Tips from our featured course
Case Managers: Discharge Planners
Discharge planners need to be aware of expanding opportunities to gain Medicaid coverage and will have to work harder and become more creative to locate funding for necessary services and durable medical equipment (DME) that uninsured patients need upon discharge.
While it used to be that having a job equated to having health care coverage, more than 65% of the individuals without coverage were employed workers and their families.
[Discharge Planning, Module A, Core Elements]
Looking Back: The Affordable Care Act (ACA) and the Uninsured
- Offers many opportunities for almost all Americans to have health insurance coverage
- Eliminates "preexisting medical conditions" as an obstacle to health insurance access
Despite several reforms, there are still numerous limitations and challenges:
- More than 26 million Americans remain uninsured in 2016
- Those who can purchase insurance may still have a high deductible
- Many hospitals with limited resources are competing in a new marketplace, yet still caring for the uninsured
The ACA provides important opportunities to redirect and improve healthcare services. With a focus on options available, the ACA assists CMs in the implementation of a methodical assessment process.
[Utilization Management, Module E, Key Quality Measures]