AHCA and Three Scenarios: Repeal, Replace, Repair

Any similarities of the title of this blog and Goldilocks and the Three Bears belies the serious decisions needed for the next round of healthcare reform. Last month, PwC’s Health Research Institute (HRI) released another fantastic research piece that maps out three possible landing spots: repeal, replace, repair. Here are 10 instances which can help you better identify when its time to look for a partner.

California Insurance Marketplace Imposes New Quality, Cost Conditions On Plans

Moving into a realm usually reserved for health care regulators, the California health marketplace Thursday unveiled sweeping reforms to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers. The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation. Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards.

By | 2017-04-02T13:28:07+00:00 April 8th, 2016|Financial, Health Insurance, Health Insurance Exchange, Quality Improvement Programs|Comments Off on California Insurance Marketplace Imposes New Quality, Cost Conditions On Plans

5 Things You Need to Know About ACA in 2015

Five years into the Affordable Care Act, the healthcare climate of the United States has continued to evolve and improve. While there are some long term changes required that have just begun to take shape, many changes brought about by the ACA are immediate gratification. Changes to Medicare and Medicaid have helped many Americans gain coverage that they previously wouldn’t have had access to. While the system is imperfect, there’s plenty of positivity to consider since it launched in 2010.

Open Enrollment 2015 | Enrolling in the Marketplace

Open enrollment doesn’t start for a couple more days, but if you’re shopping around the health insurance marketplace, you know that the “window shopping” phase of enrollment has already begun. If you remember the marketplace 1.0 fiasco from last year, and are hesitant to give the new and improved page a go, here’s a rundown of what you can expect when you head over to sign up.

By | 2017-04-02T13:28:28+00:00 November 14th, 2014|Health Care Reform, Health Insurance, Health Insurance Exchange|Comments Off on Open Enrollment 2015 | Enrolling in the Marketplace

Get Your Yearly Health Screenings, Earn an iPhone? Are Healthcare Incentive Programs On The Way To U.S. Healthcare?

A study done by Harvard Medical School, published this week, looked at a private, South African hospital that has been experimenting with incentive programs to improve patient health outcomes. Could something like this ever work in a U.S. Hospital?

Top 8 ACA Delays |Blatantly Illegal or Temporary Courses of Action?

With so many ACA delays thus far, is the ACA really what we bargained for? Should the President have the authority to delay ACA provisions at his discretion or is it his duty to uphold the law as written? The Affordable Care Act was enacted in 2010 with provisions becoming effective over several years, many of which have been delayed. Why the ACA delays? •Limited resources for implementing the law •The need to prioritize limited resources •Technological limitations, such as the “glitches” in the computer systems as they related to the healthcare exchanges •Complaints from various quite vocal groups, both political and non •Undue hardships placed on employers and / or employees •Additional time and / or funding required to comply •Tax and reporting requirements •Political reasons

Millennials: Obamacare Costs Less Than Your Cell Phone Bill

Americans were a little wary of the healthcare marketplace when it debuted this past year, but now, some are beginning to see the benefits - of the benefits. New data released this week from the Department of Health and Human Services reports that new Obamacare customers are paying, on average, about $82 in monthly premiums for their coverage. For many, that’s less than many of their utility bills, such as internet, cable and smartphones.

Play or Pay | The Triple Aim for 2015 and Beyond

What will you decide for your organization beginning 2015? Will you “play or pay”? The “play or “pay” principle basically says that if employers with 50 or more full time employees don’t meet the minimum requirements of offering insurance coverage, they will pay very steep penalties. The provision will be phased in beginning in 2015. The “play or pay” principle is part of the PPACA, specifically under the provision of “shared responsibility”.

ACA Acronyms | FFOF | Everything Has an Abbrev.

What do the ACA, ACO, FFS, DHS, and QHP all have in common? They are healthcare acronyms and most are related to the Affordable Care Act. The healthcare industry is not unlike any other industry or almost any aspect of our lives these days, especially with the advent of texting. There is always a shorter way to say something i.e. “BFF” – best friends forever or one of my favorites “*$” - Starbucks. By the way, the title “FFOF” is Fun Facts on Friday. The ACA, which is part of the “PPACA” - Patient Protection and Affordable Care Act of 2010, is regulated by “HHS” - the division of Health and Human Services, the “DOL” – Department of Labor and the “IRS” – Internal Revenue Service. HHS designates many responsibilities to “CMS” – the Centers for Medicare and Medicaid Services.

By | 2017-04-02T13:28:38+00:00 May 23rd, 2014|Accountable Care Organizations, Health Care Reform, Health Insurance, Health Insurance Exchange, Physician Compensation, Services|Comments Off on ACA Acronyms | FFOF | Everything Has an Abbrev.

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