Tuesday, August 24, 2010

AHA Spends $4.2 Million in Lobbying in Second Quarter

The American Hospital Association (AHA) boosted its lobbying budget this year, spending $4.2 million in the second quarter. The AHA lobbied on a diverse range of issues, including health reform, patient access to services, and malpractice reform.

As healthcare reform is implemented, it is expected that the AHA and other advocacy groups will continue to boost their lobbying efforts.

To read more about the AHA's efforts, click here:

Source: Bloomberg Business Week

Wednesday, August 18, 2010

States Receive over $46 Million to Monitor Insurance Costs

The Department of Health and Human Services has awarded over $46 million to 45 states and the District of Columbia in order to better monitor hikes in insurance premiums.

The grants were awarded under the Patient Protection and Affordable Care Act. The funds will allow states to create and upgrade technology to better monitor proposed insurance premium increases. The goal is to promote competition in the insurance market by making information more transparent and accessible to consumers. There are also 26 states, plus the District of Columbia, that have the authority to reject excessive and unfair premium rates. A monitoring system will help these jurisdictions enforce this power.

To read more about this grant program, click here:

Source: IFAwebnews.com

Wednesday, August 4, 2010

Patient Access Should Prepare for the Rise of Preventative Care

A major provision of healthcare reform is the expansion of preventive care. Americans will be encouraged by their health plan to receive care to prevent illness. Currently, many patients have felt pressured to forgo needed, preventive care, due to high co-pays, deductibles, and coinsurance. Finally, these financial barriers to care are being eliminated through The Patient Protection and Affordable Care Act.

Effective September 23, 2010, new plans from private insurers will be required to eliminate co-pays, deductibles, and coinsurance for preventive services. Medicare and Medicaid will follow suit on January 1, 2011. This provision will have a positive impact on the heath of our communities.

Patient Access leaders can prepare for this provision in a number of ways:

1. Analyze current volumes of preventive services/screening exams and develop methods to track new volumes, beginning January 1, 2011. Some examples are screening exams for: cardiac conditions, diabetes, cancer, prostate illness, prenatal care, and wellness for women and infants.

2. Educate staff that collections are not necessary for preventive care/screening exams and exclude these services from identified opportunity.

3. Increase competency, through training and education, on interpreting on-line eligibility data, benefits and identifying preventive care exams.

AAFP American Academy of Family Physicians
Agency For Healthcare Research and Quality

Michael Sciarabba MPH, CHAM is a member of the NAHAM Government Relations Committee.

Monday, August 2, 2010

Insurers Continue Debate on Health Care Reform

Under the health care reform plan, insurers are required to spend a minimum of 80% of each dollar collected in premiums on patient welfare. Insurance groups are currently battling with regulators as to what this requirement should translate into when written into rules.

Some insurers argue that credentialing and other quality improvement costs should be included in the 80% amount since they help to improve the delivery of care to patients. Meanwhile, consumer groups argue that this is an attempt by the companies to get away with charging consumers high administrative costs.

The following article in the The New York Times details the sides in the debate and provides a picture of the current landscape as regulators work to enact health care reform:

Source: The New York Times