Michael Gomes's blog

Insured Young Adults Rise 2.5 Million Since PPACA Enacted

Whether you are for or against the Patient Protection and Affordable Care Act (PPACA), it is changing the landscape of health care insurance as we know it. The most recent sign of the changing times is an announcement that 2.5 million young adults have picked up insurance coverage over the past year. This is largely due to PPACA’s requirement that young adults can stay on their parents’ health insurance policy until the age of 26. BenefitMall has covered this requirement extensively in a number of blogs that are posted on www.healthcareexchange.com.

Author: Michael Gomes

U.S. Supreme Court Gets Ready to Review Legality of PPACA as Qualifications of Two Justices Questioned: Full Court Likely to Hear Case

Earlier this month, the Supreme Court denied a motion by Freedom Watch arguing that Justice Elena Kagan should recuse herself from hearing the upcoming challenge to the Patient Protection and Affordable Care Act (PPACA). The law, often referred to as the “Affordable Care Act,” will be reviewed by the U.S. Supreme Court later this year. 

Author: Michael Gomes

2012 PPACA Implementation Highlights

The implementation train for the Patient Protection and Affordable Care Act (PPACA) continues to pick- up speed with a number of important implementation dates in 2012. 

Keeping up with the pace can be challenging. To assist, the U.S. Department of Health and Human Services (HHS) offers  a website that helps track the major reform efforts, titled “What’s Changing and When.” Also useful is an online article posted by the White House that gives a year-by-year overview of the PPACA timeline.    

Here’s a snapshot of some 2012 milestones:

Accountable Care Organizations

Author: Michael Gomes

Obama Administration Defends Affordable Care Act in Opening Brief Filed with U.S. Supreme Court

On January 6, 2012, the U.S. Department of Justice (DOJ) filed a brief with the U.S. Supreme Court in support of the Patient Protection and Affordable Care Act (PPACA), one of the most talked about pieces of legislation passed in recent memory. In addition, over a half dozen amicus curiae briefs have been filed since then by interested parties wanting to weigh in on the case.  Oral arguments on the merits of the new health care reform law are scheduled for late March. 

Author: Michael Gomes

PPACA Establishes New Outcomes Research Institute to Promote Evidence Based Medicine: Some Express Concerns About Funding and Objectives

Buried in the thousands of pages of the Patient Protection and Affordable Care Act (PPACA) is Section 1181, which authorized the establishment of the Patient Center for Outcomes Research Institute (PCORI), an independent, non-profit organization charged with “evaluating and comparing health outcomes and the clinical effectiveness, risks, and benefits of medical treatments, services, procedures, drugs, and other strategies or items that treat, manage, diagnose, or prevent illness or injury.”

Author: Michael Gomes

Federal Government Taps 32 Organizations to be Pioneer ACOs

On December 19, 2011, the U.S. Department of Health and Human Services (HHS) announced that the federal agency has approved 32 organizations to become Pioneer Accountable Care Organizations. 

Through the Patient Protection and Affordable Care Act (PPACA), the federal government has promised to deliver improved health care while attempting to better control future costs.

Author: Michael Gomes

U.S. Supreme Court Schedules Hearings on PPACA

The United States Supreme Court will hear oral arguments regarding the constitutionality of the Patient Protection and Affordable Care Act (PPACA) from March 26 through 28of 2012, according to the New York Times and several other media services. The amount of time set aside for the hearings, over three days, signals the gravity and importance of the issue, and is without precedent in modern times. 

The U.S.

Author: Michael Gomes

Health Insurers Facing New Financial Pressure Points under Emerging Reforms: MLR Restrictions & ICD-10 Conversion Add to Complexity

The Patient Protection and Affordable Care Act (PPACA) is not only forcing health insurers to undergo fundamental changes in the way they do business, but the law is requiring new infrastructure investment while also mandating Medical Loss Ratios (MLR) that limit the amount insurers can spend on administrative costs.   

Author: Michael Gomes

New Research Indicates Most Employers Will Continue to Sponsor Health Benefits for Employees Despite PPACA Mandates

Four recent surveys confirm the notion that the majority of employers will continue to offer employer-sponsored health benefits in 2012 and beyond. The national surveys, conducted by Mercer, Towers Watson Health Care, GfK and Kaiser Family Foundation/Health Research & Educational Trust, yielded fairly consistent results that indicate employers overall continue to view their health benefits plans as a key component of the employee benefit offerings. The survey feedback also confirms that few employers plan to terminate their health benefit plans when state health insurance exchanges, mandated by the Patient Protection and Affordable Care Act (PPACA), become operational in the fall of 2013.  

Mercer Study

Author: Michael Gomes

HHS Launches Demonstration Project to Improve Care for Medicare Beneficiaries through Federally Qualified Health Centers

The U.S. Department of Health and Human Services (HHS) recently announced a joint initiative between the Centers for Medicare and Medicaid Services (CMS) and the Health Resources Service Administration (HRSA) that allocates $42 million dollars to improve care for Medicare beneficiaries in 500 Federally Qualified Health Centers (FQHC) in 44 states across the country. This initiative is expected to help up to 195,000 beneficiaries.

Author: Michael Gomes
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