The United States - The Patient Protection and Affordable Care Act (ACA) of 2010 established “shared responsibility” between the government, employers, and individuals for ensuring that all Americans have access to affordable and quality health insurance. However, health insurance coverage remains fragmented, with numerous private and public sources as well as wide gaps in coverage rates across the U.S. population. The Centers for Medicare and Medicaid Services (CMS) administers the Medicare program (a federal program for those age 65 and older and the disabled, including those with end-stage renal disease) and works in partnership with state governments to administer Medicaid and the Children’s Health Insurance Program (a conglomeration of
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In 2014, state- and federally administered health insurance marketplaces were established to provide additional access to private insurance coverage, with income-based premium subsidies for low- and middle-income families, and federally subsidized expansion of Medicaid eligibility was made available in states choosing to participate. While it is too early to measure the impact of all of the various components of the ACA, studies already have found evidence that the number of uninsured adults has declined by about 9.5 million from July–September 2013 to April–June 2014 (Collins, Rasmussen, and Doty, 2014). Early evaluations of Medicare ACOs have also found promising results with regard to quality improvement and savings (CMS, 2014b). As of January 2015, Medicare will pay for doctors to coordinate the care of patients with chronic conditions. To be eligible for an extra $42 per patient, doctors will have to draft and help carry out a comprehensive plan of care for each patient who signs up for one. Under federal rules, those patients will have access to doctors or other health care providers on a doctor’s staff 24 hours a day and seven days a week to deal with “urgent chronic care …show more content…
Many provinces and territories have established regional health authorities that plan and deliver publicly funded services locally. Generally, these authorities are responsible for the funding and delivery of hospital, community, and long-term care, and mental and public health services. Health care providers are almost entirely private. Federal government co finances provincial and territorial programs, with conditions on adherence to the five underlying principles of the Canada Health Act, the law that sets pan Canadian standards for medically necessary hospital, diagnostic, and physician services. Principles state that each provincial health care insurance plan needs to be: publicly administered, comprehensive in coverage, universal, portable across provinces, and accessible (meaning that there are no user fees). Federal government also regulates the safety and efficacy of medical devices, pharmaceuticals, and natural health products; funds health research; and administers several public health functions. At the national level, several intergovernmental nonprofit organizations (which included the Health Council of Canada, closed in 2014) aim to improve governance by monitoring and reporting on health system performance; disseminating best practice in patient safety (the Canadian Patient Safety Institute); providing information
In 2014, state- and federally administered health insurance marketplaces were established to provide additional access to private insurance coverage, with income-based premium subsidies for low- and middle-income families, and federally subsidized expansion of Medicaid eligibility was made available in states choosing to participate. While it is too early to measure the impact of all of the various components of the ACA, studies already have found evidence that the number of uninsured adults has declined by about 9.5 million from July–September 2013 to April–June 2014 (Collins, Rasmussen, and Doty, 2014). Early evaluations of Medicare ACOs have also found promising results with regard to quality improvement and savings (CMS, 2014b). As of January 2015, Medicare will pay for doctors to coordinate the care of patients with chronic conditions. To be eligible for an extra $42 per patient, doctors will have to draft and help carry out a comprehensive plan of care for each patient who signs up for one. Under federal rules, those patients will have access to doctors or other health care providers on a doctor’s staff 24 hours a day and seven days a week to deal with “urgent chronic care …show more content…
Many provinces and territories have established regional health authorities that plan and deliver publicly funded services locally. Generally, these authorities are responsible for the funding and delivery of hospital, community, and long-term care, and mental and public health services. Health care providers are almost entirely private. Federal government co finances provincial and territorial programs, with conditions on adherence to the five underlying principles of the Canada Health Act, the law that sets pan Canadian standards for medically necessary hospital, diagnostic, and physician services. Principles state that each provincial health care insurance plan needs to be: publicly administered, comprehensive in coverage, universal, portable across provinces, and accessible (meaning that there are no user fees). Federal government also regulates the safety and efficacy of medical devices, pharmaceuticals, and natural health products; funds health research; and administers several public health functions. At the national level, several intergovernmental nonprofit organizations (which included the Health Council of Canada, closed in 2014) aim to improve governance by monitoring and reporting on health system performance; disseminating best practice in patient safety (the Canadian Patient Safety Institute); providing information