The ACA’s Impact Upon
Insurers, Providers,
and People
BCBR PULSE EVENT
NOVEMBER 12, 2013
SPEAKERS:
Susan Levy, Women’s Hea...


Passed in March 2010



Market-based health care reform with additional
public support

◦ Labeled “Obamacare”

◦ Herit...


Research, Commissions, New Funding
Consumer Website
(www.healthcare.gov)
Medicaid and CHIP Payment
Advisory Commission...


Medicare / Medicaid Reform

Closing the Medicare Drug Coverage Gap

Medicare Payments for Primary Care

Medicare Pre...
 Insurance Reform

Pre-existing Condition Insurance Plan (phasing out)

Adult Dependent Coverage to Age 26

Consumer P...
Source: The Washington Post

Who gets insurance – and how?
Health Exchange Options

Source: http://www.foxbusiness.com/personal-finance/2013/10/16/why-staterun-health-exchanges-are-...





Better care for
Individuals
Better Care for
Populations
Lower Per Capita
Costs

The Goals: The Triple Aim
Patience

Persistence
Reaching the Goals --
The #1 Goal: Healthy People
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Bcbs health reform nov. 2013 v1

  1. 1. The ACA’s Impact Upon Insurers, Providers, and People BCBR PULSE EVENT NOVEMBER 12, 2013 SPEAKERS: Susan Levy, Women’s Health Julia Hutchins, ColoradoHealthOp Sharon Caulfield, Caplan and Earnest LLC
  2. 2.  Passed in March 2010  Market-based health care reform with additional public support ◦ Labeled “Obamacare” ◦ Heritage Foundation Model ◦ Massachusetts experience ◦ Private insurance companies sell standardized products through state or federal marketplace “exchange” ◦ Support for premium payments for those at low end of Federal Poverty Level multipliers ◦ Expansion of state Medicaid programs The Affordable Care Act
  3. 3.  Research, Commissions, New Funding Consumer Website (www.healthcare.gov) Medicaid and CHIP Payment Advisory Commission Health Care Workforce Commission Comparative Effectiveness Research New Prevention Council Health Centers & National Health Service Corps Expansion of Drug Discount Program Prevention and Public Health Fund Federal Coordination of Care Office Reinsurance Program for Retiree Coverage Chronic Disease Prevention in Medicaid Center for Medicare and Medicaid Innovation Grants to Establish Wellness Programs Teaching Health Centers Medical Malpractice Grants Funding for Health Insurance Exchanges Graduate Medical Education National Quality Strategy Rebates and Tax Credits Medicare Beneficiary Drug Rebates Small Business Tax Credits Medicaid Drug Rebate New Requirements on Non-profit Hospitals Many elements of the ACA
  4. 4.  Medicare / Medicaid Reform  Closing the Medicare Drug Coverage Gap  Medicare Payments for Primary Care  Medicare Prevention Benefits  Medicare Premiums for Higher-Income Beneficiaries  Medicare Advantage Payment Changes  Medicaid Health Homes  Medicaid Payments for Hospital-Acquired Infections  Medicaid Long-Term Care Services  Medicaid Community-Based Services   Medicaid Coverage for Childless Adults (State Option) Miscellaneous  Generic Biologic Drugs  Tax on Indoor Tanning Services  Nutritional Labeling  CLASS Act (repealed)  Changes to Tax-Free Savings Accounts More elements of the ACA
  5. 5.  Insurance Reform  Pre-existing Condition Insurance Plan (phasing out)  Adult Dependent Coverage to Age 26  Consumer Protections in Insurance  Insurance Plan Appeals Process  Coverage of Preventive Benefits  Minimum Medical Loss Ratio for Insurers ACA Elements already in place
  6. 6. Source: The Washington Post Who gets insurance – and how?
  7. 7. Health Exchange Options Source: http://www.foxbusiness.com/personal-finance/2013/10/16/why-staterun-health-exchanges-are-faring-better/?intcmp=obinsite
  8. 8.    Better care for Individuals Better Care for Populations Lower Per Capita Costs The Goals: The Triple Aim
  9. 9. Patience Persistence Reaching the Goals --
  10. 10. The #1 Goal: Healthy People
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