What we need to know about health care reforms…

Here is what I learn on healthcare.gov .

Time line of what to come

2010

  • $250 Medicare drug cost rebate
  • Expanded coverage for young adults – they now can stay on their parents’ plan until they turn 26.
  • Small business tax credits – The first phase of this provision provides a credit worth up to 35% of the employer’s contribution to the employees’ health insurance.
  • Pre-Existing Condition Insurance Plans
  • More people will be on Medicaid
  • Expanded coverage for early retirees. Visit www.ERRP.gov
  • Free preventive care – All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
  • Insurance companies cannot rescind coverage when the insured get sick
  • Consumers can appeal for insurance determination
  • No more lifetime limits on coverage such as hospital stay
  • Unreasonable rate hikes will be investigated
  • Expansion of primary car workforce
  • $15b will be invested for programs that prevent obesity and cancer, etc.
  • More community health centers

2011

  • Prescription drug discounts
  • Free preventive care for seniors on Medicare
  • Curbing premiums – at least 80% to 85% of all premium dollars must be spent on health care services and health care quality improvement.
  • More research to bring down costs
  • Increase access to services at home and in the community – The new Community First Choice Option allows States to offer home and community based services to disabled individuals through Medicaid rather than institutional care in nursing homes.

2012

  • Integrated Health Systems through “Accountable Care Organizations.”
  • the law requires any ongoing or new Federal health program to collect and report racial, ethnic and language data. The Secretary of Health and Human Services will use this data to help identify and reduce disparities.
  • Reducing administrative costs and paperwork
  • Linking payment to quality outcomes – The law establishes a hospital Value-Based Purchasing program (VBP) in Original Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported.

2013

  • Increase preventive coverage
  • Increase Medicaid payments to primary care providers – no less than 100%
  • Expanded authority to bundle payments
  • More funding for Children’s Health Insurance Program (CHIP)

2014

  • The uninsured can buy insurance through an Exchange
  • Everyone is required to buy health insurance of their choice
  • Increase access to Medicaid – Americans who earn less than 133 percent of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid. States will receive 100 percent federal funding for the first three years to support this expanded coverage, phasing to 90 percent federal funding in subsequent years.
  • No discrimination on pre-existing conditions

2015

  • Paying physicians based on value not volume
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