Health Care Reform Update

Health Care reform is a highly volatile topic that is not being discussed on the campaign trails or debates……by either parties, not even the “State of the Union” speech by the President. Make no doubt about it, this program is moving forward as planned by the Obama Administration. As you can see (time line below) there isn’t much happening in 2012 but 2013 will begin enrollment procedures in many states for the insurance exchanges required to be in place by 2014. States will have some leeway in getting their exchange up and running but the Federal Government has stated that they will implement an exchange for any states that have not begun the process on their time line.
Here is a review of what has already occurred and what is planned for
 this and upcoming years:
· No Discrimination Against Children With Pre-Existing Conditions.
· Prohibits Insurance Companies from Dropping Coverage.
· Eliminating Lifetime Limits on Insurance Coverage
· Regulating Annual Limits on Insurance Coverage
· Appealing Insurance Company Decisions.
· Information for Consumers Online. Improving Quality and Lowering Costs
· Small Business Health Insurance Tax Credit.
· Relief for Four Million Seniors Who Hit the Medicare Prescription Drug “Donut Hole”.
· Free Preventive Care.
· Preventing Disease and Illness
· Cracking Down on Health Care Fraud.
· Access to Insurance for Uninsured Americans with Pre-Existing Conditions.
· Extending Coverage for Young Adults.
· Coverage for Early Retirees.
· Rebuilding the Primary Care Workforce.
· Holding Insurance Companies Accountable for Unreasonable Rate Hikes.
· Allowing States to Cover More People on Medicaid
· Payments for Rural Health Care Providers
Improving Quality and Lowering Costs
· Prescription Drug Discounts.
· Free Preventive Care for Seniors.
Improving Health Care Quality and Efficiency.
· Improving Care for Seniors After They Leave the Hospital.
· New Innovations to Bring Down Costs.
Increasing Access to Affordable Care
· Increasing Access to Services at Home and in the Community.
· Strengthening Community Health Centers.
Holding Insurance Companies Accountable
· Bringing Down Health Care Premiums.
· Addressing Overpayments to Big Insurance Companies and Strengthening Medicare Advantage.
Improving Quality and Lowering Costs
· Linking Payment to Quality Outcomes.  The law establishes a hospital Value-Based Purchasing program (VBP) in traditional Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported, beginning with measures on treating heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients’ perception of care. Effective October 1, 2012.
· Encouraging Integrated Health Systems.  The new law provides incentives for physicians to join together to form “Accountable Care Organizations,” through which doctors can better coordinate patient care and improve the quality, help prevent disease and illness and reduce unnecessary hospital admissions. If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped to save. Effective January 1, 2012.
· Reducing Paperwork and Administrative Costs.  Health care remains one of the few industries that relies on paper records. The new law will institute a series of changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care. First regulation effective October 1, 2012.
· Understanding and Fighting Health Disparities. To help understand and combat persistent health disparities, the law requires any ongoing or new Federal health program to collect and report racial, ethnic and language data. The Secretary of Health and Human Services will use this data to help identify and fight disparities. Effective March, 2012.
Increasing Access to Affordable Care
· Providing New, Voluntary Options for Long-Term Care Insurance.  The law creates a voluntary long-term care insurance program — called CLASS — to provide cash benefits to adults who become disabled.  Effective October 1, 2012.
In our next blog posting, we will cover all the upcoming new changes to the Health Care Systems in 2013 and beyond.
For more information on what employee benefit options may be available to your company and its employees, please contact your LL Roberts Group PEO Consultant (toll free) at 877.878.6463.
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