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Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
Communicating changes in health care
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Communicating changes in health care

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This slide show discusses Colorado and federal developments in health care reform.

This slide show discusses Colorado and federal developments in health care reform.

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  • 1. Colorado Healthcare Communicators: Communicating Changes in Health Policies <ul><li>Amy Fletcher, amyfletcher media </li></ul>Feb. 23, 2011 (what a difference a year makes)
  • 2. amyfletcher media <ul><li>Former health care reporter, mostly at Denver Business Journal </li></ul><ul><li>Founded afm in 2009: communications planning/strategy, media relations, writing </li></ul><ul><li>Clients: health care, lobbyists, nonprofits </li></ul><ul><li>Today’s info.: ArpegioHealth, Colorado Managed Care newsletter </li></ul>
  • 3. (High-level) overview for today <ul><li>Reform update </li></ul><ul><ul><li>Federal - Affordable Care Act </li></ul></ul><ul><ul><li>State - Exchanges, Medicaid expansions, etc. </li></ul></ul><ul><li>Resources to track reform </li></ul><ul><li>Questions? </li></ul>
  • 4. Affordable Care Act <ul><li>1,000-page bill Pres. Obama signed into law March 23, 2010 </li></ul><ul><li>Designed to: </li></ul><ul><ul><li>Lower costs - premiums unaffordable, strain on govt. budgets </li></ul></ul><ul><ul><li>Close holes in coverage - 17 % uninsured, pre-existing conditions </li></ul></ul><ul><li>How it does it: </li></ul><ul><ul><li>Private insurance reform and individual mandate </li></ul></ul><ul><ul><li>Expand public programs (Medicare, Medicaid) </li></ul></ul><ul><ul><li>Exchanges </li></ul></ul><ul><ul><li>Experiments in managing care (ACOs) </li></ul></ul>
  • 5. Affordable Care Act: 2010 <ul><li>Phased in through 2019 (2010*, 2011*, 2014*) </li></ul><ul><li>Implemented in 2010: </li></ul><ul><ul><li>Colorado high-risk pool, GettingUsCovered: must have pre-existing condition; uninsured for 6 months (gettinguscovered.org) </li></ul></ul><ul><ul><li>Kids can stay on parents‘ insurance until age 26; eliminated exclusions for pre-existing conditions for kids up to age 19. </li></ul></ul><ul><ul><li>Certain evidenced-based preventive care covered at no cost. </li></ul></ul>
  • 6. Affordable Care Act: 2011 <ul><li>Insurers must spend at least 85 % of premiums on direct claims costs (vs. administration) </li></ul><ul><li>Medicare beneficiaries in the “doughnut hole” receive 50% discount on brand-name drugs. </li></ul><ul><li>Funding for states (including Colorado) to research and plan building “a better health insurance marketplace” and determine how their Exchanges will be operated and governed. (more on this) </li></ul>
  • 7. Affordable Care Act: 2014 + <ul><ul><li>Expands Medicaid to people with incomes up to 133% FPL and provides enhanced federal matching payments for new eligibles. </li></ul></ul><ul><ul><li>Allows all hospitals to make presumptive eligibility determinations for all Medicaid-eligible populations. </li></ul></ul><ul><ul><li>Mandate: individuals must have qualifying health coverage (phased-in tax penalty for those without coverage) </li></ul></ul><ul><ul><li>Creates state-based exchanges, administered by a governmental agency or non-profit organization </li></ul></ul><ul><ul><li>No refusal based on health status </li></ul></ul>
  • 8. Legal / Congressional challenge <ul><li>Congress divided on ACA (House voted to repeal) </li></ul><ul><li>Obama said he is open to compromise on some parts, but no major revamping. </li></ul><ul><li>Meanwhile, U.S. District Judge Roger Vinson in Florida ruled insurance mandate is unconstitutional. Obama Administration said it will appeal. (Also challenged in Virginia). </li></ul>
  • 9. Colorado: Exchanges <ul><li>Online “one stop shop” for information, comparison and purchase. Estimated 300,000 to millions will use eventually. </li></ul><ul><li>For individuals and small groups. (Larger groups may be allowed in 2017) </li></ul><ul><li>Stakeholders in Colorado are watching closely developments on structure and governance. (docs, hospitals, etc.) </li></ul><ul><li>States will set own rules. In Colorado, bill(s) to be introduced in Senate and House (Boyd & Stephens) </li></ul><ul><li>Opportunity for safety net. </li></ul>
  • 10. Electronic Health Records <ul><li>Health Information Technology for Economic and Clinical Health (HITECH) incentive program. Part of American Recovery and Reinvestment Act of 2009. </li></ul><ul><li>Medicare: Eligible professionals can receive as much as $44,000 over a 5 years. Medicaid: as much as $63,750 over 6 years. Medicare and Medicaid: eligible hospitals may receive millions for “meaningful use.” </li></ul><ul><li>CORHIO: info. on incentives, serving to connect through exchanges </li></ul><ul><li>Will be tied to Medicare payments. </li></ul>
  • 11. Accountable Care Organizations <ul><li>Designed to encourage integrated health systems. </li></ul><ul><li>A group of health care providers provide coordinated care, chronic disease management to improve the quality of care. </li></ul><ul><li>Payment is tied to achieving health care quality goals and outcomes that result in cost savings. Starts with Medicare in 2012. </li></ul><ul><li>Race to form ACOs has begun. Insurers, hospitals, docs are vying to run them. </li></ul>
  • 12. Resources to follow reform <ul><li>Kaiser Family Foundation www.kff.org/healthreform </li></ul><ul><li>Colorado Managed Care www.hmo-info.com </li></ul><ul><li>U.S. Dept. Health and Human Services www.healthreform.gov </li></ul><ul><li>Your national, state trade associations </li></ul><ul><li>Updates from lobbyist (internal or contract) </li></ul><ul><li>Media: Ed Sealover (DBJ), Eric Whitney (NPR), Denver Post </li></ul>
  • 13. Thank you <ul><li>Amy Fletcher, principal </li></ul><ul><li>[email_address] </li></ul><ul><li>720-350-3144 </li></ul><ul><li>Twitter @fletchermedia </li></ul>

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