Heart Health

Health Reform … One Year Later

March 29, 2011
CHI Health


Health Reform … One Year Later

At times it’s hard to believe it’s only been one year since President Obama signed the Affordable Care Act – better known as healthcare reform – into law. At this time last year, millions of high-risk adults had nowhere to turn when insurance companies denied them coverage. Insurance companies could dictate how much money you could spend on essential services, like hospital stays, during the course of your life. And just six months ago, children could be forced to live without health insurance simply because they had a pre-existing condition.

We told you at the start of this journey that we’d keep you informed on the reforms as they take effect, including this round-up of the major provisions from the first six months of health reform. Now, it’s time to look at everything that took effect during the second half of this busy year:

  • Hold insurance companies accountable for unreasonable rate hikes. $250 million in new grants are now being awarded to states to implement measures requiring insurance companies to justify their premium increases.
  • Rebuild the primary care workforce. New incentives, such as scholarship funds and loan forgiveness programs, have been established to encourage more students to become primary care doctors, nurses and physician assistants.
  • Establish Consumer Assistance Programs. Grants have been awarded to help states set up or expand independent offices to help consumers navigate the often complicated world of private health insurance.
  • Prevent disease and illness. $15 billion has been pumped into the new Prevention and Public Health Fund to invest in programs proven to help keep Americans healthy, including smoking cessation and obesity.
  • Strengthen Community Health Centers. Funding is now available to support the construction and expansion of services at community health centers, such as Omaha’s One World Community Health Center.
  • Payments for rural health care providers. The government has increased payments to providers who work in rural areas, in an effort to attract and retain talent in these areas.
  • Prescription drug discounts. The gap in Medicare’s prescription drug coverage closed a little more at the start of the year. Now seniors who reach the gap will receive a 50% discount when buying Medicare Part D covered brand-name prescription drugs.
  • Free preventive care for seniors. As of January 1, seniors on Medicare are now eligible to receive certain preventive services free of cost. These include annual wellness visits and personalized prevention plans.
  • Bring down health care premiums. Insurance companies must now use at least 85% of all premium dollars collected from large employer plans (80% for individuals & small employers) on health care services and quality improvement. If they don’t, they must provide rebates.
  • Address overpayments to big insurance companies/strengthen Medicare Advantage. Medicare has started work to eliminate the discrepancy between payments made to Medicare Advantage plans vs. traditional Medicare (Medicare spends approx. $1,000/person on Medicare Advantage than Medicare).
  • Improve health care quality and efficiency. The Center for Medicare & Medicaid Innovation has been created and will begin testing new ways of delivering care in an effort to improve quality and slow the rate of growth in costs for Medicare, Medicaid and the Children’s Health Insurance Program.
  • Improve care for seniors after they leave the hospital. The government has established the Community Care Transitions Program to help coordinate care following a hospitalization of a high-risk Medicare beneficiary in order to avoid unnecessary readmissions.

As you can see in this list, a lot of the work being done in 2011 will merely build the foundation for some of the more impactful changes to come over the following years. Remember, health reform was a 1,000-plus page document (single-spaced, mind you) and we’ve only just begun to scratch the surface of what it aims to accomplish.

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