Impacts of Medicaid, Medicare, and the ACA on SDOH and Health Disparities

Benefiting the Community and Those in Need
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Benefiting the Community and Those in Need
Introduction
The Affordable Care Act (ACA) recognizes the discrepancies in determinants of health and health care disparities within the United States (US) healthcare system. The most important goals of the ACA included reducing the number of uninsured populations and making healthcare services accessible for all Americans. Healthcare disparities are the differences in variables such as insurance coverage, access, and the quality of healthcare services delivered. Healthcare disparities happen when a given demographic group experiences higher costs and burdens of illnesses, injury, mortality, or disability than another group. This paper discusses the impact of organizational health policies on the social determinants of health (SDOH) and health disparities based on federal health care financing policies such as Medicaid, Medicare, and the ACA.
The Impact of Medicaid, Medicare, and the ACA on SDOH and Health Disparities
SDOH comprises contexts within which individuals are born, grow up, work, and age. The SDOH impacting different population groups are educational levels, socio-economic level, physical surroundings or neighborhood, social support systems, employment, and access to medical services (Longest, 2016). In 2016, the ACA established the Center for Medicare and Medicaid Innovation (CMMI), announcing an innovative “Accountable Health Communities” framework that emphasized linking Medicaid and Medicare recipients with community care services and addressing social needs affecting health care. Within this framework, the federal government provides financing to examine whether systematically pointing out and addressing social needs impacting health outcomes of Medicaid and Medicare recipients via diagnostics, community navigation, and referral services would impact medical care costs and lower outpatient and inpatient utilization. This initiative reflects funding and demonstration authorities offered via Obamacare to address SDOH as well as improve healthcare quality (Longest, 2016). It also reflects a system-wide shift towards “whole-person” care delivery and integration, which is inclined to meet patients’ social, psychological, and physical needs, and drive the transformation to reimbursement based on quality, value, and treatment outcomes (Campbell & Shore-Sheppard, 2020).
Organizational health policies recognize that the poor receive their care differently. The poor are susceptible to receiving a patchwork of services, provided mainly by public hospitals, local health departments, and clinics, rather than well-coordinated continuing, as well as comprehensive care. Adversarial economic, social, and cultural circumstances disproportionately impact Native Americans, African Americans, Latinos, and Asian immigrants, thus creating a barrier between these populations and the health care system (Longest, 2016). Organizational health policies centered on ACA improve the health of the populations as mentioned above by safeguarding them from financial ramifications of deteriorated health outcomes. The ...