Submitted on Tue, 2013-06-04
By SMART Health Claims

Passed all the way back in March of 2010, the Patient Protection and Affordable Care Act is ready to begin having a large impact on local health departments.

affordable care act and local health departments

The controversial healthcare reform bill sees many of its key insurance mandates become mandatory January 2014; and local health departments need to be prepared for the new questions that will arise from the bill.

First though, what is the Affordable Care Act and why is healthcare reform in general important for the future health of our nation? At its core, the Affordable Care Act is aiming to improve the health of America’s individual citizens and the population as a whole, all while driving down per-capita healthcare costs. This is necessary because of six major problems facing our current healthcare system:

 

  • High Rate of Uninsured Citizens - The rate of uninsured Americans under 65 years old currently sits around 20% and rising. With the Affordable Care Act, this number is anticipated to drop to 9% by 2016. 
     
  • System Focuses on Treatment and Not Prevention -  An estimated 70% of deaths in the U.S. are from preventable diseases (obesity, heart disease, etc.). 75% of money spent on healthcare in the US goes towards treating those diseases, but only $0.03 of each of those dollars goes towards prevention.
     
  • Unsustainable Healthcare Spending in the U.S. - Healthcare spending in 2010 was at 18% of the total U.S. GDP. That number is anticipated to rise to 20% by 2020 if there is no reform.
     
  • Health Disparities Between Demographics - Minorities and the poor have undeniable disparities in preventable diseases from the population as a whole.
     
  • Low-ranking U.S. Health Outcomes - The U.S. spends the most on healthcare of any country by a huge amount, but only has the 24th highest life expectancy.
     
  • Inefficient Delivery and Payment Systems - There are many inefficiencies in the current healthcare payment cycle and some local health departments do not bill for everything they could.

The Affordable Healthcare Act attempts to tackle all six of these issues to help ensure a healthier tomorrow for the U.S. by placing a stronger emphasis on public health.

The biggest impact of healthcare reform on local health departments will come as a result of making sure more of the population is insured. There are a number of questions that will arise for local health departments as the rate of those without insurance drops.

  • How will their role as a “navigator” in their communities be impacted? Will local health departments still be seen as the medical process expert for those that previously were uninsured?
     
  • Will the previously uninsured consumers return for their services once more options are open to them?
     
  • If these consumers continue to come back for their services, will the local health departments be billing their insurance provider? (Short Answer: They Better Be!)
     
  • If the number of people coming to the health departments drops, how will that impact staff? Is it going to lead to layoffs, or can the staff be reutilized in roles that are more research-orientated and benefit the entire community.
     
  • What about those that are still uninsured? How will health departments continue to provide services to them while also focusing on the community as a whole?

There is one more key part of the Affordable care Act that will prove to have a major impact on local health departments: the Public Health Prevention Fund. While insurance reform focuses on the health of America’s citizens, the Prevention Fund focuses on improving the infrastructure of the healthcare system. Mandatory public health funding will lead to faster, cheaper, and more efficient services. Local health departments just need to have the technology and billing systems in place to keep up with the changes.

Check back over the coming weeks as we dig deeper into the Affordable Care Act’s impact on local health departments through insurance reform and the Public Health Prevention Fund.