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ObamaCare: Why Should You Care?
 

ObamaCare: Why Should You Care?

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Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health ...

Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health insurance providers, business owners and YOU? If yes, then join the Young Professionals of Chicago as we host a panel of diverse health care professionals that will be discussing current healthcare reform and taking questions on the impact of the United States' new healthcare policy. The distinguished panelists will also provide some insight and clarity into what this massive bill means for individuals like you. There will also be an opportunity for open networking with other young professionals before and after the discussion.

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    ObamaCare: Why Should You Care? ObamaCare: Why Should You Care? Presentation Transcript

    • Obamacare:Why Should You Care?
      Presenters:
      Jermaine Paul / Danyale Ellis
      Art Estler / Anwer Kahn
    • State of Healthcare
      Increasing Uninsured Population
      • Estimated 45 million individuals lack health insurance
      • Non-elderly adults make up the largest percentage of the uninsured
      • 80% of uninsured are comprised of individuals from working families
      Unsustainable Rising Cost
      • Total health expenditures reached $2.3 trillion in 2008
      • 16.2% of the Gross Domestic Product (GDP)
      • Aging population
      • Overutilization of services
      • Medical bills are the #1 cause of bankruptcy
      • Increasing number of medical errors
      Underinvestment in prevention and public health
      • Lack of access to preventative services
      • Poor personal choices
    • The Solution
      Health Care and Education Affordability Reconciliation Act of 2010 & Patient Protection and Affordable Care ActExpand health insurance coverage to 32 million individuals
      Expansion of Medicaid eligibility
      Requires states to expand Medicaid to include childless adults
      Expanded to 133 percent of the federal poverty level
      Individual Mandate
      In 2014, everyone must purchase health insurance or face an annual fine of a flat dollar amount or percent of income
      Employer Mandate
      In 2014, employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance
      Preventative care
      Plan will be required to provide free preventative care
      Not subject to deductible or co-payment
    • The Solution Cont.
      Health Insurance Exchanges
      • Uninsured and self employed can purchase insurance through state-based exchanges
      Subsidies available for families between 100% -400% of the federal poverty level
      Separate exchanges for small businesses
      Tax credits will be made available to companies
      Insurance Companies
      • Insurers will be prohibited from denying coverage for pre-existing conditions
      • Insurers required to provide coverage for non-dependent children up to age 26 under their parents’ plan
      • Bans annual caps and lifetime maximums on coverage
      Electronic Health Information Technology Investment
      • Electronic Medical Records
    • Cost of Health Care Reform
      Congressional Budget Office (CBO) score
      • The plan will cost $940 billion over the next 10 years
      • Cuts the deficit by $143 billion in the first 10 years
      • Cuts the deficit by $1.2 trillion in the second 10 years
      • Reduces annual growth in Medicare expenditures by 1.4 percentage
      points per year
    • Financing
      Medicare Payroll Tax
      • Beginning in 2012, the Medicare Payroll Tax will be expanded to include unearned income. That will be a 3.8% tax on investment income for families making more than $250,000 per year ($200,000 for individuals)
      Excise Tax
      • Beginning in 2018, insurance companies will pay a 40% excise tax on "Cadillac" high-end insurance plans worth over $27,500 for families ($10,200 for individuals)
      • 10% excise tax on indoor tanning services
      • Beginning in 2013, medical device manufacturers will pay a 2.9% excise tax on the sale of any product
    • Financing Cont.
      Medicare Advantage Plans
      • Government payments will be reduced by $132 billion over the next 10 years
      New “Fees”
      • In 2011, new fees will be imposed for brand-name drug makers based on market share in 2011
      • In 2014, new fees will be imposed on health insurance companies based on market share
      Enhance Fraud Abuse Checks
      • New screening procedures will be implemented to help eliminate fraud and waste
    • Healthcare Reform: Federally Qualified Healthcare Facilities
      Presented By:
      Danyale Ellis
    • FQHCs Role in ObamaCare
      You may be asking yourself, “How does FQHC’s relate to the Healthcare bill?” The current healthcare system does not have the capacity to serve the anticipated millions of individuals who will transition from uninsured to insured once the law goes into effect. Thus, President Obama has and will invest in community health centers to take on a large percentage of the care.
    • Federally Qualified Health Centers
      • Created under federal law over 40 years ago
      • Receive Federal Grant: Section 330 of the Public Health Service Act
      • Administrated by Health Resources and Services Administration (HRSA)
      • 1,200 centers nation-wide
      • Serve over 18 million patients
      • Over a dozen located in Cook County
    • Federally Qualified Health Centers
      • They provide a variety of services:
      • Primary Care
      • Case Management
      • Transportation
      • Dental Care
      • Mental Health
      • Pharmacy
    • Current Reform Bill Impacts
      The current healthcare system does not have the capacity to care for the millions of Americans who will transition from uninsured to insured. Thus, President Obama has and will invest in community health centers to take on a large percentage of the care.
    • Federal Stimulus Money
      • What has happened?
      • Through Federal Stimulus Dollars in 2009, community health centers:
      • Opened new health centers;
      • Purchased Electronic Health Records Systems;
      • Took on growing number of uninsured; and
      • Renovated or built new facilities
    • Healthcare Reform
      What will happen?
      Through the healthcare reform bill, community health care centers will receive $11.9 billion over the next five years in order to expand their operational capacity to serve nearly 20 million new patients.
    • Federally Qualified Health Centers
      Currently serves over 18 million patients, after the implementation of the healthcare bill, they will nearly double the number of patients served. Due to the funding received through the healthcare reform act, federally qualified health centers will continue to provide quality and affordable health care services to serve those in need
    • Health Care Reform: Prevention
      Presented By:Arthur Elster, MD, MJ
    • Leading Causes of Death: 30-40 yrs
      Causes Female (%) Male (%)
      Cancer 21% 8%
      Unintentional Injury 21% 30.5%
      Ht Dis. 10% 12%
      Suicide 6% 12.5%
      Homicide 4% 8%
      HIV Dis. 4% 4%
      Stroke 3% 2%
      Diabetes Mellitus 2.5% 2%
      Liver Dis. 2% 2%
    • Preventable Causes of Death
      Tobacco (18%)
      Poor Diet and Physical Activity (16.5%)
      Alcohol Consumption (3.5%)
      Microbial Agents (3%)
      Toxic Agents (2.5%)
      Motor Vehicle (2%)
      Firearms (1%)
      Sexual Behavior…including HIV (1%)
      Illicit Drug Use (1%)
      Non-preventable ….around 50%
    • Current Issues
      US health care and insurance industries center on acute care, not prevention (exception….non-for-profit HMO)
      The greatest advances in health over the past several decades have come from public health and preventive medicine
      Wellness is often presumed to reside in the personal domain
      But… an ounce of prevention (may be) worth a pound of cure
    • What are Preventive Services?
      Screening, counseling, and immunizations services aimed at “otherwise well populations” delivered in an office setting
    • Health Care Reform and Preventive Services
       "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements for evidence-based items or services that have in effect a rating of `A' or `B' in the current recommendations of the United States Preventive Services Task Force."
    • Us Preventive Services Task Force:Sample of Recommendations
      Screening for:
      • HIV
      • STD
      • High Blood Pressure,
      • Type II Diabetes (in people with marginally high B.P.)
      • Cervical Cancer
      • Colorectal Cancer
      • Depression
      • Mammography (50-74 yrs)
      • Tobacco Cessation Counseling
      • Screening and Intensive Counseling for Obesity
      For the complete list, see www.ahrq.gov/clinic/cps3dix.htm
    • The Changing Landscape of American Healthcare
      Presented By:
      Anwer Khan
      23
    • Discussion Points
      • Playing Ball
      • Managing Change
      • Making an Impact:
      • Data Integration
      • “Meaningful” Application
    • Playing Ball – Broad & Complex Field
      The healthcare landscape is becoming increasingly more broad and complex...
      tomorrow's healthcare organization must be built on a platform of information-driven transparency; one that illustrates:
      Compelling Cost Savings
      Repeatable Outcomes
      Plausible Innovation
      Good
      Bad
      • Cheaper catastrophic coverage
      • No Denials for Pre-existing Conditions or Lifetime Limits
      • More Access to Information – personal portals and electronic health records
      • Higher taxes and premiums for upper income earners
      • Overtime health care costs will rise – forcing the need to save a significant amount for your and potentially your parent’s future
      • Increased competition across insurers and care providers will require more due diligence from you
      For
      You:
    • Playing Ball– Principal Components of Healthcare Reform
      The “ABCDE” of
      Today’s Healthcare:
      • Access
      • Best Quality
      • Cost
      • Disparities
      • Effectiveness
      President Obama’s FY 2010 Budget overview:
      • Reduce long-term growth of health care costs for businesses and government.
      • Protect families from bankruptcy or debt because of health care costs.
      • Guarantee choice of doctors and health plans.
      • Invest in prevention and wellness.
      • Improve patient safety and quality care.
      • Assure affordable, quality health coverage for all Americans.
      • Maintain coverage when you change or lose your job.
      • End barriers to coverage for people with pre-existing medical conditions.
    • Playing Ball– Balancing Cost, Quality & Outcomes
      Patient Education
      Loss of Position
      Care Delivery Equilibrium
      Performance Incentives
      Data Transparency
      Delivery Costs
      Quality of Outcomes
      Privacy
      Resource Mix
      Competitive Position
      Physician Education
      Achieving equilibrium is the responsibility of every member of the Healthcare Ecosystem, including the Patient
    • Managing Change– Good and Bad
    • Managing Change–Individual and Collective Calls to Action
    • Making an Impact: High Performance Medicine
      Clinical Operations at the intersection of Business and Technology
      • Qualify for meaningful use incentive payments
      • Increase referral volume from community providers
      • Minimize redundant procedures
      • Reduce in-patient re-admits
      • Improve quality, safety, efficiency, and reduce health disparities
      • Engage patients and families
      • Improve care coordination
      • Improve population and public health
      • Enhance patient safety by reducing medication errors system-wide
      Streamline business processes:
      • Pre-registration
      • Provider Information request
      • Reimbursement information capture
      • Fulfillment of patient information requests
      • Ensure adequate privacy and security protections for personal health information
      • Patient Satisfaction
      Clinical Practice
      Business Growth
      • Expand disease management programs by supporting activities for certain patients with chronic illnesses
      • Increase capture of ancillary services
      • Improve cost effectiveness through managing utilization trends and analysis of variance
      Information Technology
    • Thank You!
      31