Analysis of Healthcare Policy and Medicaid Expansion under ACA

The report analyzes the impact of the ACA and Medicaid Expansion on a selected local healthcare organization, that is, the Brigham and Women’s Hospital in Boston. The report discusses the relevance of the expansion of Medicaid, the organizational areas affected by the policy, identification of key organizational stakeholders, consideration of community impact, and expected impact on organizational outcomes.

Running head : ANALYSIS OF HEALTHCARE POLICY
ANALYSIS OF HEALTHCARE POLICY
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1ANALYSIS OF HEALTHCARE POLICY
Executive Summary
The Affordable Healthcare Act was a pioneering public health policy released by the federal
government, which aimed to enhance the reception of insurance coverage among individuals
residing in low income group families. The following report aims to assess the effects of the
healthcare policy and Medicaid expansion administered under the ACA. The effects of this
policy will be analyzed considering the local level organization, Brigham and Women’s Hospital
in Boston. Considering the importance attached to community development and the effects of
increased patient flow due to enhanced insurance coverage by the ACA, the effects of this policy
on the chosen organization may comprise of increased profits, reduced burden of uncompensated
healthcare, reallocation of staff and customer satisfaction.

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Table of Contents
Introduction..........................................................................................................................3
Discussion............................................................................................................................3
Policy Relevance to the Organization..............................................................................3
Organizational Areas affected by the Policy...................................................................4
Identification of key Organizational Stakeholders..........................................................4
Consideration of Community Impact..............................................................................5
Expected Impact on Organizational Outcomes...............................................................5
Conclusion...........................................................................................................................6
References............................................................................................................................7

3ANALYSIS OF HEALTHCARE POLICY
Introduction
The People’s Protection and Affordable Care Act (ACA) was formulated with the aim to
ensure the deliverance of accessible and financially feasible healthcare to all individuals through
provision of subsidies, expand Medicaid insurance coverage to all citizens with income below
the federal poverty level of 138% and provision of advanced healthcare resources and services
resulting in reduction of overall medical expenses for the nation (Sen &DeLeire, 2018).The
following paragraphs discuss the impact of the ACA and Medicaid Expansion on a selected local
healthcare organization, that is, the Brigham and Women’s Hospital in Boston.
Discussion
Policy Relevance to the Organization
One of the key areas of relevance upon administration of the ACA’s Medicaid expansion
in the chosen hospital was noted in the provision of uncompensated care. The expenses which
are not covered by the hospital are known as uncompensated care, and with the expansion of
the Medicaid, families and adults with an income level of 138% below the federal poverty level,
now were eligible for insurance. Hence, the relevance of the expansion of the same in the state of
Massachusetts, will result in decreases of uncompensated expenditures incurred by the hospital,
which will includecharity care and bad debts (Dranove, Gartwaite&Ody, 2017). Thus, the
ACA ‘s expansion of Medicaid, was relevant to the hospital, since it resulted in significant
increments in the profits which further allowed the chosen organization to redirect costs towards
provision of enhanced and affordable healthcare services – another key feature of the ACA
policy, resulting in increased consumer satisfaction (Sommers et al., 2016).

4ANALYSIS OF HEALTHCARE POLICY
Organizational Areas affected by the Policy
The ACA, in response to the subsidies provided to hospitals, necessitated healthcare
organizations to redirect their expenditures towards the conductance of assessments and
community health programs, for the purpose of screening and dissemination of adequate
healthcare services to ensure positive health outcomes at a public level, failure of which, may
result in penalties. The chosen hospital conducts a key community ‘violence prevention’
program, which will receive a key boost upon administration of the ACA. Hence, the community
health department of the chosen hospital will be positively affected in the form of greater
recognition and increased profits (Luthra, 2017). Further, the ACA’s Medicaid expansion will
allow insurance coverage to a number of individuals hailing from low socioeconomic families.
Such individuals comprise of the majority of patient admissions in the hospital’s burn and trauma
care departments. Hence, the ACA policy beneficially effect the burn and trauma organizational
department of the chosen hospital (Scott et al., 2018).
Identification of key Organizational Stakeholders
As observed from the above, the key organizational stakeholders whose duties will be
affected greatly upon administration of the ACA’s expansion of Medicaid, will include
healthcare staff employed in the burn and trauma centers as well as those involved in the
hospital’s community program of ‘violence prevention’. The ACA necessitates the conductance
of community healthcare assessments and programs for the purpose of ensuring positive health
outcomes in the public. Hence, the healthcare staff employed in the chosen hospital’s healthcare
program will be required to implement robust changes to further enhance the public reach of the
program in order to prevent penalties (Hertel-Fernandez, Skocpol& Lynch, 2016). The ACA’s
Medicaid expansion resulting in greater insurance coverage may enhance the flow of patients

5ANALYSIS OF HEALTHCARE POLICY
belonging to low income groups in burn and trauma care departments as mentioned above, hence
necessitating the need to enhance the workforce and medical equipment employed in the
concerned departments (Wright et al., 2016).
Consideration of Community Impact
The healthcare policy of ACA is expected to result in increased activities of the chosen
organization’s community program. Hence, this will aid in greater expansion resulting in greater
community treatment where individuals enrolling for the program will benefit by gaining
awareness on healthcare and social issues pertaining to violence and abuse. Further, Medicaid
expansion will allow greater accessibility to healthcare services provided by the hospital, among
individuals residing in low income groups. Hence, the ACA’s policy and Medicaid expansion
will encourage greater dissemination and accessibility of community and institutionalized
healthcare services by the hospital resulting in positive health outcomes in the community
(Mazurenko et al., 2017).
Expected Impact on Organizational Outcomes
As per the above, the healthcare policy Medicaid expansion under ACA will necessitate
increased administration of community health programs by the chosen hospital, which may
further compel the hospital to recruit increased staff for the dissemination of the same (Luthra.,
2017). Hence, greater workforce delegation towards community development may be a key
organizational outcome of the same (Callaghan & Jacobs, 2016). Further, the Medicaid
expansion under ACA will further increased patient flow which may compel hospitals to
reallocate their onsite healthcare staff for management of the same – which is successful, may
result in organizational outcomes of greater profits and consumer satisfaction. Further, reduction

6ANALYSIS OF HEALTHCARE POLICY
of the burden of uncompensated costs will lead to additional organizational outcomes of
increased outcomes in the chosen hospital (Anderson et al., 2016).
Conclusion
It can hence be observed that the ACA’s Medicaid expansion will require the selected
healthcare organization to increase their efforts towards community development. The ACA’s
healthcare policy may also increase patient eligibility and admissions to trauma care departments
hence necessitating increase staff efforts to ensure positive health outcomes. Hence, it can be
concluded that the ACA’s Medicaid expansion will result in greater profits, increased patient
flow, increased staff functioning and positive consumer satisfaction in the chosen local hospital.

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References
Anderson, M. E., Glasheen, J. J., Anoff, D., Pierce, R., Lane, M., & Jones, C. D. (2016). Impact
of state medicaid expansion status on length of stay and in‐hospital mortality for general
medicine patients at US academic medical centers. Journal of hospital medicine, 11(12),
847-852.
Callaghan, T., & Jacobs, L. R. (2016). Interest group conflict over medicaid expansion: the
surprising impact of public advocates. American journal of public health, 106(2), 308-
313.
Dranove, D., Gartwaite, C., &Ody, C. (2017). The Impact of the ACA's Medicaid Expansion on
Hospitals' Uncompensated Care Burden and the Potential Effects of Repeal. Issue brief
(Commonwealth Fund), 12, 1-9.
Hertel-Fernandez, A., Skocpol, T., & Lynch, D. (2016). Business associations, conservative
networks, and the ongoing republican war over Medicaid expansion. Journal of health
politics, policy and law, 41(2), 239-286.
Luthra, S. (2017). The Affordable Care Act pushed nonprofit hospitals to do good beyond their
walls. Now what? | FierceHealthcare. [online] Fiercehealthcare.com. Available at:
https://www.fiercehealthcare.com/population-health/aca-pushed-nonprofit-hospitals-to-
do-good-beyond-their-walls-now-what [Accessed 15 Jan. 2019].
Mazurenko, O., Balio, C. P., Agarwal, R., Carroll, A. E., &Menachemi, N. (2018). The Effects
Of Medicaid Expansion Under The ACA: A Systematic Review. Health Affairs, 37(6),
944-950.

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Scott, J. W., Neiman, P. U., Uribe-Leitz, T., Scott, K. W., Zogg, C. K., Salim, A., &Haider, A.
(2018). Impact of ACA-related Insurance Expansion Policies on Mortality and Access to
Post-Discharge Care for Trauma Patients: An Analysis of the National Trauma Data
Bank. The journal of trauma and acute care surgery.
Sen, A. P., &DeLeire, T. (2018). How does expansion of public health insurance affect risk pools
and premiums in the market for private health insurance? Evidence from Medicaid and
the Affordable Care Act Marketplaces. Health economics, 27(12), 1877-1903.
Sommers, B. D., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2016). Changes in utilization and
health among low-income adults after Medicaid expansion or expanded private
insurance. JAMA internal medicine, 176(10), 1501-1509.
Wright, B. J., Conlin, A. K., Allen, H. L., Tsui, J., Carlson, M. J., & Li, H. F. (2016). What does
Medicaid expansion mean for cancer screening and prevention? Results from a
randomized trial on the impacts of acquiring Medicaid coverage. Cancer, 122(5), 791-
797.