The document provides an update on health care reform implementation including:
1) The pace of implementation may vary by state and depend on the 2012 election outcomes.
2) Key provisions that have already gone into effect or will by 2013 include premium rate reforms, medical loss ratio requirements, coverage mandates, and taxes/fees.
3) Major changes coming in 2014 include the establishment of health insurance exchanges, an individual mandate, employer penalties, and Medicaid expansion.
4) Compliance priorities for employers include reporting requirements, taxes/fees, and preparing for the potential impacts of 2014 reforms.
1) The document summarizes a policy brief about accountable care organizations (ACOs) and the key issues in designing them.
2) An ACO aims to deliver coordinated, efficient care to a defined population by holding local healthcare providers accountable for quality and costs. It would receive bonuses for meeting targets but penalties for failing.
3) There are open questions about how to design ACs, including what types of providers must participate, how patients will be involved, and what payment methods should be used. The brief discusses these issues and implementation challenges.
Insurance reforms were implemented between 2010-2018 that prohibited lifetime or annual limits on coverage, pre-existing condition exclusions, and cancellations. Standard coverage documents and definitions were also developed. A "Cadillac tax" on high-cost employer health plans went into effect in 2018. Hospitals with high readmission rates faced reduced Medicare payments beginning in 2012. Individuals and families making over $200,000/$250,000 respectively paid higher Medicare taxes starting in 2013.
Re-Evaluating Your Managed Care Revenue Improvement Opportunitieschriskalkhof
Within your span of control are:
1) Preparing strategically through internal/external assessments and developing contracting/pricing strategies.
2) Negotiating effectively to optimize reimbursement, payment rules, and contracts.
3) Integrating agreements into revenue management operations through the revenue cycle.
The document discusses social impact bonds (SIBs) as a way to raise investment for preventative social services. A SIB is a contract between public commissioners and investors where the commissioner commits to pay for improved social outcomes that yield cost savings. Investors provide upfront capital for interventions, and receive a financial return based on the degree of improved outcomes. The document outlines the first SIB pilot in the UK focusing on reducing recidivism among short-term prisoners leaving Peterborough prison through social reintegration services.
This document outlines the key points from a presentation on the future of nursing and healthcare reform. It discusses the challenges facing the US healthcare system including rising costs and access issues. It also examines issues in nursing including a lack of educational preparation and faculty shortages. The presentation reviews recommendations from the IOM report on nursing calling for higher levels of education and full practice authority. The report advocates for nurses to play a leadership role in healthcare redesign through initiatives like the Patient Protection and Affordable Care Act.
Emerging Business Models for Hospital and Physician Integration: Clinical In...chriskalkhof
The document discusses emerging business models for hospital and physician integration, focusing on clinical integration as a business strategy. It provides an overview of the evolving regulatory landscape under the Affordable Care Act and its impact on provider revenues. It then discusses emerging provider business models and financing options, highlighting clinical integration organization (CIO) models. The presentation outlines steps to develop a clinical integration and business plan, including assessing readiness, defining the organizational model, and planning initial clinical integration initiatives. The goal is to create a fully integrated network capable of managing patient populations and risks.
The Affordable Care Act expands access to health insurance coverage in three main ways: 1) by expanding Medicaid eligibility to 138% of the federal poverty level; 2) by establishing health insurance exchanges to allow individuals to purchase subsidized plans; and 3) by implementing an individual mandate requiring most Americans to have health coverage or pay a penalty. The expansion is projected to significantly reduce the number of uninsured, especially low-income adults, women, and people of color. However, implementation challenges remain regarding state participation and ensuring newly covered individuals can afford plans with adequate benefits.
Buck Voluntary Benefits Integrated Solutions (VBIS) provides voluntary benefits to employers to help attract and retain talent while lowering overall benefit costs. VBIS aims to creatively design voluntary benefit solutions that support employer objectives and employee financial well-being through long-term sustainable partnerships. VBIS helps employers reduce expenses by integrating supplemental health plans to fill coverage gaps when medical plans are made more aggressive, and through permissible redistribution of voluntary benefit commissions. VBIS also assists employers in increasing participation in favored health plans and strengthening retention by measuring success of selected voluntary plans.
1) The document summarizes a policy brief about accountable care organizations (ACOs) and the key issues in designing them.
2) An ACO aims to deliver coordinated, efficient care to a defined population by holding local healthcare providers accountable for quality and costs. It would receive bonuses for meeting targets but penalties for failing.
3) There are open questions about how to design ACs, including what types of providers must participate, how patients will be involved, and what payment methods should be used. The brief discusses these issues and implementation challenges.
Insurance reforms were implemented between 2010-2018 that prohibited lifetime or annual limits on coverage, pre-existing condition exclusions, and cancellations. Standard coverage documents and definitions were also developed. A "Cadillac tax" on high-cost employer health plans went into effect in 2018. Hospitals with high readmission rates faced reduced Medicare payments beginning in 2012. Individuals and families making over $200,000/$250,000 respectively paid higher Medicare taxes starting in 2013.
Re-Evaluating Your Managed Care Revenue Improvement Opportunitieschriskalkhof
Within your span of control are:
1) Preparing strategically through internal/external assessments and developing contracting/pricing strategies.
2) Negotiating effectively to optimize reimbursement, payment rules, and contracts.
3) Integrating agreements into revenue management operations through the revenue cycle.
The document discusses social impact bonds (SIBs) as a way to raise investment for preventative social services. A SIB is a contract between public commissioners and investors where the commissioner commits to pay for improved social outcomes that yield cost savings. Investors provide upfront capital for interventions, and receive a financial return based on the degree of improved outcomes. The document outlines the first SIB pilot in the UK focusing on reducing recidivism among short-term prisoners leaving Peterborough prison through social reintegration services.
This document outlines the key points from a presentation on the future of nursing and healthcare reform. It discusses the challenges facing the US healthcare system including rising costs and access issues. It also examines issues in nursing including a lack of educational preparation and faculty shortages. The presentation reviews recommendations from the IOM report on nursing calling for higher levels of education and full practice authority. The report advocates for nurses to play a leadership role in healthcare redesign through initiatives like the Patient Protection and Affordable Care Act.
Emerging Business Models for Hospital and Physician Integration: Clinical In...chriskalkhof
The document discusses emerging business models for hospital and physician integration, focusing on clinical integration as a business strategy. It provides an overview of the evolving regulatory landscape under the Affordable Care Act and its impact on provider revenues. It then discusses emerging provider business models and financing options, highlighting clinical integration organization (CIO) models. The presentation outlines steps to develop a clinical integration and business plan, including assessing readiness, defining the organizational model, and planning initial clinical integration initiatives. The goal is to create a fully integrated network capable of managing patient populations and risks.
The Affordable Care Act expands access to health insurance coverage in three main ways: 1) by expanding Medicaid eligibility to 138% of the federal poverty level; 2) by establishing health insurance exchanges to allow individuals to purchase subsidized plans; and 3) by implementing an individual mandate requiring most Americans to have health coverage or pay a penalty. The expansion is projected to significantly reduce the number of uninsured, especially low-income adults, women, and people of color. However, implementation challenges remain regarding state participation and ensuring newly covered individuals can afford plans with adequate benefits.
Buck Voluntary Benefits Integrated Solutions (VBIS) provides voluntary benefits to employers to help attract and retain talent while lowering overall benefit costs. VBIS aims to creatively design voluntary benefit solutions that support employer objectives and employee financial well-being through long-term sustainable partnerships. VBIS helps employers reduce expenses by integrating supplemental health plans to fill coverage gaps when medical plans are made more aggressive, and through permissible redistribution of voluntary benefit commissions. VBIS also assists employers in increasing participation in favored health plans and strengthening retention by measuring success of selected voluntary plans.
Employers are facing large unfunded liabilities for retiree medical benefits and must choose how to manage this liability. Options include terminating plans and providing access only, continuing pay-as-you-go funding, partial pre-funding via a Voluntary Employees' Beneficiary Association (VEBA) trust, or fully pre-funding the liability with a group annuity through a VEBA. These options vary in the level of funding and security provided to retirees.
Joel Gilbertson, vice president of government and public affairs for Providence Health & Systems, provided a "Health Reform 101" presentation at the Alaska Providers Forum Sept. 2, 2010
An12 353 - learning to speak the healthcare languageEd Dodds
The document discusses a presentation on healthcare payments given by representatives from the Federal Reserve Bank of Atlanta and The Clearing House. It provides background on the US healthcare landscape and spending, legislative efforts to improve the system, and standards for electronic healthcare payments. It focuses on the CCD+ format and reassociation trace number that allows linking electronic payments to remittance advice documents. Next steps for financial institutions include evaluating capabilities and educating staff on providers' needs for healthcare payments.
The document summarizes changes to employer-provided health care plans under the Affordable Care Act (ACA). Key changes for employers beginning in 2014 include requiring plans to cover at least 60% of costs and be affordable or employers may face penalties. Employers with 50+ full-time employees must also offer coverage or may be penalized. Individuals without employer coverage may receive subsidies to purchase plans on insurance exchanges if they earn between 100-400% of the federal poverty level.
Health care reform_timeline_chart_1-28-13Eric Stern
The timeline summarizes important dates in the implementation of the Affordable Care Act between 2010 and 2018. Key provisions include:
- 2010-2011: Dependent coverage must be offered until age 26 and pre-existing conditions can be covered through high-risk pools.
- 2011-2013: Medical loss ratio and electronic transactions rules apply, health care exchanges are established.
- 2014: Most individuals must have coverage or pay a penalty and health insurance market reforms take effect.
- 2015-2018: Additional taxes and fees are imposed on health plans, and remaining ACA provisions are implemented.
Kentucky health cooperative an overviewjacktillman
The document provides an overview of Consumer Operated and Oriented Plans (CO-OPs), which were established under the Affordable Care Act to foster the creation of nonprofit health insurers. It discusses the role of CO-OPs and health insurance exchanges, and federal regulations for CO-OPs. It then introduces the Kentucky Health Cooperative as an example CO-OP that was awarded funding to operate in Kentucky.
Accountable Care Organizations - The Camel's Nose Is In the TentDavid Harlow
Accountable Care Organizations (ACOs) are a tool promoted by the Centers for Medicare and Medicaid Services to help achieve the "Triple Aim" of better care, better health, and lower costs. ACOs integrate high-performing healthcare providers into coordinated systems using financial incentives to encourage population health management. While the goals of ACOs are to improve quality and lower costs, setting them up requires significant investments in care coordination infrastructure and overcoming cultural barriers. Physicians will be central to developing successful ACO models. Overall, ACOs are one part of various bundled payment and value-based initiatives aimed at shifting to alternative payment models.
This document introduces the Medical Bridge OpportunitySM, a solution that helps employers and employees manage rising health care costs. It offers benefits counseling and enrollment at no direct cost to employers. The solution involves redesigning health plans with higher deductibles and coinsurance while offering employees supplemental insurance through Colonial Life's Group Medical Bridge 1.0 plan. This bridges the gap in out-of-pocket costs and provides benefits for hospitalization, outpatient surgery, and wellness visits. It is appealing as it offers guaranteed issue underwriting with no health questions and flexible rating options.
This document discusses planning for expansion of health insurance coverage under the Affordable Care Act. It provides an overview of who will be newly eligible, their characteristics, and variation across states. Sources of federal data on demographics are described, as well as microsimulation models used to estimate enrollment. Resources mentioned include the SHADAC Data Center for accessing estimates from surveys like the ACS and CPS, and contact information is provided for the authors.
Health Decisions Webinar: December 2012 union trustsSi Nahra
Every major reform has winners and losers. Obamacare is no exception. With all the talk about state health exchanges, new fees, and pay-or-play, the opportunity for union trusts to be big winners can be easily overlooked. This webinar will present that perspective. We start by exploring the differences between union trusts and other self-funded plans. Those differences afford union trusts the ability to offer their members a health coverage experience that can be more attractive and less costly than traditional employer-controlled coverage. Those differences, if pursued by union trusts, can also assist in recruiting union membership and countering the impacts of right-to-work and other anti-union initiatives. While not inevitable, the perspective shared in this webinar is as probable as the predictions of doom and gloom that so permeate the discussion around health reform.
For more information, please visit: http://www.healthdecisions.com
This document summarizes Bill Freedman's presentation on major features of the Affordable Care Act that concern employers. It discusses provisions related to health insurance exchanges, employer and individual mandates, limits on cost sharing, reporting requirements, and other regulatory changes taking effect in 2014. The summary provides an overview of how the law affects employer-sponsored health plans.
This document summarizes a presentation given by Diane Oakley of the National Institute on Retirement Security (NIRS) about public pension plans. The presentation discusses opportunities and challenges facing public pensions, stakeholders in public pensions, the importance of focusing on retirement policy, and lessons learned from well-funded plans. It provides statistics on the economic impacts of public pension benefits and expenditures. The presentation aims to distinguish facts from assertions and prevent short-sighted policies in public pension discussions.
2010 HIMSS Advocacy Day - Jonah Frohlichhimsssocal
This document provides population statistics for different regions in California and discusses successes and challenges of health IT initiatives. It then outlines requirements and priorities for the federal health information exchange (HIE) program, including establishing core HIE services, setting technical standards, and providing incentives for meaningful use of electronic health records.
The document discusses improving opportunities for patient and consumer engagement in health technology assessment (HTA) in Australia. It notes that while mechanisms exist for patient input, the overall HTA process is not well understood, advocacy groups are under-resourced, and the timeline for submissions is short. It proposes the formation of HTA_AUS, a coalition of interested parties including patient groups, government, industry and others, to address this issue and develop practical solutions like supporting patient submissions and extending deadlines. The coalition aims to increase awareness, education and support for patient engagement in HTA.
Health Care Reform: The Franchise Operator's Guide 10-26-12Franchise Workforce
The document summarizes key provisions of the Affordable Care Act that take effect in 2014, including:
1) The Supreme Court upheld the individual mandate and entire Affordable Care Act.
2) State health insurance exchanges will offer plans to individuals and small businesses.
3) Most individuals will be required to have minimum essential health coverage or pay a penalty. Low-income individuals can receive subsidies.
4) Employers with 50+ full-time employees that do not offer affordable coverage may pay penalties.
5) Nondiscrimination rules are expanded to prevent fully insured group health plans from favoring highly-compensated employees.
This document provides a glossary of terms related to individual health insurance. It defines terms like agent, annual deductible, coinsurance, network providers, pre-existing conditions, and premiums. It also provides contact information for Celtic Insurance Company, an individual health insurance provider. Celtic aims to offer consumers affordable and easy-to-understand insurance plans. The glossary helps explain insurance concepts and Celtic's services.
Buying a home requires careful consideration of market timing. Research property values and trends to understand the local real estate market and determine if prices are rising or falling. Seek expert advice from real estate agents on the optimal time to purchase based on current market conditions to get the best deal and avoid overpaying.
Employers are facing large unfunded liabilities for retiree medical benefits and must choose how to manage this liability. Options include terminating plans and providing access only, continuing pay-as-you-go funding, partial pre-funding via a Voluntary Employees' Beneficiary Association (VEBA) trust, or fully pre-funding the liability with a group annuity through a VEBA. These options vary in the level of funding and security provided to retirees.
Joel Gilbertson, vice president of government and public affairs for Providence Health & Systems, provided a "Health Reform 101" presentation at the Alaska Providers Forum Sept. 2, 2010
An12 353 - learning to speak the healthcare languageEd Dodds
The document discusses a presentation on healthcare payments given by representatives from the Federal Reserve Bank of Atlanta and The Clearing House. It provides background on the US healthcare landscape and spending, legislative efforts to improve the system, and standards for electronic healthcare payments. It focuses on the CCD+ format and reassociation trace number that allows linking electronic payments to remittance advice documents. Next steps for financial institutions include evaluating capabilities and educating staff on providers' needs for healthcare payments.
The document summarizes changes to employer-provided health care plans under the Affordable Care Act (ACA). Key changes for employers beginning in 2014 include requiring plans to cover at least 60% of costs and be affordable or employers may face penalties. Employers with 50+ full-time employees must also offer coverage or may be penalized. Individuals without employer coverage may receive subsidies to purchase plans on insurance exchanges if they earn between 100-400% of the federal poverty level.
Health care reform_timeline_chart_1-28-13Eric Stern
The timeline summarizes important dates in the implementation of the Affordable Care Act between 2010 and 2018. Key provisions include:
- 2010-2011: Dependent coverage must be offered until age 26 and pre-existing conditions can be covered through high-risk pools.
- 2011-2013: Medical loss ratio and electronic transactions rules apply, health care exchanges are established.
- 2014: Most individuals must have coverage or pay a penalty and health insurance market reforms take effect.
- 2015-2018: Additional taxes and fees are imposed on health plans, and remaining ACA provisions are implemented.
Kentucky health cooperative an overviewjacktillman
The document provides an overview of Consumer Operated and Oriented Plans (CO-OPs), which were established under the Affordable Care Act to foster the creation of nonprofit health insurers. It discusses the role of CO-OPs and health insurance exchanges, and federal regulations for CO-OPs. It then introduces the Kentucky Health Cooperative as an example CO-OP that was awarded funding to operate in Kentucky.
Accountable Care Organizations - The Camel's Nose Is In the TentDavid Harlow
Accountable Care Organizations (ACOs) are a tool promoted by the Centers for Medicare and Medicaid Services to help achieve the "Triple Aim" of better care, better health, and lower costs. ACOs integrate high-performing healthcare providers into coordinated systems using financial incentives to encourage population health management. While the goals of ACOs are to improve quality and lower costs, setting them up requires significant investments in care coordination infrastructure and overcoming cultural barriers. Physicians will be central to developing successful ACO models. Overall, ACOs are one part of various bundled payment and value-based initiatives aimed at shifting to alternative payment models.
This document introduces the Medical Bridge OpportunitySM, a solution that helps employers and employees manage rising health care costs. It offers benefits counseling and enrollment at no direct cost to employers. The solution involves redesigning health plans with higher deductibles and coinsurance while offering employees supplemental insurance through Colonial Life's Group Medical Bridge 1.0 plan. This bridges the gap in out-of-pocket costs and provides benefits for hospitalization, outpatient surgery, and wellness visits. It is appealing as it offers guaranteed issue underwriting with no health questions and flexible rating options.
This document discusses planning for expansion of health insurance coverage under the Affordable Care Act. It provides an overview of who will be newly eligible, their characteristics, and variation across states. Sources of federal data on demographics are described, as well as microsimulation models used to estimate enrollment. Resources mentioned include the SHADAC Data Center for accessing estimates from surveys like the ACS and CPS, and contact information is provided for the authors.
Health Decisions Webinar: December 2012 union trustsSi Nahra
Every major reform has winners and losers. Obamacare is no exception. With all the talk about state health exchanges, new fees, and pay-or-play, the opportunity for union trusts to be big winners can be easily overlooked. This webinar will present that perspective. We start by exploring the differences between union trusts and other self-funded plans. Those differences afford union trusts the ability to offer their members a health coverage experience that can be more attractive and less costly than traditional employer-controlled coverage. Those differences, if pursued by union trusts, can also assist in recruiting union membership and countering the impacts of right-to-work and other anti-union initiatives. While not inevitable, the perspective shared in this webinar is as probable as the predictions of doom and gloom that so permeate the discussion around health reform.
For more information, please visit: http://www.healthdecisions.com
This document summarizes Bill Freedman's presentation on major features of the Affordable Care Act that concern employers. It discusses provisions related to health insurance exchanges, employer and individual mandates, limits on cost sharing, reporting requirements, and other regulatory changes taking effect in 2014. The summary provides an overview of how the law affects employer-sponsored health plans.
This document summarizes a presentation given by Diane Oakley of the National Institute on Retirement Security (NIRS) about public pension plans. The presentation discusses opportunities and challenges facing public pensions, stakeholders in public pensions, the importance of focusing on retirement policy, and lessons learned from well-funded plans. It provides statistics on the economic impacts of public pension benefits and expenditures. The presentation aims to distinguish facts from assertions and prevent short-sighted policies in public pension discussions.
2010 HIMSS Advocacy Day - Jonah Frohlichhimsssocal
This document provides population statistics for different regions in California and discusses successes and challenges of health IT initiatives. It then outlines requirements and priorities for the federal health information exchange (HIE) program, including establishing core HIE services, setting technical standards, and providing incentives for meaningful use of electronic health records.
The document discusses improving opportunities for patient and consumer engagement in health technology assessment (HTA) in Australia. It notes that while mechanisms exist for patient input, the overall HTA process is not well understood, advocacy groups are under-resourced, and the timeline for submissions is short. It proposes the formation of HTA_AUS, a coalition of interested parties including patient groups, government, industry and others, to address this issue and develop practical solutions like supporting patient submissions and extending deadlines. The coalition aims to increase awareness, education and support for patient engagement in HTA.
Health Care Reform: The Franchise Operator's Guide 10-26-12Franchise Workforce
The document summarizes key provisions of the Affordable Care Act that take effect in 2014, including:
1) The Supreme Court upheld the individual mandate and entire Affordable Care Act.
2) State health insurance exchanges will offer plans to individuals and small businesses.
3) Most individuals will be required to have minimum essential health coverage or pay a penalty. Low-income individuals can receive subsidies.
4) Employers with 50+ full-time employees that do not offer affordable coverage may pay penalties.
5) Nondiscrimination rules are expanded to prevent fully insured group health plans from favoring highly-compensated employees.
This document provides a glossary of terms related to individual health insurance. It defines terms like agent, annual deductible, coinsurance, network providers, pre-existing conditions, and premiums. It also provides contact information for Celtic Insurance Company, an individual health insurance provider. Celtic aims to offer consumers affordable and easy-to-understand insurance plans. The glossary helps explain insurance concepts and Celtic's services.
Buying a home requires careful consideration of market timing. Research property values and trends to understand the local real estate market and determine if prices are rising or falling. Seek expert advice from real estate agents on the optimal time to purchase based on current market conditions to get the best deal and avoid overpaying.
The document provides instructions for adding content to boxes on Libguides pages. It describes how to add new boxes, select the box type, add text, images, links, and embedded media. It also explains how to edit box content and properties, reorder boxes on the page, and resize columns.
This document discusses technical considerations for measuring and monitoring reductions in greenhouse gas emissions from avoided deforestation. It notes that quantifying such reductions requires measuring changes in forest cover and carbon stocks over time. Satellite imagery is the primary method for measuring forest area changes at national scales, and various digital analysis techniques can be used depending on factors like national capabilities. Measuring forest degradation is more challenging than deforestation but improving. Guidelines exist for carbon accounting but uncertainties remain that new technologies may help reduce. Several developing countries have national deforestation monitoring systems, but capacity and data access are still issues that need international coordination to address.
Este documento presenta una guía clínica sobre el tratamiento ambulatorio de la enfermedad pulmonar obstructiva crónica (EPOC) elaborada por el Ministerio de Salud de Chile en 2013. La guía contiene recomendaciones sobre el diagnóstico, tratamiento, seguimiento y manejo de pacientes con EPOC en atención primaria, así como aspectos relevantes sobre la epidemiología, gravedad y complicaciones de esta enfermedad.
This apresentation part of course Utah Networxs Hardening Web Servers.
The target is show any options to configure security apache web server and protect to possible hackers attacks.
The package debian_hardening-0.1_beta.deb is available in http://www.utah.com.br/deb/debian_hardening-0.1_beta.deb and source code to change or generate a new debian available in http://www.utah.com.br/src/debian_hardening-0.1_beta.tar.gz
Thanks...
Utah Networxs
Walking to Giants
The document provides an overview of key events and figures during the American Revolutionary War. It discusses the formation of the Continental Army in 1775, the rejection of the Olive Branch Petition by King George III, and the impact of Thomas Paine's "Common Sense" pamphlet in 1776. It also summarizes the signing of the Declaration of Independence that same year and profiles some of the major leaders and groups involved in the Revolutionary War, including Washington, Franklin, soldiers, Indians, enslaved people, and women.
The document discusses the legislative process and its relation to health policy in the United States. It covers the branches of government involved in legislation, including the House, Senate and President. It explains how a bill becomes law, from recognizing a problem through drafting, building support, committee reviews, votes, reconciling differences and presidential approval. It also covers the roles of federal, state and local governments in developing health policy and issues around access, cost and quality of care.
The document discusses reinventing the free monad to model effects in different ways, including with pure effects, effects with returns, and simpler effects using bind. It also covers composing effects, type-safe mocking, runtime optimization, aspect-oriented programming, and hacking the free monad to add capabilities like parallelism, failure handling, and nondeterminism. However, it notes that excessively hacking the free monad can lead to poor composability and performance due to deeply nested types, and can blur the distinction between effects and machinery.
- A monad from a category theoretic perspective is a monoid in the category of endofunctors. From a computational perspective, it is defined by return, bind, and monad laws.
- Kleisli triples and monads are equivalent based on work by Manes in 1976. Monads can be derived from algebraic operations and equations if they have finite rank based on work by Kelly and Power in 1993.
- Algebraic effects classify effects based on algebraic theories and provide a way to modularly combine effects through sums and products. This provides benefits for equational reasoning about monadic programs.
This document provides an overview of monads in Clojure. It begins with an introduction to type signatures in Haskell and defines the monad type class. It then demonstrates some basic monads like the list monad and maybe monad. It provides an example of using the reader monad to cleanly pass configuration to functions. The document includes code samples and explanations of how monads like the list and reader monad work in Clojure. It aims to explain monads in a beginner-friendly way using Clojure examples.
The document is an advertisement for Pimacott, a new brand of 100% pure Pima cotton. Pimacott uses a DNA tagging system to verify that the cotton is 100% Pima from crop to consumer. The company is taking commitments now for fiber from this year's harvest in fall. It invites readers to join the movement ensuring products contain 100% pure Pima cotton verified through their tracking system.
This document provides an overview of operations management at Crompton Greaves Limited (CG), an Indian transformer manufacturing company. It discusses CG's quality certifications, product offerings across power systems, industrial systems, and consumer products. It then examines different aspects of CG's organizational structure, including marketing, materials management, production design/manufacturing/testing, human resources, IT, and engineering/maintenance. The document concludes with a brief section on CG's production planning and control processes.
This document introduces monads for programmers who are familiar with lambdas. It uses a bank API example to demonstrate how monads can be used to compose functions in a cleaner way that avoids null pointer exceptions. The code is refactored using a bind function to chain the API calls together in a way that looks like the business logic. This introduces the reader to how monads can increase modularity and manage complexity in large codebases.
The document discusses how to become a person of influence. It begins by defining influence as the power to change or affect others without directly forcing change. It then outlines that influence matters because teams and organizations grow as a result, and new ideas are implemented through influence. The document provides tips for becoming more influential, such as overcoming influence blockers like self-doubt, using authoritative body language, and believing in oneself. It emphasizes that influence starts from within and is demonstrated through one's beliefs, words, and actions. The overall message is that anyone can develop influence through courage, confidence, and strategic leadership.
Health Decisions Webinar: The Five Levers of Management Control for Your Heal...Si Nahra
As every employer knows, health plan costs are one of their largest and fastest growing expenses. Like any business expense, health plan costs must be managed strategically and proactively. This webinar is for employers and their health plan fiduciaries, executives, managers, administrators, and their advisory teams. The presentation is structured around the "Five Levers of Management Control" that encompass all the health plan management options available to employers.
For more information, please visit: http://www.healthdecisions.com
What does “administrative simplicity” really mean? From eligibility verification to claim adjudication to payment/remittance processing, what does a necessary solution entail? What are the likely obstacles payers and providers will face as they seek a solution?
This document discusses an integrated wellness solution that identifies risks, plans incentives, and measures outcomes. It analyzes data to identify cost drivers and provide money-saving solutions. The solution assists with establishing wellness programs that incentivize participation and health improvements through premium adjustments. It provides services like biometric screenings, online tools, and support with appeals and regulations to implement effective wellness programs.
Driving Decisions From Predictive ModelingAnand Rao
This document discusses strategic applications of predictive modeling in healthcare. It provides examples of using system dynamics modeling to create patient flow models and examine the impact of healthcare policies. It also describes a case study where Diamond used system dynamics modeling to prototype a diabetes management intervention in South Africa. The prototype aimed to use multi-channel communication and social networking to increase prevention, self-care, and primary care of diabetes patients while gathering data to evaluate the intervention's efficiency and efficacy.
This document discusses the impacts of health care reform on individuals, businesses, and the insurance industry. It provides an overview of key provisions taking effect in 2010 related to dependent coverage, preexisting conditions, annual/lifetime limits, and medical loss ratios. Industry representatives discuss challenges of the medical loss ratio requirement and strategies for health insurance agents and brokers to adapt to commission changes by focusing on efficiencies, cross-selling, product diversification, and expanding into new markets like Medicare.
Stephen Frank - Role of Private Insurance for Prescription Drugs in CanadaPharmacare 2020
Private insurance plays an important role in supplementing Canada's public healthcare system by covering around 14% of total healthcare spending. While private insurers have to navigate a complex system with different provincial rules, they have adopted outsourcing and active plan management strategies to reduce costs and increase efficiency. Going forward, a mixed public-private system is optimal to ensure universal coverage while leveraging the strengths of both sectors in adapting to changes and controlling expenditures.
Notes Version: Part 1. The Next Extraordinary Marketing Opportunity- Healthca...Vivastream
The document discusses the opportunities for health insurers in the changing healthcare landscape due to the Patient Protection and Affordable Care Act (PPACA). It notes that health reform could generate billions in new revenue and millions of new customers for insurers. Health benefit exchanges opening in 2014 will create a $60 billion market reaching $200 billion by 2019 and covering 28 million people. Insurers will need to transition from a wholesale to a retail model and focus on direct consumer outreach. Data-driven marketing and segmentation will be key to understanding and engaging the diverse new customer groups that insurers will need to attract. Superior customer experience across all touchpoints will differentiate brands in the emerging competitive marketplace.
Notes Version: Part 1. The Next Extraordinary Marketing Opportunity- Healthca...Vivastream
The document discusses the opportunities for health insurers in the changing healthcare landscape due to the Patient Protection and Affordable Care Act (PPACA). It notes that health reform could generate billions in new revenue and millions of new customers for insurers. Health benefit exchanges opening in 2014 will create a $60 billion market reaching $200 billion by 2019 and covering 28 million people. This represents an opportunity for insurers to transition from a wholesale to a retail model and directly market to consumers. Insurers will need to segment customers, understand their needs and behaviors, and engage them through multiple channels to succeed in this new environment.
This document discusses how healthcare payers can get ahead by optimizing processes, connecting technology solutions, and managing data. It provides a case study of how one healthcare payer client used process improvement, prioritization, and impactful solutions to reduce costs and meet requirements for a competitive bid to become a Medicare Administrative Contractor. The client was able to define a strategy, prioritize program elements, gather detailed requirements, and build impactful solutions to help them win the bid and take on twice the workload with over 30% lower cost per claim.
This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses and practices like yours. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
The document discusses the future of nursing and healthcare. It outlines challenges facing the US healthcare system including rising costs and access issues. It also discusses challenges and opportunities for nursing including an aging population, need for higher levels of education, and calls to expand nursing's leadership role. The IOM report on nursing recommends increasing the proportion of nurses with bachelor's degrees and doubling the number with doctorates by 2020 to help transform the healthcare system and improve outcomes.
A Road Map: Moving From Participation Based Wellness to Outcomes Based WellnessTanya Gonzalez
The document discusses the current state of the U.S. healthcare crisis, noting that costs have risen dramatically in recent decades and now exceed $3 trillion annually. It also notes that over 1/4 of healthcare costs are related to obesity, overweight, and physical inactivity issues. The document then discusses results-based wellness programs and incentives as an approach for employers to address rising healthcare costs by rewarding health outcomes. It provides examples of successful incentive structures and summarizes results from several organizations that saw decreased healthcare costs and improved health metrics after implementing a results-based wellness program.
The document discusses the future of physician payments and the transition away from fee-for-service towards value-based and accountable payment models. It outlines emerging accountable care organization models including single-provider, multi-provider, insurer-led, and insurer-provider partnership models. It also summarizes Medicare and private payer initiatives focusing on shared savings programs and population-based payment approaches. Finally, it provides best practices for physicians and practices to position themselves for success under new payment reforms.
Washington National Insurance Company provides supplemental health and life insurance products to middle-income Americans. It offers a variety of individual and group insurance products, including critical illness, accident, hospital indemnity, disability, dental, life and vision insurance. Washington National has over 5,000 agents across the U.S. and distributes primarily through the worksite channel, serving approximately 1 million policyholders and 25,000 groups. It has a strong financial profile with $4.4 billion in assets and $586 million in annual premiums.
1) The document discusses key issues for states to consider in implementing health insurance exchanges as required by the Affordable Care Act.
2) States must decide whether to establish their own state-based exchange or defer to a federally-run exchange. Factors in this decision include funding, regulatory authority, and promoting state health policies.
3) Additional decisions for states include the governance structure of an exchange, its administration, and whether to have a single statewide exchange or explore regional or multi-state exchange models.
This document provides a summary of the major provisions of the Affordable Care Act that impact employers and recommendations on how to prepare. It includes an overview of requirements that are already in place and future requirements. It also notes that Colonial Life's voluntary benefits are exempt from many of the health insurance reforms and discusses important considerations for voluntary benefits like the health insurance exchanges, employer reporting on W-2 forms, and the excise tax.
Implementation Of The Minimum Medical Loss Ratiojpwlinkedin
The document summarizes key aspects of the implementation of the Minimum Medical Loss Ratio (MLR) requirement under the Affordable Care Act. It discusses the MLR calculations and adjustments at the state and federal level, how rebates are determined and paid out if the MLR is not met, and some of the impacts on insurance carriers, agents, and brokers. It provides details on the regulatory process between the NAIC and HHS to establish definitions and methodologies.
Health Decisions Webinar: Health Reform: A Contrarian's PerspectiveSi Nahra
The document summarizes a presentation on health reform from a contrarian perspective. It begins by stating that true health reform will continue independently of federal efforts. It then outlines five contrarian perspectives on health reform: 1) the US will not adopt single-payer healthcare, 2) actual reform occurs outside of policy debates, 3) Americans are willing to pay for services used not insurance, 4) the uninsured are a permanent but changing group, and 5) individuals not corporations will drive future reform. It concludes by suggesting areas where self-funded plans and individuals could better align financial interests.
Health Decisions Webinar: October 2012 Things an Effective DEA Should IncludeSi Nahra
Dependent Eligibility Auditing has become a more common practice among organizations striving to keep health care benefits affordable. As more and more companies are choosing to conduct dependent audits, more and more vendors are offering audit services, but with varied methods, approaches, and fee structures.
This free webinar reveals those aspects of a dependent eligibility audit service that are most important for success. Judy Mardigian, CEO of Health Decisions, Inc., shares statistics, case studies, and anecdotes from the many dependent eligibility audits the company has done over the past 15 years.
For more information, please visit: http://www.healthdecisions.com
Similar to Health Care Reform October 2012 Update (20)
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The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
This document provides a full-body stretching routine that can be done at one's desk at work. It includes stretches targeting the neck, shoulders, chest, back, hands, and legs. Implementing regular stretching breaks is recommended to help employees relax, reduce stress and tension, improve flexibility and alertness, and decrease injury risk. Stretches should be done slowly and gently without pain, and employees should check with their doctor first if they have any health concerns.
This document discusses issues and recommendations related to calculating and reporting the Affordable Care Act tax credit. It notes that a person's tax credit for 2014 was based on their 2012 taxes, but their life circumstances like marital status and income may have changed. It recommends accounting for lower incomes when people are single or going through a divorce. The document also addresses reporting changes in family size, income, and health insurance coverage throughout the year. It provides an example of calculating credits for a separated woman and her children. Overall, the recommendations are to simplify the rules and forms, clearly define reporting responsibilities, and better educate consumers and staff to make the credit process less complicated.
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This document discusses concerns with certain wellness program designs that tie health insurance costs and incentives to health outcomes. It may jeopardize access to affordable coverage for those with greater health risks. The Affordable Care Act changes wellness programs by increasing the maximum incentive to 30% of premiums. Regulations are needed to ensure wellness programs do not undermine the ACA's affordability provisions and consumer protections. Strengthening alternatives and waivers from outcome requirements can better protect consumers.
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1. Health Care Reform Update
HEALTH CARE REFORM UPDATE
Affordable Care Act (ACA)
October 3rd 2012
Presentation By:
2012 – H Group Benefits, Inc.
David Heller
Jason White, CBC
H Group Benefits, Inc.
This should be used for informational purposes only. Please consult with an attorney or tax professional for further guidance.
2. Health Care Reform Update
2012 Elections and ACA Implementation
States will continue to determine pace of ACA implementation
Obama with divided Obama with Republican Romney with Republican
Congress Congress Congress
Democratic Priorities
• ACA validation • Implementation • Prevent ACA repeal
• Implementation proceeds • Fight to maintain
proceeds • Maintain as much of ACA popular insurance
• Highlight “popular” as possible reforms
provisions” • Potential compromises • Fight to maintain
2012 – H Group Benefits, Inc.
• Single issue fixes on cost, coverage, and Exchange Subsidies and
possible, but hard timeline Medicaid expansion
Republican Priorities
• Full ACA repeal effort • Initial ACA repeal effort • Legislative and
• Highlight ACA cost and • Push defunding and regulatory ACA repeal
complexity delay effort
• Potential compromise on • Potential compromises • Some popular provisions
cost, coverage, and on cost, coverage, and remain
timeline timeline • Replacement unclear
3. Health Care Reform Update
What has already happened?
2010
• Benefit coverage changes
– Preventive Care at 100% in network
– Dependent children under the age 26
– No pre-ex under the age 19
– Prohibits rescissions except fraud
– No lifetime or annual dollar limits on essential benefits
– Patient protections
– Appeals and External Review updates
• Temporary high-risk pool (Pre-existing Comprehensive Insurance Plan)
• Uniform Medical Loss Ratio (MLR) definition (NAIC)
2012 – H Group Benefits, Inc.
• Health & Human Services (HHS) Plan Finder established
2011
• Minimum Medical Loss Ratio (MLR) requirements
• Medicare Advantage plans begin to have payments frozen
• Medicare Advantage cost sharing limits effective for certain covered services
• Pharmaceutical fee
• Rate review implementation
4. Health Care Reform Update
What is happening now?
2012
• Patient Centered Outcomes Research fee
• Medical Loss Ratio (MLR) reporting goes “live”
• Administrative Simplification begins to phase in
• Summary of Benefits and Coverage (SBC)
• Women’s Preventive Services
2013
• Medical Device fee
• Exchange coverage notice
2012 – H Group Benefits, Inc.
• Flexible Spending Account (FSA) Cap
• Tax deduction for employers for Medicare Part D subsidy eliminated
5. Health Care Reform Update
What is happening next?
2014
• Guaranteed issue
• Individual coverage mandate
• Individual subsidy
• State individual and small group Exchanges operational
• Rating rule changes
• Insurer taxes
• Employer “Pay or Play” Mandate
• Essential health benefits
• Medicaid expansion
2012 – H Group Benefits, Inc.
• 90-Day maximum waiting period
• Auto-Enrollment of Newly Hired, Newly Eligible Full-Time Employees
• Annual reporting of employee coverage
• Definition of full-time employees
• Wellness incentives
• Medicare Advantage Medical Loss Ratio (MLR) Requirements
2015 – 2018
Email Jason if you are interested in learning more about the future of Health Care Reform
6. Health Care Reform Update
ACA Compliance Priorities for 2012+
Targeted Areas of Focus in Targeted Areas of Focus in
Targeted Areas of Focus in 2012
Anticipation of 2014 Anticipation of 2014+
Medical Loss Ratio (MLR) Continued Readiness for 2014+ Adaptation to 2014+ Marketplace
• 6/1/12 reporting for 2011 Marketplace
experience year • Exchanges Taxes & Fees
• Payment of rebates by 8/1/12 • Other 2014 Insurance Reforms • Increased health insurer taxes
• Guarantee Issue and • “Cadillac tax” (2018)
Employer Reporting Rating Changes
Requirements • Individual Mandate Additional Insurance Reforms
• Summary of Benefits & • Tax Credits and • States must allow groups with
Coverage (SBC) Subsidies <100 employees into
• W-2 reporting • Employer Mandate Exchanges (2016)
• Increased penalties on
2012 – H Group Benefits, Inc.
Taxes & Fees Product & Plan Impacts individual mandate
• Patient Centered Outcome
Research Institute Fee Additional Employer Reporting
Requirements
Women’s Preventive Health
Services Taxes & Fees
• Annual health insurer fee
Administrative Simplification • Reinsurance Fee
Operating Rules
Medicare MLR
Readiness for 2014+ Marketplace
7. Health Care Reform Update
Employer Impact: Benefit Strategy
Beginning in 2014, a number of prominent ACA provisions take effect, including the launch of state and
federal exchanges, which may impact employer benefit strategies and purchasing decisions.
Individual Exchange
• US citizen or legal alien
• Not incarcerated
• Resident of the state in which Exchange is based
Small Business Health Options Program (SHOP)
• Full-time employees of small businesses from 1 to 100 employees
• State option to limit to businesses of 50 or less until 2016
• States will decide on the degree of choice offered to employees through the small
business Exchange and how employers can provide contributions toward employee
2012 – H Group Benefits, Inc.
coverage
• Beginning in 2017, states will have the option to open the Exchanges to large
employers
Private Exchange
• Free market for plans to target employers that are potentially interested in defined
contribution for their employees
• Potentially more plan flexibility as plans may not need to meet Qualified Health Plan
(QHP) standards
• No access to tax credits and subsidies
8. Health Care Reform Update
Employer Impact: Products & Plans
Full-Time Employee Definition: Effective in 2014, employers must offer all “full-time” employees
“affordable” coverage not below a defined “minimum value.”
Provision Overview
• ACA defines full-time employee as those who work an average of at least 30 hours per
week, effective 1/1/14 *Note: definition relates to FTEs in employer’s affordable
coverage requirement
• New guidance was issued on 8/31/12, and will provide greater flexibility for
employers to reasonably determine whether a current or new variable hour or
seasonal employee qualifies for full-time benefits for purposes of the employer
mandate rules under the ACA
2012 – H Group Benefits, Inc.
• Employers may now apply a so-called "look-back" period of up to 12 months to
determine whether or not a variable hour or seasonal employee is "full-time" (i.e.,
averages 30 or more hours per week) under the ACA
• Importantly, this guidance also describes how the ACA provision limiting group health
plan waiting periods to no more than 90 days coordinates with the employer
mandate, look-back period guidance
• The new guidance regulations largely adopts an approach actively advocated by most
insurance carriers and its employer community allies, notably the Employers for
Flexibility in Health Care
9. Health Care Reform Update
Employer Impact: Other Impacts
90 Day Maximum • Waiting periods for coverage of greater than 90 days will be eliminated for
Waiting Period for new individual and employer-sponsored insurance plans effective 2014
Private Insurance • Existing plans will need to amend waiting periods to not exceed this new
requirement
Flexible Spending • Provision limits the amount of contributions to a Flexible Spending Account
Account Cap (FSA) for medical expenses to $2,500 per year beginning 2013
• The Flexible Spending Account (FSA) cap will be increased annually by the
cost of living adjustment following implementation effective 1/1/13
Wellness Incentives • Employers will be permitted to offer employees rewards of up to 30% of
the cost of coverage for participating in a wellness program and meeting
certain health-related standards (potentially increasing to 50% of the cost
2012 – H Group Benefits, Inc.
of coverage) in 2014
• 10 state pilot programs will apply similar rewards in the individual market in
July 2014
Auto-Enrollment • Employers with more than 200 full-time employees and who offer health
coverage will be required to automatically enroll new, full-time employees
in a coverage option and continue existing elections for current full-time
employees from year to year
• This ACA provision was originally slated to be effective in 2014
10. Health Care Reform Update
Employer Impact: Administrative Reporting
Key ACA-Mandated Employer Reporting Requirements
2012 2013 2014
• Employers will be required to • Employers must notify • Employers must notify
disclose the value of the benefits employees about: employees about:
they provide for each employee’s • The availability of state • Whether the employer’s
health insurance coverage on the health insurance plan meets minimum
employee’s annual W-2 form (for Exchanges coverage requirements
W-2s issued in January 2013) • How to access defined by ACA provisions
information regarding
• Summary of Benefits and premium subsidies that • In addition, employers must
Coverage (SBC) will be provided might be available for report the following information
to all participants of health plans Exchange-based coverage to the Secretary of HHS:
by the employer or insurer. SBC • The length of any
will provide participants with applicable waiting period
2012 – H Group Benefits, Inc.
information regarding cost • Certification that all full-
sharing, continuation of time employees were
coverage, limitations on offered health care
coverage, and details on where coverage
participants can obtain more • The time period during
information about their health which coverage was
plans available
• The premium charged to
• Other reporting requirements the employee for the plan
will also be promulgated through • The employer’s share of
regulation, e.g., quality of care the cost of the plan
reporting
11. Health Care Reform Update
Employer Impact: Taxes, Fees & Penalties
Patient Centered • Sponsors of self-funded health plans and insurers will contribute $1 per
Outcome Research participant covered under each self-insured health plan or health insurance
Fee policy for plan years ending during fiscal year 2013 and $2 per participant
thereafter. The $2 amount will be adjusted in the future for increases in
health care spending.
• The fee does not apply to plan years or policy years ending after September
2019
Reinsurance • A temporary program that offsets a portion of the adverse selection
entering the insurance marketplace operated at the state level in 2014+
• This ACA provision will become effective in 2014
Health Insurer Fee • Entities that provide health insurance coverage to a “United States health
2012 – H Group Benefits, Inc.
risk” are subject to an annual fee, the amount of which will be determined
by Treasury
• This will be effective in 2014 and required annually thereafter
Cadillac Tax • Insurers and Group Health Plan of employer-sponsored coverage will be
taxed on policies costing more than $10,200 for individual coverage and
$27,500 for family coverage beginning in 2018
• Taxes will be 40% of the total premiums that exceed the threshold (listed
above)
12. Health Care Reform Update
Resources
H Group Benefits, Inc.
• David Heller davidh@hgroupbenefits.com (847) 564-1640
• Jason White, CBC jasonw@hgroupbenefits.com (847) 564-1640
Online Resources
• Federal Government http://www.healthcare.gov/
• IL Dept. of Insurance http://www.insurance.illinois.gov/hiric/
• State of Illinois http://www2.illinois.gov/gov/healthcarereform/
• US Dept. of Labor http://www.dol.gov/ebsa/healthreform/
• The White House http://www.whitehouse.gov/healthreform
2012 – H Group Benefits, Inc.
• Kaiser Family Foundation http://healthreform.kff.org/
• NAIC and CIPR http://www.naic.org/index_health_reform_section.htm
Insurance Carriers
• BlueCross BlueShield of IL http://www.bcbsil.com/affordable_care_act/index.html
• Humana http://www.humana.com/resources/healthcare_reform/
• United HealthCare http://www.uhc.com/united_for_reform_resource_center.htm
• Aetna http://www.aetna.com/health-reform-connection/index.html