Historical developments in health care delivery and ✓ Solved

Historical developments in health care delivery and value-based care [Video]. Walden University Canvas. 2 Week 1 Discussion - Delivery of Healthcare Student’s First Name, Middle Initial(s), Last Name Institution Affiliation Course Name and Number Instructor’s Name and Title Assignment Due Date Week 1 Discussion - Delivery of Healthcare The Social Security Amendments of 1965, which established Medicare and Medicaid, dealt with the economic vulnerability of the aged and low-income groups who were not insured and hospitals that were not compensated, and lacked quality supervision. Prior to the enactment of the Patient Protection and Affordable Care Act of 2010, the uninsured working-age adults had issues with prematurely rising premiums, elimination of existing conditions, and inability to obtain routine primary care, which raised questions of inefficiency in cost and access (Ercia, 2021).

The discontent with the fee-for-service payment system and the Sustainable Growth Rate formula at the time predetermined the introduction of the Medicare Access and CHIP Reauthorization Act in 2015, when policymakers aimed to reduce the pace of spending and base payments on performance. All of these laws contributed to the promotion of value-based delivery, which was linked to requirements of efficient and high-quality care, which were tied to federal financing. This trend was increased by the Affordable Care Act by covering more and adding incentives, including accountable care organizations and hospital readmission fines, which tie payment to quality and cost performance (Ercia, 2021). MACRA expanded upon this base with the Quality Payment Program, which directs clinicians to either merit-based incentives or alternative payment models where better outcomes happen instead of volume in service received and relies upon performance metrics obtained via electronic health records (Anzalone et al., 2025).

These changes transformed the policy of paying visits individually to paying for population health and coordinated care. Medicare and Medicaid led to more coverage of older adults and low-income groups after their implementation and became national costs, which boosted interest in value-based strategies. The Affordable Care Act evidence shows that insurance coverage has increased, more people use primary and preventive services, and more people can now afford insurance despite some still having high deductibles or living in states that have not expanded Medicaid (Ercia, 2021). Initial reviews of MACRA have reported quality reporting improvements and involvement in alternative payment models, as well as administrative load-bearing and disparate preparedness in small practices (Anzalone et al., 2025).

These acts transformed delivery into financial incentives and punishments that promote equity in access, results, and cost stewardship by organizations. References Anzalone, A. J., Geary, C. R., Dai, R., Watanabe-Galloway, S., McClay, J. C., & Campbell, J.

R. (2025). Lower electronic health record adoption and interoperability in rural versus urban physician participants: a cross-sectional analysis from the CMS quality payment program. BMC Health Services Research , 25 (1), 128. Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California, and Texas.

BMC Health Services Research , 21 (1), 920. Week 1 Learning Resources Financial Management Overview As a leader, you may need to take part in decisions regarding the long-term vision of your organization, including investment decisions. Through financial management, you can be better equipped with the data to support this vision. A company’s leadership will use financial management concepts to address questions such as, “Where should we invest our money and resources?†Using these resources, you will explore an overview of financial management and how to find financial information for a corporation. · Brigham E. F., & Houston, J.

F. (2022). An overview of financial management. In Fundamentals of financial management (16th ed., pp. 2–21). Cengage Learning. · The Duomo Initiative. (2020, May 28).

How to read company financial statements (basics explained)Links to an external site. [Video]. YouTube. · Learn to Invest. (2020, September 12). How to read an annual report - 10k for beginners Links to an external site. [Video]. YouTube. · Merrill Lynch. (2003). The Merrill Lynch guide to understanding financial reports Links to an external site. . · Walden University, LLC. (2014–2021).

The main roles of the financial management department [Video]. Walden University Canvas. The Role of Financial Management in Promoting a Company’s Success Financial management is the art and science of managing an organization’s money so that the organization can meet its goals. It is a way to track how money is flowing into and out of the organization by working with all department managers to determine how available funds will be used, how much money will be needed, and what the best sources are to obtain the required funding. Through these resources, you will examine how financial management is used within organizations to promote their success. · Allegretti, S., Seidenstricker, S., & Kasseckert, A. (2018).

Factors for success in business model innovationLinks to an external site. . Journal of Strategic Innovation and Sustainability , 13 (5), 10–42. · Guliyeva, L. (2020). The influence of financial accounting and reporting on the management of a business organization and a case studyLinks to an external site. . Scholedge International Journal of Management & Development , 7 (9), 136–143. · Sharma, A. (2019). The influence of financial literacy on the performance of small and medium-scale enterprisesLinks to an external site. .

IUP Journal of Accounting Research & Audit Practices , 18 (2), 52–61. Time Estimate: 14 minutes · SME Strategy Consulting. (2021, April 16). Four core decisions for strategic CEOs to improve financial management & grow their profitability Links to an external site. [Video]. YouTube. Increasing International Shareholder Value As businesses continue to compete in an ever-increasing global economy, companies based in the United States will continue to search for opportunities in other countries in terms of sales and profits.

Managers today should have a solid understanding of multinational companies and what it means to operate as one, especially considering the inherent risks associated with them. Through these resources, you will explore how financial management principles apply to multinational operations within an organization. · Brigham E. F., & Houston, J. F. (2022). Multinational financial management.

In Fundamentals of financial management (16th ed., pp. 625–656). Cengage Learning. 2 Week 1 Discussion- Managerial Finance Student’s First Name, Middle Initial(s), Last Name Institution Affiliation Course Name and Number Instructor’s Name and Title Assignment Due Date Week 1 Discussion- Managerial Finance Ford Motor Company is a US-based automotive manufacturing company based in the United States of America, with its headquarters in Dearborn, Michigan. The company develops and produces vehicles in the form of cars, trucks, and sport utility vehicles.

This corporation has assembly facilities, a captive finance organization, and a dealer network that serves both retail and business clients. Ford has recently focused more and more investments on electric cars, and it is highly dependent on extremely profitable lines of trucks, which is why it makes it an attractive object to research financial management and organizational culture. Ford has sound financial management practices, especially in capital planning and liquidity control. Management makes use of capital budgeting to accept new vehicle programs, whereby cash flow forecasts can be applied to test assumptions prior to capital investment. These decisions should be constantly controlled and evaluated.

This liquidity focus is confirmed by the fact that the United States construction companies have proved that controlling the working capital and focusing on the cash conversion cycle leads to profitability growth (Esfahani et al., 2025). Ford also has diversified funding to reduce the refinancing risk and operations. These financial practices are encouraged in the culture of Ford, which focuses on transparency, disciplined decisions, and accountability. Top managers discuss financial goals and require managers to have business cases to support proposals. The experience of United States companies indicates that the application of strong corporate cultures characterized by integrity and teamwork is linked to financing decisions that minimise agency issues and enhance the quality of credit (Datta et al., 2024).

This culture will help managers perceive financial limitations as mutual guardrails, which will help strengthen sound management of capital throughout the company. Such financial management practices have indeed contributed significantly to the general success of Ford, especially in dealing with industry shocks and financing strategic changes. In the case of the recent disruption of the supply chain, conservative liquidity levels and elastic credit facilities enabled Ford to continue manufacturing its most profitable lines of trucks, as some of its competitors were forced to either close for extended periods. This has been assisted by the structured capital planning that the company undertook in its electric vehicle investment program, which drew in partners and incentives, supported its balance sheet, and made Ford a respectable long-term player in the drive towards cleaner transportation.

References Datta, S., Doan, T., & Toscano, F. (2024). Does firm culture influence corporate financing decisions? Evidence from debt maturity choice. Journal of Banking & Finance , 169 , 107310. Esfahani, M.

H., Killingsworth, J., Harper, C. M., & Schaller, Z. (2025). The relationship between working capital management and corporate profitability for US construction companies. Journal of Financial Management of Property and Construction .

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Full 1500-Word Essay on Historical Developments in Health Care Delivery and Value-Based Care

The evolution of health care delivery in the United States is the result of decades of legislative reform, shifting financial priorities, and growing recognition of systemic inefficiencies within traditional fee-for-service models. From the introduction of Medicare and Medicaid in 1965 to the transformative Affordable Care Act (ACA) in 2010 and the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, each major milestone has contributed to a transition toward value-based care. This approach emphasizes efficiency, quality, accountability, and better patient outcomes. Understanding these historical developments is essential for healthcare leaders, policymakers, and clinicians seeking to navigate modern financial models and population health initiatives.

Historical Context: Medicare and Medicaid

The Social Security Amendments of 1965 represent the beginning of large-scale federal involvement in healthcare delivery. Prior to this legislation, older adults and low-income individuals lacked access to insurance coverage, hospitals operated without standardized reimbursement processes, and quality oversight systems were limited. Medicare and Medicaid addressed these deficiencies by providing coverage to the elderly and economically disadvantaged populations. These programs not only filled insurance gaps but also catalyzed greater accountability in the health system. Yet they also dramatically increased federal expenditures and became long-term drivers for health policy reform.

Fee-for-Service Limitations and the Need for Reform

By the late 20th century, rising healthcare costs and the inefficiencies of fee-for-service reimbursement models prompted policymakers to consider alternative systems. Fee-for-service encourages volume of care rather than quality, leading to unnecessary procedures, fragmented care, and poor health outcomes. As insured populations expanded under Medicare and Medicaid, concerns surrounding sustainability intensified. Attempts to control spending—such as the implementation of prospective payment systems and managed care—only partially addressed these issues.

Additionally, the Sustainable Growth Rate (SGR) formula introduced in 1997 attempted to cap physician spending but proved ineffective. For years, Congress passed temporary “doc fix” solutions to avoid steep reimbursement cuts. These challenges set the stage for comprehensive reform efforts that addressed not only cost but also quality and access.

The Affordable Care Act (ACA): Expanding Access and Improving Quality

The Patient Protection and Affordable Care Act of 2010 marked a watershed moment in healthcare delivery. As Ercia (2021) describes, uninsured working-age adults prior to the ACA faced rising premiums, denial of coverage based on preexisting conditions, and limited access to primary care. These conditions led to worsening chronic illnesses, delayed interventions, and high preventable mortality rates. The ACA responded by expanding Medicaid eligibility in participating states, creating health insurance marketplaces, prohibiting preexisting condition exclusions, and offering subsidies to increase affordability.

In addition to expanding coverage, the ACA introduced a number of value-based reforms. Accountable Care Organizations (ACOs), hospital readmission penalties, and bundled payment models incentivized hospitals and clinicians to prioritize cost efficiency and quality outcomes rather than service volume. These initiatives began shifting healthcare organizations toward team-based, coordinated, and population-focused care. For the first time, reimbursement was tied directly to measurable outcomes, promoting transparency and performance-driven decision-making.

MACRA and the Quality Payment Program (QPP)

The Medicare Access and CHIP Reauthorization Act of 2015 further accelerated the value-based movement. Dissatisfaction with the SGR formula, as well as ongoing cost concerns, prompted policymakers to redesign physician reimbursement models. MACRA established the Quality Payment Program (QPP), which introduced two pathways: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Both pathways aim to reward clinicians for high-quality, cost-efficient care and penalize poor performance.

MACRA also emphasized the use of electronic health records (EHRs) and interoperability. Anzalone et al. (2025) found that rural clinicians remain less likely to adopt robust EHR systems, highlighting disparities in digital infrastructure and reporting readiness. Despite challenges, MACRA strengthened accountability, encouraged participation in alternative models, and promoted the use of technology to drive quality improvement.

Value-Based Care and Its Impact on Health Care Delivery

The cumulative effect of these laws has been a profound shift in healthcare delivery. Value-based care aims to create a system where incentives align with improved health outcomes, reduced disparities, and better resource stewardship. Instead of paying for each visit or procedure separately, value-based models focus on entire populations, care coordination, preventive interventions, and measurable improvements in health.

The ACA’s success in expanding coverage has increased the number of Americans using primary and preventive care services. This has contributed to earlier detection of chronic conditions and reduced reliance on emergency departments for non-emergent issues. Research indicates that insurance coverage under the ACA has disproportionately benefited marginalized communities, improving access for groups historically excluded from the healthcare system.

MACRA further refined value-based initiatives by incentivizing clinicians to submit quality measures, adopt interoperable EHRs, and participate in APMs that prioritize coordination, prevention, and patient engagement. These changes represent a departure from fragmented care toward integrated systems capable of responding to the health needs of diverse populations.

Role of Financial Management in Modern Healthcare

Financial management plays a central role in supporting the transition to value-based care. According to Brigham and Houston (2022), financial management involves monitoring financial inflows and outflows, evaluating investment decisions, and determining the best methods to allocate resources. In healthcare, this requires integrating clinical outcomes with cost analytics, forecasting financial risks, and developing long-term strategic plans.

Healthcare organizations increasingly depend on financial managers to assess the return on investment (ROI) for new technologies, population health initiatives, and care coordination programs. Effective financial management ensures that value-based models remain sustainable, particularly as reimbursement shifts from volume to performance metrics. Organizations must invest in care teams, patient-centered technologies, data analytics, and quality reporting systems to remain competitive.

Managerial Finance: Lessons from Corporate Practice

Lessons from corporate finance can also inform healthcare settings. Ford Motor Company, for example, demonstrates how strong financial management supports long-term organizational resilience. As described in the managerial finance discussion, Ford’s strategies—such as capital budgeting, diversified funding, and liquidity control—mirror essential practices used in modern healthcare systems. Esfahani et al. (2025) show that managing working capital effectively improves profitability, while Datta et al. (2024) emphasize that strong organizational culture promotes ethical financial decision-making and minimizes risk.

Conclusion

Historical developments in U.S. healthcare—including Medicare, Medicaid, the ACA, and MACRA—have shaped today’s emphasis on value-based care. These policies expanded coverage, improved access, promoted transparency, and implemented financial incentives linked to outcomes. Value-based care has transformed the healthcare landscape by prioritizing prevention, care coordination, and measurable improvements in quality. Financial management plays an essential role in this transformation, helping organizations navigate complex reimbursement models and invest strategically in patient-centered initiatives. As healthcare continues to evolve, the integration of policy, financial strategy, and clinical innovation will be vital for promoting equitable, high-quality, and cost-effective care.

References

1. Anzalone, A. J., Geary, C. R., Dai, R., Watanabe-Galloway, S., McClay, J. C., & Campbell, J. R. (2025). Lower electronic health record adoption and interoperability in rural versus urban physician participants. BMC Health Services Research.
2. Brigham, E. F., & Houston, J. F. (2022). Fundamentals of Financial Management. Cengage Learning.
3. Datta, S., Doan, T., & Toscano, F. (2024). Does firm culture influence corporate financing decisions? Journal of Banking & Finance.
4. Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care. BMC Health Services Research.
5. Esfahani, M. H., Killingsworth, J., Harper, C. M., & Schaller, Z. (2025). Working capital management and corporate profitability. Journal of Financial Management of Property and Construction.
6. Allegretti, S., Seidenstricker, S., & Kasseckert, A. (2018). Business model innovation success factors. Journal of Strategic Innovation and Sustainability.
7. Guliyeva, L. (2020). Financial accounting and management decisions. Scholedge International Journal.
8. Sharma, A. (2019). Financial literacy and SME performance. IUP Journal of Accounting Research.
9. Walden University. (2014–2021). Financial management overview videos.
10. The Duomo Initiative. (2020). Understanding financial statements. YouTube.