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Decision Making in Healthcare and the Impact of ACA

Running head: EXECUTIVE BRIEF:ACA Executive Brief: ACA Zaid Naima Walden University EXECUTIVE BRIEF: ACA 2 Executive Brief: ACA Introduction The University of Kansas Hospital Health System, TUKH, is a nonprofit, academic medical center located in Kansas, United States. The ACA's goal is to help remedy the situation of the majority of Americans who cannot afford healthcare coverage, and this can be done by providing access to a better healthcare coverage which will, in turn, help to improve the healthcare conditions of Americans significantly (Bowling et al., 2018). Given that TUKH is in Wyandotte County, which is historically a low-income county, the impact of ACA will have on the organization must be examined. Furthermore, a large percentage of patients are out-of-state patients will also have a significant impact on the financial, operational, and clinical operations of TUKH. Financial Impact on TUKH TUKH operating margins will be improving due to the safety-net clinics, as the safety-net clinics in Medicaid expansion states operated with better margins than those in states that did not expand. Examining historical data from TUKH, would indicate that from 2012 to 2015. operating margins for safety-net clinics increase from --2.4 percent to --1.8. The increase can be accounted for the increased Medicaid revenues and reduced uncompensated care costs(Annual Reports at The University of Kansas Health System, 2019). The improved financial steadiness of safety-net clinics will allow TUKH to continue increasing outpatient volume, realign strategies to enhance care, and develop better quality control to monitor costs. These improvements not only benefit TUKH, but it also fulfills the mission and values of serving the community. Operational Impact On Cost Structure and Reimbursement Rates EXECUTIVE BRIEF: ACA One study, found that 69 percent of federally qualified health centers in Medicaid expansion states were significantly more likely to report financial stability and funding improvement since the implementation of the ACA, as well as being better suited to deliver behavioral health and social services (Joseph, et al., 2016). Another study showed that the post ACA period was related to a significantly lower uninsured rate (p < 0.001). At the same time, there was a significant increase in Medicaid patients. This was associated with significantly improved hospital reimbursements (p < 0.001) (Rosenbaum, 2011). Hence, TUKH will benefit from the better reimbursements rates, an increase in patient volume and utilization of clinics run by the hospital. Clinical Impact The implementation of ACA has led to a decrease in the number of uninsured trauma patients. This was associated with an increase in TUKH reimbursements that substantially enhanced the financial revenues. Recent studies have shown that implementation of ACA has the potential to substantially improve the financial outcomes of trauma centers through Medicaid expansion, which can apply to TUKH ("Hospital Reimbursements and the ACA - Health Professionals & Allied Employees", 2016). Clinical Impact on Physicians Overall, a report published by the American Medical Association demonstrates that most physicians see a range of patients by coverage type, though there are some marked differences based on specialty. In 2016, o