Policy presentation2

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Policy presentation2

  1. 1. Stacey Kram, Salisbury University Policy Synopses at theFederal and State Level
  2. 2. Federally Facilitated Changes • Created by the Robert Wood Johnson Foundation • Discusses the implications of state versus federally run insurance exchanges
  3. 3. What is an Exchange?• One stop shopping• State-run• Regionally –run• Federally facilitated
  4. 4. The Core Functions of an Exchange• Setting eligibility requirements• Enrollment assistance• Plan management specifications• Consumer assistance• Financial management
  5. 5. Foreseen Complications withFederally Facilitated Exchanges • States will have locally and federally regulated plans simultaneously • Meeting local regulations of various states • “Churning”
  6. 6. More Complications…• “Adverse selection threats”• Limits on Medicaid expansion• Customer service
  7. 7. A More Practical Approach? • Creation of state-based exchanges • Expansion of Medicaid • Extending deadlines to states • Offering establishment grants
  8. 8. Telehealth Provider Credentialing • MD House Bill 1042, introduced February 8, 2013 • Discusses overcoming barriers to telehealth delivery
  9. 9. Current Complications• CMS requirements for reimbursement• Legislation slow to change at state level• Excessive cost and burden to rural organizations and telemedicine providers
  10. 10. More Complications…• Limited access to specialty care• Single-site provider is cost-prohibitive• Current estimate of $4.8 million annually for one provider
  11. 11. A More Practical Approach? • Credentialing by Proxy • Federal Credentialing Program for Health Care Providers – VetPro
  12. 12. References• Health Affairs. (2013, January). Federally facilitated exchanges. Retrieved from: http://healthaffairs.org/healthpolicybriefs/brief_pdf s/healthpolicybrief_84.pdf• Hospitals-Credentialing and Privileging Process-Telemedicine, MD- H.B. 1042, 2013 Regular Season. (2013).• National Rural Health Association. (2010). Telehealth provider credentialing. Retrieved from: http://www.nrharural.org

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