Major Health Affairs Conference Discusses What's next for PPACA Implementation

A few weeks ago, many of the country’s leading health experts gathered in Washington D.C. at a Health Affairs sponsored conference entitled “What’s Next for the Affordable Care Act (PPACA) Implementation.”

Understanding the Impact of PPACA’s Health Insurance Premium Tax

Beginning in 2014, many Americans will start paying for a new tax on health insurance that will be assessed against health plans and insurers but will actually be paid through increased premium rates, according to several prominent insurance and financial experts. Buried within the Patient Protection and Affordable Care Act (PPACA), Section 9010 requires individuals, families, and others to help pay a total of $73 billion over five years.  Implementation of this provision is generating mixed reviews by various stakeholder groups.   

AHIP Roundtable of State Medicaid Directors Addresses Medicaid and Financing Concerns

The resounding cry of three state Medicaid directors at a recent roundtable focused on concerns related to the financing of state Medicaid and welfare programs. The directors participated in panel discussion held during the American Health Insurance Plan’s (AHIP) annual Medicaid Conference in Washington, D.C.

CMS Head Touts the Need for a Comprehensive Strategy to Support Medicare: Calls for Partnership with the Private Sector

In a keynote address delivered at the American Health Insurance Plan’s (AHIP) annual Medicare Conference on September 12, Donald M. Berwick, MD, administrator for the Centers for Medicare & Medicaid Services (CMS), addressed a number of issues associated with the long-term financial health of the Medicare Program.[1]

His 45-minute speech centered on the need to address the rising costs required to fund the federal program supporting American seniors and a few special populations. In a humorous moment, Dr. Berwick noted that he just celebrated a big birthday last week and is now eligible to become a Medicare beneficiary himself, which has added some urgency to the matter.    

The Need for Private Exchanges to Co-Exist with Public Exchanges

Last week, I had the opportunity to present at the American Health Insurance Plans’ (AHIP) “Exchange Conference” in Washington, D.C.  In a panel session entitled, “Understanding the Exchange’s Front Office Operations,” I was joined by several panelists to talk about key issues that must be addressed to ensure expanded coverage of the uninsured under the Patient Protection and Affordable Care Act (PPACA).  

Keeping an Eye Out for Accountable Care Organizations

One of today’s emerging hot topics is the concept of Accountable Care Organizations (ACOs).  Under the Patient Protection and Affordable Care Act (PPACA), the federal government is developing regulations that will empower ACOs to support patients who are enrolled in the Medicare Program pursuant to Section 3022 of PPACA. 

ACOs are intended to deliver quality health care services more efficiently and improve the patient experience through a Medicare “shared savings program.”  The buzz about ACOs is significant in many circles, and several pilot programs have been established, even though the business model has not been fully identified.   

The Center for Medicare and Medicaid Services (CMS) is scheduled to release the regulations about ACOs in mid-January 2011, and will detail how ACOs can help reduce costs and share in savings generated by their interventions.

Preventive Measures to Come to New Plans

As part of the new health care regulations, preventive care is now to be included in new health plans for no additional member costs. This applies solely to new plans. Current grandfathered plans are not required to institute the preventive measures outlined in the new bill.

Some of the preventive measures will take effect now, while others will take effect next year. Among the measures that will go into effect with the new plans include mammograms, immunizations, colonoscopies and other preventive services.