising costs of healthcare, value-based performance (VBP) of hospitals under the Affordable Care Act (ACA) and consumers’ satisfaction with the ACA.

Learn more about healthcare reform for your research paper. (Credit: Insurance Marketplace)

Learn more about healthcare reform for your research paper. (Credit: Insurance Marketplace)

Here is some Obamacare news to get you started on your term paper.

Healthcare costs keep rising

For your term paper, you could discuss why health insurance costs in the United States keep rising, despite provisions in the ACA expected to slow this trend. Healthcare costs are projected to rise by 7.5% in 2017 for people buying insurance under the ACA. For example, a health plan in Pennsylvania is losing $30 million a year on coverage sold in the state, so it felt it needed to raise rates 20%.

The problem is that as more Americans get health insurance under the ACA (a good thing), these newly insured people, most with pre-existing conditions who couldn’t get reasonably priced health insurance before, are sicker and need more expensive care (a financial strain on the system). In the article “Why Do Healthcare Costs Keep Rising? These People Know,” by Robert Pear, in New York Times, June 9, 2016, Kevin J. Counihan, the chief executive of the federal insurance marketplace, acknowledged that “pent-up demand for health care is greater than people expected and is lasting longer than expected.” But as these sicker people are treated and gain control of their conditions (such as diabetes), they will eventually not need such expensive care in the future.

Value-base performance reimbursement

Another term paper topic is to explain Value-based Performance (VBP), a new strategy in overhauling Medicare and Medicaid payments to hospitals. The idea is that if you do well, you get a bonus. As part of the ACA, the Centers for Medicare & Medicaid (CMS) instituted an incentive and penalty program under which hospitals receive reimbursement payments from Medicare and Medicaid based on how well they perform on things like efficiency, patient experience, health outcomes and patient readmissions. It’s a quality control measure to make sure hospitals are providing quality care to patients. Under VBP, hospitals pay into a pool (about 2% of operating payments). If the hospital performs well, it receives a bonus, which gives it a net increase over what it paid into the pool. If it performs badly, it gets a penalty and loses what it put into the pool.

Does this work? Are hospitals improving? According to Tawnya Bosko and Teresa Koenig in “Understanding Value-Based Incentive Models and Using Performance as a Strategic Advantage” in Journal of Healthcare Management, January 1, 2016, “Since enactment of the readmissions penalties in 2013, readmissions have dropped, but approximately one in five patients admitted to the hospital is still readmitted within 30 days of discharge.”

Most people with ACA are satisfied

Notwithstanding the nearly blind man in South Carolina who refused health insurance under the ACA for his diabetes, then blamed Obamacare for his ill health, most people are satisfied with their health coverage under the ACA, according to a survey by the Commonwealth Fund. But consumers are still worried about rising healthcare costs. Half of ACA participants did not previously have health insurance, and 72% of new enrollees used their coverage for medical treatment. The survey found that 82% of ACA participants are satisfied with the coverage.

In “Most with ACA coverage are satisfied,” posted June 13, 2016, in Modern Healthcare, Shannon Muchmore reported: “If the fundamental purpose of health insurance is to provide people with adequate access to needed health care, then it would seem that, on balance, the Affordable Care Act’s coverage expansions are working well for most of the people who have enrolled in them,” said the authors of the survey.

For more information, check out Questia’s library on healthcare reform.

What other areas of healthcare reform would make good term paper topics?

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