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Vmi highlights healthcare reform 10 3 12

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  • 1. Highlights ofHealthcare Reform VMI Desert Valley Hospital
  • 2. ProblemCost of Health Care – Rising – 18% ofGross Domestic Product ($2.6 Trillion) –Highest in the World – however, US ranks50th in the world in life expectancy50 million people are uninsured1 in 6 AmericansThree pandemics contribute to preventablechronic diseases – tobacco use, obesity &lack of physical activityCapitalism in Health Care – health caredriven by profit
  • 3. Federal Healthcare Reform 2010 Overall Expected Outcomes Reduction in Cost of Health Care Keeping People Healthy and Preventing Illness Treating the Sick and Keeping Costs Low
  • 4. Federal Healthcare Reform 2010 Strategies Include Illness and Disease Prevention Improving Access to Healthcare Quality Care Incentives Restructure Healthcare Delivery and Operations Restructure Insurance Products
  • 5. Federal Healthcare Reform 2010 Illness and Disease Prevention $5 billion from 2010 to 2014 in the Public Health Fund to invest in increasing the number of health professionals and to increase programs in smoking cessation, weight loss, immunizations, etc.; $2 billion for each subsequent fiscal year Providing free preventive care, such as: mammograms and colonoscopies for Seniors Offering Seniors prescription drug discounts, such as: 50% discount for brand name and generic drugs
  • 6. Federal Healthcare Reform 2010 Improving Access to Healthcare Options for States to cover more people on Medicaid starting in 2010. Federal matching funds for broadening coverage will be available in 2014 when program is mandatory Tax credits to employers with 25 employees or less & average annual wages of < $50,000 that provide health insurance for employees Permanently authorizes the Federally Qualified Health Centers (FQHC) and National Health Service Corps (NHSC) programs and increases funding for FQHC and the NHSC from 2010 - 2015 Increasing access for Medicaid recipients for services at home and in the community. This provision allows States to provide disabled individuals care at home rather than in institutions
  • 7. Federal Healthcare Reform 2010 Quality Care Incentives Reduced Medicaid payments to hospitals for hospital acquired conditions, such as a hip fracture resulting from a fall Reduced Medicare payments to hospitals for hospital acquired conditions, such as infections Reduced Medicare payment to hospitals for excess (preventable) readmissions Medicare establishes a “value based purchasing” program to pay hospitals based on Patient outcomes and quality performance
  • 8. Federal Healthcare Reform 2010 Restructure Healthcare Delivery and Operations Incentives for physicians to form Accountable Care Organizations to coordinate patient care, prevent illness and reduce admissions to hospitals to share in Medicare cost savings Implementing electronic health records to reduce paperwork, administrative burdens, and most importantly reduce medical errors Bundled payments to hospitals, physicians, and other providers to align incentives, and to allow savings to be shared between providers and the Medicare program Reducing healthcare fraud and waste in Medicare and Medicaid
  • 9. Federal Healthcare Reform 2010 Restructure Insurance Products Extends dependent coverage for adult children up to age 26 for all individual and group policies 09/2010 Grants to States to plan for Health Insurance Exchanges for purchase of insurance by individuals and small employers States may create a basic health plan for uninsured individuals with incomes between 133 – 200% FPL Requires Federal Government to create a process in conjunction with States, for insurers to justify unreasonable premium increases. Grants provided to States for reviewing premium increases Requires U.S citizens and legal residents to have qualifying health coverage 01/2014
  • 10. Mitt Romney Plans to have federal government issue waivers to all fifty states from current health care reform legislation Restore State Leadership and Flexibility Block grant Medicaid and other payments to states Limit federal standards and requirements on both private insurance and Medicaid coverage
  • 11. Mitt RomneyEnsure flexibility to help the uninsured,including public-private partnerships,exchanges, and subsidiesEnsure flexibility to help the chronically ill,including high-risk pools, reinsurance, andrisk adjustmentOffer innovation grants to explore non-litigation alternatives to dispute resolution
  • 12. Mitt Romney Promote Free Markets and Fair Competition Cap non-economic damages in medical malpractice lawsuits; provide innovation grants to states for reforms such as alternative dispute resolution or health care courts Empower individuals and small businesses to form purchasing pools Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage for a period of time Facilitate IT interoperability
  • 13. Mitt Romney Empower Consumer Choice End tax discrimination against the individual purchase of insurance – reform the tax code Allow consumers to purchase insurance across state lines without costly state benefit requirements Unshackle HSAs by allowing funds to be used for insurance premiums
  • 14. Mitt Romney Empower Consumer Choice Promote "co-insurance" products Promote alternatives to "fee for service“ Encourage "Consumer Reports"-type ratings of alternative insurance plans