There is never a dull moment in congress, particularly as it relates to healthcare reform! While we have been reading and hearing, for most of the year, about congressional efforts to eliminate so called “surprise medical bills”, and reduce escalating drug prices, what we ultimately got were ACA tax cuts. In total, $373 billion worth of ACA related tax cuts are coming as a result of the House and Senate passed spending/funding bill.
Both the pace and scope of changes in the healthcare/health insurance space accelerated this past week (7/15/19-7/19/19) with several important developments. Here’s a recap of what all took place…
Since the passage of the Affordable Care Act (ACA) in March of 2010, much has been discussed, debated, written, and deployed relative to healthcare FINANCING reforms (see insurance, Medicare, Medicaid, self-insured employers, fees/taxes, pre-existing conditions, essential health benefits, community rating, minimum loss ratio, etc.). But very little has been written, or even revealed for that matter, about the ACA’s healthcare DELIVERY reforms and incentives. This is too bad, since we know that $.80 to $.85 of every dollar of billed health insurance premium is directly related to healthcare delivery. So it stands to reason that if we could reduce health CARE costs, health insurance PREMIUMS would follow suit. Enter Accountable Care Organizations (ACO) into the equation. Let’s examine what ACO’s are…who they are…and why many are looking to them to save America’s healthcare system from imploding.
Earlier this week (4/9/2018) the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) issued final regulations and guidance that profoundly alter the Affordable Care Act (ACA) both immediately, and in 2019 and beyond. The objective of the new guidance is “…to increase coverage access in the ACALEARN MORE
The recently signed (1/22/2018) “short-term spending bill”, also referred to as the “continuing resolution” (CR) does more than keep the United States government open and fully functioning until February 8, 2018. It also delivers yet another set of Affordable Care Act (ACA) delays. Employers offering group health insurance to their employees can breathe a collectiveLEARN MORE
In order to accomplish its objective of “affordable health insurance coverage”, the Affordable Care Act (ACA) created three (3) separate, cost reducing initiatives: 1. Premium Tax Credits – reduce out of pocket PREMIUM costs; 2. Cost Sharing Reductions (CSR) – reduce point of service out of pocket costs such as copays, deductibles, and coinsurance; andLEARN MORE
This particular blog post is primarily directed to residents of my adopted home state of Nebraska. However it may shed light on some of the “when’s, who’s and what’s” that health care/insurance stakeholders may be facing in other parts of the country next year. As we inch closer to the 2018 individual health insurance openLEARN MORE
On May 4, 2017, the U.S. House of Representatives passed an amended version of the “American Health Care Act” or AHCA, on a 217-213 vote tally. In and of itself, this vote DOES NOT ALTER THE HEALTHCARE/HEALTH INSURANCE LANDSCAPE! There are a number of phases (at least 3, but likely several more procedural steps) that must be completed in order for the Affordable Care Act (ACA) to be partially repealed. And to be clear, the AHCA would represent a partial, piecemeal repeal of the ACA, and would in fact, retain much of the ACA. So here’s where we are and what we know, as of today…
Patient Centered Outcomes Research Institute (PCORI) Fee, also known as the Comparative Effectiveness Research Fee (CERF)Fee periods and payment schedule For CERF payments, ERISA plan year is important, and determines both the timing and amount of payment to the IRS. If your ERISA plan year and renewal date differ, the ERISA plan year should be usedLEARN MORE