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The Patient Protection and Affordable Care Act (ACA) contains several provisions that address access to community based services for the 4.5 million people in the U.S. with intellectual and developmental disabilities (I/DD). Many of these provisions are aimed at balancing the array of services between those offered in institutions and those in the community.
Despite slower health care spending growth over the last few years, long-term forecasts for overall health spending – and for public programs like Medicare – signal continuing concern. The idea behind numerous recent proposals is to find lasting solutions, and some areas of consensus are beginning to emerge.
Increasingly, hospitals are “observing,” instead of admitting, Medicare beneficiaries, even when they are there for more than 48 hours.
Health insurance marketplaces, or exchanges, opened October 1, and while states have released some enrollment data, and much of the attention has been on the initial technical challenges, there has been less information about overall consumer experience.
Many employers have begun to adopt a strategy known as “reference pricing” to help reduce health care costs. Under this benefit design, employees get insurance plans that set price caps on certain services and procedures. Enrollees are allowed to use any provider. But if they use providers with fees higher than the “reference price,” they must pay the difference between the reference price limit, determined by the employer or insurer, and the actual charge.
Health care policy leaders are counting on public and private initiatives, such as paying for performance, to improve value in the health care equation in which cost and quality at times seem to be at odds.
More than a third of Pioneer ACOs succeeded in reducing costs in Medicare in their first year, according to a recent Centers for Medicare and Medicaid Services (CMS) report. The program initially saved Medicare about $87 million and cut Medicare spending by 0.5 percent.
The Association of Health Care Journalists’ DC Chapter and the Alliance for Health Reform will hold a reporters’ roundtable, for reporters only, on Covering the ACA Marketplaces.
With millions of people projected to obtain health insurance coverage under the Patient Protection and Affordable Care Act (ACA), access to care is expected to be an issue. Efforts to promote telehealth and telemedicine could help.
Top congressional health care staff members will meet with reporters Wednesday, August 28 to discuss upcoming pressing health care policy topics.
Following the terrorist attacks of September 11, 2001 and the subsequent anthrax assaults, the federal government began to reevaluate the nation’s preparedness for public health emergencies. Since then, the nation has been hit by massive floods, hurricanes and other disasters, and last year Hurricane Sandy swept up the east coast, crippling several states and nearly exhausting emergency services. Despite the continued need for a strong emergency response infrastructure to combat natural disasters, reemerging diseases, pandemics and food-borne illnesses, state health department budgets have been shrinking.
This Alliance for Health Reform webinar gave you the latest on what insurance rates will look like when state insurance exchanges open for enrollment on October 1.
The Patient Protection and Affordable Care Act (ACA) sets October 1, 2013 as opening day for enrollment in health insurance plans through marketplaces, or exchanges. The law allowed states to choose between running their own exchanges or having the Department of Health and Human Services (HHS) run a federally facilitated exchange.
A new Alliance for Health Reform video features two former Medicare administrators — Gail Wilensky and Bruce Vladeck — on their ideas about how to save the program.
Sixty-two million Americans live in rural areas and they have higher rates of mortality, disability and chronic disease than their urban counterparts. With high poverty and unemployment rates, low rates of health insurance coverage and an undersupply of health care providers, the ills of the health care system are especially notable in rural communities. The Patient Protection and Affordable Care Act (ACA) contains provisions relating to access to care, coverage and delivery system reform. But the impact of these provisions is uncertain in rural America, with its unique challenges.
Recent proposals to combine the two main parts of Medicare would mean streamlining deductibles and other cost-sharing for beneficiaries. But health care policy experts are cautioning that such a change is complicated and requires analysis. A July 22 briefing explored the impact on beneficiaries.
The Alliance for Health Reform held a webinar that gave you the latest on a flurry of state legislation to allow nurses, nurse practitioners and other medical providers to do more to care for patients.
With a continued focus on the need to control the high and rising cost of care, Congress is looking for low cost, high yield policy solutions. Chronic illnesses are among the biggest drivers of growing health care costs, and a drain on worker productivity in our nation. For example, researchers note that per person health care spending for obese adults is 56 percent higher than for normal-weight adults. Diabetes and other chronic illnesses can be prevented or greatly delayed with solutions beyond or outside of medical care. Many fall into the category of health-related behaviors, such as whether we smoke, get exercise, eat a healthy diet– factors that are newly falling into the spheres of public health or population health.
Provisions of the 2010 health reform law, combined with mental health parity legislation, promise to make mental health care available to millions more Americans in 2014 through both private insurance and Medicaid. But, the sweeping changes that these laws make to financing for mental health care will require states, mental health providers, private insurers and patients to make major adjustments. As more people gain coverage, mental health experts fear that access to care could become an issue, and members of Congress already are introducing legislation to address this concern.
The Philadelphia chapter of the Association of Health Care Journalists and the Alliance for Health Reform on Tuesday, June 18 held a special event to explore the challenges that Pennsylvania and New Jersey face this year leading up to the 2014 health law changes. This year the giant health law begins to move into its most climactic phase. Tens of millions of people are about to get health insurance, and this meeting will help reporters understand the epic challenges ahead.
Big changes are coming to Medicare Advantage, through which 28 percent of Medicare beneficiaries now get coverage in such private health plans as HMOs and PPOs. A June 10 Alliance briefing looked at the program’s chances for survival and growth.
The federal government currently spends about 15 percent of its budget on Medicare, and the program faces substantial growth in beneficiaries as baby boomers continue to age into eligibility. A June 3 briefing, “Medicare for the 21st Century,” addressed the sustainability of Medicare under its current design.
Starting in 2014, employers will be allowed to charge their workers up to 30 percent more for health insurance premiums if they don’t meet certain health goals, under the Patient Protection and Affordable Care Act (ACA). An Alliance for Health Reform briefing, “Worker Wellness Programs: Do They Work?” explained the provisions in the law, and examined employer efforts to improve worker wellness, along with evidence about savings.
Over nine million Americans receive benefits from both Medicare and Medicaid costing over $315 billion in health care services in the two programs combined. The dual eligibles account for 15 percent of the Medicaid population and almost 40 percent of all Medicaid expenditures for medical services; and 20 percent of the enrollees in Medicare, but 30 percent of the expenditures.
The federal government has launched demonstration projects to test whether patient-centered medical homes (PCMHs) can tackle some of the biggest problems facing the nation’s health care system. Advocates are holding out hope that medical homes will help to slow the growth of health care spending while improving the quality of care. The medical home is a model that aims to transform the organization and delivery of primary care. The PCMH model focuses on personalized care, teamwork, and coordination of care to ensure that patient needs are met effectively and efficiently. The Patient Protection and Affordable Care Act (ACA) provides opportunities for the PCMH model by supporting nationwide medical home demonstration projects administered by the Center for Medicare and Medicaid Innovation (CMMI).
An April 26 briefing, ACA 101: What You Need to Know, was intended to be especially helpful to congressional staff members and others with limited knowledge of the Patient Protection and Affordable Care Act (ACA), but also to be a useful review for anyone dealing with the complex issues leading up to major changes scheduled to take effect in 2014.
The Patient Protection and Affordable Care Act (ACA) calls for increased consumer involvement in health care decision-making. Transparency in price and quality as a tool for consumer engagement is a critical component of that process. One does not buy food, clothing or housing without comparison shopping. Yet in health care, equally important and typically a large part of the family budget, consumers have not had the tools to compare prices and quality of the product they are buying. The data are spotty and the little data that are available are not consumer friendly.
The Patient Protection and Affordable Care Act (ACA) has the potential to greatly increase the number of insured people and change how health care services are delivered. What the additional coverage will mean regarding access to providers, who those providers will be and what services they will deliver are issues that affect all segments of the health care workforce.
Proposals to fix the Sustainable Growth Rate (SGR) abound and there is agreement that policy makers must take action, but the question of how to reach a permanent solution remains. The SGR originated as part of the Balanced Budget Act of 1997 to control federal Medicare spending. Congress began overriding the SGR in 2002 and has continued to delay scheduled physician reimbursement cuts ever since. Medicare physician payments were maintained at their current rates in 2012 as a result of The Middle Class Tax Relief and Job Creation Act of 2012. Most recently, Congress extended payment rates until January 2014 as part of the “fiscal cliff” negotiations.
A March 1 briefing, Medicaid 101: What You Need to Know, was especially helpful to congressional staff members and others new to the issue, but it was also a useful review for anyone dealing with Medicaid issues, particularly as many states prepare to expand their programs.
A February 11 briefing, Medicare 101: What You Need to Know, was especially helpful to congressional staff members and others new to the issue, but it also was a useful review for anyone dealing with Medicare issues, particularly as pressure intensifies to slow the growth of program spending.
Top congressional health care staff members will meet with reporters January 31 to discuss pressing health care policy topics in the year ahead.
Health spending in the U.S. climbed to $2.7 trillion and constituted 17.9 percent of the nation’s gross domestic product (GDP) in 2011. A recent report released by actuaries at the Centers for Medicare and Medicaid Services (CMS) found that health spending as a share of GDP remained steady at 17.9 percent from 2009 through 2011. Despite that stability, some analysts warn that, as the economy improves and the population ages, cost increases could again accelerate. Effects of cost constraining provisions in the Patient Protection and Affordable Care Act (PPACA) are largely unknown, since major provisions will not be implemented until 2014.
With Americans living longer, some policymakers are proposing to gradually raise Medicare’s eligibility age from age 65 to 67 as part of a broader package to reduce the federal debt. The later starting point is projected to reduce federal spending by $113 billion over the next decade, according to the Congressional Budget Office, which estimates that most people would gain insurance coverage through other sources.
We submitted our blueprint application to Federal Health and Human Services last month, in November, for the Partnership Exchange. That means that the federal government will be operating the exchange, they’ll be administering the bulk of the functions, the enrollment, the eligibility, the premium assistance. The state [Illinois], we have indicated that we want to retain some functions, particularly around the plan management.
Following the Supreme Court’s decision this summer on the Patient Protection and Affordable Care Act, the nation’s governors and state leaders face the choice to participate or opt out of the Medicaid expansion. Currently, twelve states have decided to participate in the expansion, seven states have decided to opt out, and the remaining states have yet to announce their participation status. As state officials move forward with selecting an approach, a November 30 briefing examined the economic impact of expanding Medicaid to 138 percent of the federal poverty level.
As Washington attempts to steer clear of the “fiscal cliff,” it is important that policymakers, stakeholders and the public have a clear understanding of the components of this key policy crossroads and the likely consequences of inaction – on everything from expiring tax cuts to debt ceiling increases to scheduled budget reductions. The goal of a Nov. 16 briefing was to foster that understanding.
Electronic devices are pervasive throughout our culture. Still, they are a relatively new phenomenon in the physician’s office, even though electronic health records (EHRs) can help consumers stay connected with their care managers, monitor their health, and get reminders that it’s time to take their medicine. They can also help to better coordinate care, avoid duplication of services and eliminate medication errors.
The Census Bureau announced today that the number of people without health insurance dropped from 50 million to 48.6 million in 2011, marking the first decrease since 2007. That information came from the Current Population Survey, but it isn’t the only data that Census is releasing on the uninsured.
There is widespread agreement that the current health care delivery system is fragmented. Your primary care physician may be the last to know what your cardiologist is doing, or your radiologist or pharmacist, for that matter. Though the providers may be well trained and supplying good care, they are part of a system that is less than efficient, a problem that could only get worse as the population ages and chronic conditions become more prevalent.
We don’t often associate crowded emergency departments with dental complaints. But according to The Pew Center on the States, preventable dental conditions were the primary diagnosis in over 800,000 visits to ERs in the U.S. This makes sense, as more than 100 million Americans lack oral health coverage, and therefore have impaired access to dental care. What’s more, poor oral health is an integral factor in physical health, associated with conditions such as diabetes, heart and lung disease, stroke and preterm birth. So regular detection and treatment of oral health problems – which are received more regularly by those with coverage – can improve physical health and quality of life.
A consumer walks down the street using a smartphone – but rather than texting a friend, calling home or checking email, she is reporting data that will inform a clinician about the status of her asthma management. Is this scenario real or fantasy? As Americans grow more and more comfortable with technology in daily life – at work, at home and at play – one wonders why personal technology isn’t more widely used in health care. Patients are frustrated that they can’t access many of their providers through email; that they have to fill out paper forms multiple times, even in the same office; and that they must endure an office visit to their provider to have their progress monitored when they can visit their relatives across the ocean through Skype.
Medicaid can be as much as 25 percent or more of a state’s expenditures — a share that appears to be rising, not shrinking. In 2011 Medicaid accounted for 24 percent of total state spending, including federal grants. To address their budgetary challenges, an increasing number of states are turning to Medicaid managed care. As of 2009, 47 percent of all Medicaid beneficiaries were enrolled in a managed care plan. Looking to save money in categories where the most is being spent, more states are starting to enroll older beneficiaries and those with disabilities in such plans, not just for acute care services, but for long-term services and supports (LTSS).
According to the health reform law, health insurance exchanges are to begin covering people in every state by January 2014. While some states have made progress toward establishing their own exchanges by this deadline, others have displayed little activity in this arena. Now that the Supreme Court has ruled on the constitutionality of the law, many states are just now beginning to think about their options for state-run exchanges and federal-state partnerships to run them. With implementation and evaluation deadlines rapidly approaching, state governments face the challenge to decide and act quickly.
Community health centers (CHCs) play a critical role in providing care to vulnerable populations, especially at a time when employer-sponsored coverage has declined and the demand for safety-net services has gone up. Currently, there are more than 1,100 community health centers providing care to approximately 20.2 million people in every state across the U.S.
It’s been said that the Supreme Court’s ruling on the Patient Protection and Affordable Care Act will keep legions of lawyers employed for years to come. The same could be said for health reporters, political writers, bloggers, editorialists, talk show bookers, TV news producers and documentary makers.
The Supreme Court has ruled on the constitutionality of the health reform law. Now it remains for stakeholders, policymakers, analysts and taxpayers to take it from here. Shifts in health care delivery towards more coordinated care to improve quality and efficiency are already taking place in the public and private sector. But many provisions in the law require specific actions to be taken and deadlines to be met by states, providers and others in order to implement various aspects of health reform scheduled to take effect in January, 2014.
Urgent care centers and retail clinics are rapidly emerging within the health care system — a partial response to rising health care costs and a possible flood of new demand for care as the Patient Protection and Affordable Care Act is fully implemented. The number of patient visits to retail health clinics grew by 1,000 percent in just the last two years, according to a RAND Health study.
Though there is still disagreement about the extent to which various cost drivers contribute to the troubling trajectory of health care spending in the United States, there are success stories. This briefing took a look at some of the innovative strategies in both the public and private sectors that have bent the cost curve downwards and some that may hold promise for lowering the rate of growth of national health care spending. The briefing also featured Dr. Paul Ginsburg presenting a paper that was commissioned especially for this series. The paper examines a range of policy strategies that might promote changes in health financing and delivery that would encourage higher quality and more efficient care delivery.
Safety-net hospitals play a critical role in providing care to vulnerable populations, especially at a time when employer-sponsored coverage has declined and the demand for safety-net services has gone up.
This is the second event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. The series marks the Alliance for Health Reform’s 20th year of promoting informed and balanced discussion of health policy issues.
An estimated one out of five adults in the U.S. suffers with mental illness. Some 11 million adults reported an unmet need for mental health care in the past year, a situation no doubt made worse by the recent recession and higher-than-normal unemployment.
This was the first event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. The series marks the Alliance for Health Reform’s 20th year of promoting informed and balanced discussion of health policy issues.
Many analysts and policymakers agree that the fragmentation of the health care delivery system results in uncoordinated care, frustrated patients, higher costs, wasted administrative dollars and lost opportunities for rapid improvement in our health care system. There is less agreement as to how to reform health care payments in order to harmonize health care delivery and reduce this fragmentation. How do institutions, communities and practitioners transform their organizations to deliver high-quality, patient-centered care when different payers pay at different rates, and some patients have no one paying at all?
The health care overhaul law passed by Congress in 2010 sets out national goals and requirements. But many of the key decisions implementing the law are left to the states.
The constitutional challenges to the Patient Protection and Affordable Care Act finally come to a head the week of March 26.
Headlines regularly call attention to pockets of fraudulent activity in the health care area–scams that amount to millions and potentially billions of dollars. The stories typically focus on catching the “crooks” but not so much on efforts to prevent fraud, waste and abuse in health care programs. Both types of efforts are important. With continued concerns about rising health care costs and the current focus on deficit reduction, how much money can be saved and put to better use by reducing waste, abuse and outright fraud?
Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges – as well as non-grandfathered plans offered in the individual and small group markets – will be required to cover a set of health benefits and services called the “essential health benefits” package. Guidance issued last month by the Department of Health and Human Services will give each state some discretion to specify benefits within the 10 categories specified in the law.
The 9 million beneficiaries dually eligible for Medicare and Medicaid are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of spending in both programs. Many deficit reduction plans under recent discussion have recognized the need to improve care for this population and provide care in a more cost-effective way.
The Budget Control Act of 2011 tasked six senators and six representatives, from both sides of the aisle, to find at least $1.2 trillion in deficit reduction over the next decade. After weeks of deliberation, members of the “Super Committee” did not reach an agreement by the November 23 deadline. As a result, automatic spending cuts to defense and social welfare programs are set to kick in beginning in January 2013, leaving many questions about the short-term and long-term consequences of the committee’s failed negotiations.
Medicaid currently provides health and long-term care to 68 million Americans, and the Patient Protection and Affordable Care Act would significantly expand Medicaid beginning in 2014. As a countercyclical program, Medicaid typically faces increased enrollment at the same time that states are looking to cut their budgets. Although the Budget Control Act of 2011 exempts safety-net programs like Medicaid from across-the-board cuts, Medicaid has remained a keenly debated topic in discussions of how to reduce the deficit.
Spending on prescription drugs in the U.S. rose at a faster clip in 2009 than spending for hospital and physician care, a trend that is expected to continue through 2020. By some estimates, prescription drugs account for 15 cents of every health care dollar spent. Thus, federal and state budget cutters – as well as private health plans and hospitals – have a keen interest in restraining drug costs.
According to a recent survey, a number of states have expressed interest in expanding managed care approaches within their Medicaid programs. But while managed care may present an opportunity for better delivery of care, it presents challenges within certain populations and geographic areas.
According to figures released last month by the U.S. Census Bureau, some 50 million Americans lacked health insurance in 2010. That number is almost a million higher than for 2009, though the percentage of people uninsured remained largely unchanged.
Medicare has been a keenly debated topic in discussions of how to reduce the deficit. It accounts for a large and growing share of both federal spending and of the national economy, although the projected pace of growth is now at a historic low. Its policies often set the pace for the rest of the health care system.
The ongoing debate over the federal budget and deficit reduction presents a balancing act for policy makers, as many compelling interests compete for scarce dollars. But for 10 million older adults and people with disabilities who need long-term services and supports, there is a “rebalancing act” in progress. The aim is to serve more people at home and in the community, and fewer people in institutions.
After much heated debate on the U.S. debt limit, the Budget Control Act of 2011, containing more than $900 billion in spending reductions over 10 years, was passed on August 2. The members of the Super Committee created by that law are hard at work, and the process is in gear to achieve at least $1.2 trillion in additional deficit reduction — either through Congress adopting the committee’s recommendations or through further automatic spending cuts.
The high and rising cost of health care is a central concern for governments at all levels, employers and families. A large portion of the cost problem can be traced to the care received by persons with chronic conditions like asthma or diabetes. Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending as of 2010. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs.
Under the American Recovery and Reinvestment Act of 2009, providers can receive Medicare and Medicaid payment incentives when they adopt electronic health records and demonstrate their “meaningful use.” Additionally, the Patient Protection and Affordable Care Act requires states to establish a website by 2014 for Medicaid beneficiaries to electronically enroll and renew coverage. Yet many challenges remain so that health information technology (HIT) can help the Medicaid program operate more effectively.
The Patient Protection and Affordable Care Act (ACA) authorized the creation of the Center for Medicare and Medicaid Innovation (CMMI) under the Centers for Medicare & Medicaid Services. CMMI seeks to test innovative health care payment and service delivery models that can potentially enhance quality of care for beneficiaries while reducing costs. From 2011 to 2019, the ACA provides $10 billion in funding to support the Innovation Center’s goals.
There is a national epidemic of chronic disease. Though it does not get the news coverage devoted to floods and tornadoes, it deserves attention and is starting to get it. There is a groundswell of activity in local communities to support healthier lifestyles and help people make long-lasting and sustainable changes that can reduce their risk for chronic diseases. A number of provisions in the health reform law are aimed directly at improving population health by addressing conditions where Americans live, learn, work, and play – at their schools, worksites, restaurants and more.
This was an introductory session designed to inform the staff of new members of Congress both in Washington and in district or state offices about the people who receive benefits from both the Medicaid and Medicare programs (often called “dual eligibles”). The briefing was designed to be helpful to staff members unfamiliar with this important issue.
When fully implemented, the Patient Protection and Affordable Care Act will increase the number of insured Americans through two primary strategies – expanding Medicaid and providing insurance through state-based insurance exchanges. As an individual’s household income exceeds the maximum for Medicaid eligibility, he or she will be eligible for subsidies to buy coverage through an exchange, up to a household income of 400 percent of the federal poverty level (FPL). This switch in eligibility also works in reverse. If a person’s household income shrinks below 133 percent of the FPL, he or she will become eligible for Medicaid.
In addition to expanding coverage to 32 million previously uninsured Americans, the health reform law of 2010 aims to improve the health of the population and the quality of health care delivery, while reducing costs. One tool to pursue these goals is the creation of a national voluntary program for accountable care organizations (ACOs). The law authorizes Medicare, beginning next year, to contract with accountable care organizations in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs.
More than 25 years have passed since what is now the Centers for Medicare and Medicaid Services (CMS) began publishing hospital mortality data. Great strides have been taken since then in collecting and making public more and better information about the quality of care delivered by hospitals and other providers. CMS’s websites, like www.hospitalcompare.gov, make much of this information available to a wide audience.
The fact that health care costs vary sharply around the country is becoming well known; less understood is that there is also wide regional variation in health care quality. Some regions enjoy low cost, high quality care while others report high cost, lower quality care. Some people have ready access to providers and good care; others may not be receiving necessary care or may be receiving unnecessary, health-endangering care. The root cause of these differences has been the subject of many studies and discussions.
Although the rise in unemployment in this recession has resulted in lost health insurance coverage for many adults, a record 90 percent of children now have coverage – one-third of whom are covered by public programs, Medicaid and CHIP. About 7.5 million children remain uninsured, including 5 million who are eligible for Medicaid and CHIP but not enrolled.
Understanding how Medicare works is essential to understanding federal health policy. Medicare is the federally administered health insurance program for individuals ages 65 and older and for younger people with permanent disabilities. In 2010, the program covered an estimated 47 million people. It comprised an estimated 15 percent of the federal budget and over one-fifth of total national health expenditures.
Medicaid will play a major role in extending coverage to millions of uninsured people in 2014 through provisions in the Patient Protection and Affordable Care Act. More than 16 million newly qualified individuals are expected to enroll as a result of the law.
The relationship between patients and doctors has been changing from the traditional model in which a doctor decides on a treatment course without significant patient input. In recent years, awareness of the importance of the patient’s role in managing his or her own care has been steadily growing–fed not only by such trends as the proliferation of health information on the internet and direct-to-consumer advertising, but also by the emerging science of patient-centered decision making.
Unemployment has hit everyone hard since the economic downturn began in 2007. And while workers age 50-64 tend to have lower rates of uninsurance than other age groups, they are especially hard hit by losing their jobs and with them their employer-sponsored health benefits. About 8.6 million adults ages 50 to 64 were uninsured in 2009, 1.1 million more than in 2008, a bigger percentage increase than other age groups.
One of the goals of the Affordable Care Act is improving the quality of health care while also slowing the growth of spending. This will not be easy as 30+ million individuals gain insurance and the need for chronic care coordination increases with an aging population. In order to meet this challenge, the law aims to move the health care system away from an episodic, fee-for-service approach and towards a coordinated, preventive model of care delivery.
The rising number of uninsured, who they are and how they might obtain health insurance coverage were much debated during the consideration and passage of health reform in the last year. In the meantime, rising unemployment rates and an economic recession have exacerbated the declines in health insurance coverage. According to the Current Population Survey, 50 million Americans were uninsured for all of 2009. The Medicaid and CHIP programs have offered a safety net of coverage for some of those facing financial hardship and have helped to prevent more people from being uninsured. Even as they continue to face severely strained budgets, states are enrolling record numbers of beneficiaries in Medicaid.
In today’s evolving health care system, many providers and policymakers envision team-based care as an important component of the plan to improve quality, maximize resources, promote wellness, expand preventive care and enhance the value of the health care dollar. The health workforce “dream team” includes physicians, nurses, nutritionists, physical therapists, social workers, nurses’ aides, direct care workers, home health aides and others who contribute to coordinated care in a high quality system.
For years, there have been concerns about whether the supply of physicians can meet the demand of our nation’s population – a population that is growing in size, age and diversity. One consideration: The physician workforce is aging as many physicians approach retirement. And physicians are increasingly looking for opportunities that allow them to balance their professional and family obligations.
Health reform is law. But how the law is implemented, and how quickly, depend in part on the results of the midterm election.
Health information technology can help prevent medical errors, improve care coordination, increase access to providers in rural areas and improve the quality and value of care. At the same time, questions have been raised about the cost of implementation, personal privacy considerations and potential disruption to the business of health care, especially for providers in individual and small group practices.
The Affordable Care Act (ACA) enacted in March 2010 calls for the establishment of state health insurance exchanges – marketplaces through which individuals and small businesses can purchase affordable insurance. These exchanges must begin operation by January 1, 2014.
All states, even those with large centers of urban population, have rural communities and rural residents among their citizens. Residents of rural communities face unique health care challenges, including fewer health care providers, higher rates of chronic disease, and lower adoption rates of health IT.
Most of the emphasis during the health reform debate centered on affordable health coverage for the uninsured, strategies to control the growth in health care spending, and delivery system reforms. Relatively little attention was given to the many provisions of the new law that deal directly with long-term care.
The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA) made a series of changes that will significantly affect the way employers provide health coverage to their employees, and transform many of the choices and protections consumers have in the marketplace.
As the second in a series to explore implementation of the Patient Protection and Affordable Care Act, this briefing provided an overview of how the states and the federal government are working together to implement various provisions of the new law. For example, while the law allows for flexibility in the way states set up exchanges, states will likely need technical assistance from the federal government to get the job done.
Diabetes and obesity have evolved from a national public health concern to a problem of epidemic proportions. Type 2 diabetes, which is linked to obesity and physical inactivity, accounts for 90 to 95 percent of diabetes cases for people over 40. Moreover, in 2007 an estimated 57 million American adults had “pre-diabetes,” the precursor to diabetes. Childhood obesity, which has more than tripled in the last three years, impacts these numbers because obese children are at greater risk of developing diabetes as an adult.
Now that the Patient Protection and Affordable Care Act is law, what’s happening behind the scenes (as well as in public) to implement it? This briefing, cosponsored by the Alliance and the Robert Wood Johnson Foundation, provided an overview of federal policymaking and the efforts by stakeholders and others to affect final policies pertaining to the health reform law.
For reporters covering health reform, the subject can now seem more complicated than ever. Implementation timelines go on for page after page. Many questions appear to have no answers, at least not yet.
Young adults have some of the highest uninsurance rates in America. In 2008, three in 10 uninsured Americans– almost 14 million people – were between 19 and 29 years of age. As the health reform legislation was developed, it became evident that covering the uninsured in this age group would be a major component of the effort to improve quality and lower costs in our health care system.
The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 contain a number of changes in the way health care is paid for, particularly in public programs. Delivery system changes intended to improve quality and contain costs will, at the same time, impact the revenues of health care providers.
As part of an ongoing series to explore what is in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, this briefing dealt exclusively with how the reform law affects Medicare. As this legislation was developed, proposed changes to Medicare were among the most hotly debated issues. The briefing illuminated what is really in the law and what its provisions will mean for administrators, beneficiaries and the health care sector in the U.S. Cosponsored by the Alliance for Health Reform and the Kaiser Family Foundation.
As part of an ongoing series to explore the provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act, this briefing dealt with how the new health reform law affects access to private coverage. A range of specific provisions were covered, including the new federal high-risk pools, tax credits for small businesses, health insurance exchanges, the individual mandate, and employer obligations. The law’s provisions governing private health insurance mark a dramatic change from past practice, and much attention has been paid by opposing sides to the potential implementation and legal issues.