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The Affordable Care Act and The Retirement Community

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seniors looking over affordable care act

The Affordable Care Act (ACA) has been getting plenty of coverage in the news recently and has been subject of many a story passed around online. And not just because the new legislation was set to go into full effect at the beginning of October.

Turmoil and uncertainty surrounds the ACA and the healthcare exchanges it established.

With all of the conflicting opinions about the new healthcare law, it isn’t any surprise that many seniors are uncertain of how or if their doctor’s visits, hospital stays, and other healthcare expenses will be covered.

Is the Affordable Care Act going to change how I get healthcare?

Not in the sense that the medical professionals that you have become comfortable with will be replaced. You certainly won’t be losing the senior care team who knows your medical history and has walked with you through care and recovery.

The changes that will be brought to the senior healthcare industry will actually be in your favor. That’s all thanks to one of the lesser known facts about the ACA—the full title of the new legislation is actually the Patient Protection and Affordable Care Act. And, included in the reforms, are provisions that seek to better the quality of care that patients receive.

We spoke once before about how the Affordable Care Act is changing the patient-provider paradigm.

“In the past, healthcare has typically been provided on a ‘fee-for-service’ model where older adults (and all other healthcare consumers) paid for any service or treatment rendered— regardless of quality and effectiveness.

The changes to the healthcare landscape will bring a transition to value-based payments. Providers will be forced to step up the quality of their senior care as remittance of payment will now hinge on the outcomes of patient care. Basically, senior healthcare providers will be paid more if their treatments prove to be effective for their patients and less if they don’t work.”

You’ll still have access to the same kinds of care as you did before Affordable Care—but the new legislation gives hospitals and doctors an incentive to provide an even better level of healthcare.

You don’t even have to give up your primary care physician.

Will the Affordable Care Act change my insurance?

Yes, but not how you may think.

The ACA will not replace any insurance program you are already enrolled in—whether you have Medicare, Medicare Advantage, or private insurance— but you’ll probably start to see a number of new perks available with your current coverage.

That’s because the Affordable Care Act will actually extend Medicare benefits.

With the new reforms, Medicare will expand the kinds of care you have access to, covering more preventive care services, like mammograms and colonoscopies, and helping you save money on prescriptions.

However, one area where you won’t see much change is in long term care. Medicare coverage still maxes out at 100 days, so you’ll still need your nursing home insurance if you want coverage for an extended stay at or permanent move to a skilled nursing care home. But, as we’ve said before, there’s good news here, too.

“In furthering this goal of lower readmission rates, hospitals have begun working more closely with skilled nursing facilities and rehabilitation centers like the Deupree Cottages [or Lee Gardens] to provide post-acute care that helps older adults make a safe and healthy transition home after a hospital stay.

We’re working with clinical staff at local hospitals to establish standardized protocols that help the whole senior care system better serve older adults from initial hospital stay to discharge into post-acute care and even the home of the senior.”

The expansion of preventative care included as part of Medicare benefits is encouraging care providers into better cooperation, so retirement communities are starting to take a more central role in senior healthcare.


Image credit: stylephotographs / 123RF Stock Photo
Bryan Reynolds
October 29, 2013
Bryan Reynolds is the Vice President of Marketing and Public Relations for Episcopal Retirement Services (ERS). Bryan is responsible for developing and implementing ERS' digital marketing strategy, and overseeing the website, social media outlets, audio and video content and online advertising. After originally attending The Ohio State University, he graduated from the College-Conservatory of Music at the University of Cincinnati, where he earned a Bachelor of fine arts focused on electronic media. Bryan loves to share his passion for technology by assisting older adults with their computer and mobile devices. He has taught several classes within ERS communities as well as at the Osher Lifelong Learning Institute run by the University of Cincinnati. He also participates on the Technology Team at ERS to help provide direction. Bryan and his wife Krista currently reside in Lebanon, Ohio with their 5 children.

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