ABSTRACT
Transforming healthcare and healthcare organizations has been ongoing since the 1960s. Challenges in enforcing the Affordable Care Act (ACA), the children’s health insurance programs program, the initiative for Medicaid-Medicare taxes, and the creation of the Accountability Care Organization, and now the repealing of the ACA, have kept legislators and the public very busy. In 1980, federal legislation abolished physicians’ restrictions to accept health maintenance organization (HMO), and HMO became widespread across the country. The first thing that needs to be considered is that healthcare organizations must have quality and patient care in mind at all times. The first healthcare insurance in the United States was established by Justin Kimbal under the board of trustees of the University of Texas, in creating the Blue Cross in 1930. Under the capitation payment system, the healthcare provider receives a fixed amount per patient, per month to provide specific services, often for consultation of patient and outpatient services offered.
