Six Major Health Reform Provisions Effective Today

Today, six of the major provisions of the Affordable Care Act go into effect. They are:

• Extended coverage for young adults under their parents' plan
• Plans must offer free preventative care services
• Insurance companies are prohibited from rescinding coverage if a person becomes sick
• The ability for Americans to select between two appeal processes when challenging an insurance decision
• Elimination of lifetime caps on coverage
• Regulation of insurers' ability to set dollar limits on coverage

To read more details about these provisions, click here:
http://www.healthcare.gov/news/factsheets/overview.html

Curious about when the other provisions of the Affordable Care Act will go into effect? Click here to see a full timeline of changes that will occur:
http://www.emblemhealthreform.com/pub/ersm/tl/2010/?o=0

Sources: healthreform.gov, EmblemHealth

Secretary Sebelius Urges Insurers to Stop Blaming Premium Increases on Health Reform

Secretary of Health and Human Services Kathleen Sebelius has written a letter to America's Health Insurance Plans (AHIP), urging their members "to stop using scare tactics and misinformation to falsely blame premium increases for 2011 on the patient protections in the Affordable Care Act."

According to the Secretary, several companies have already started informing customers that increases in premiums were occurring due to health reform provisions. Her letter provides a summary analysis of how the Affordable Care Act will have a minimal impact on plan costs.

Text of the Secretary's letter can be found here:
http://www.healthcare.gov/news/blog/lettertoAHIP.html


Source: healthcare.gov

HHS Prepares for Insurance Changes by Emphasizing "Health Literacy"

An article in Bloomberg Businessweek discusses one step that the Department of Health and Human Services (HHS) is taking to ensure that Americans are prepared for the health insurance exchanges scheduled to begin in 2014 by promoting "health literacy."

The article defines health literacy as "the capacity to obtain, process and understand basic health information to make appropriate health decisions." The article also mentions that only about one-third of American adults possess what is considered a basic level of health literacy.

HHS has developed a National Action Plan to Improve Health Literacy by 2014. Strategies include improving access to health information and using more basic terminology when communicating health issues to the public.

The Bloomberg Businessweek article can be found here: http://www.businessweek.com/lifestyle/content/healthday/642134.html

The National Action Plan to Improve Health Literacy can be found here:
http://www.health.gov/communication/HLActionPlan/


Source: Bloomberg Businessweek

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:
http://www.businessweek.com/ap/financialnews/D9HP72IG0.htm


Source: Bloomberg Business Week

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:
http://ifawebnews.com/2010/08/18/states-get-millions-to-act-against-insurers-unreasonable-rate-hikes/


Source: IFAwebnews.com

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.


Sources:
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.

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:
http://www.nytimes.com/2010/07/24/business/24insure.html?emc=eta1


Source: The New York Times