Communicating changes in health care


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

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Communicating changes in health care

  1. 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. 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. 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. 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. 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 ( </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. 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. 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. 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. 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. 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. 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. 12. Resources to follow reform <ul><li>Kaiser Family Foundation </li></ul><ul><li>Colorado Managed Care </li></ul><ul><li>U.S. Dept. Health and Human Services </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. 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>