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OBAMACARE: Quick overview of the changes that went into effect January 1, 2014 due to the Affordable Care Act

The four principal changes that went into effect as of January 1, 2014, are described in this brief opinion piece published online first in JAMA: The Journal of the American Medical Association.  These four changes include:

  1. Individuals can no longer be denied the ability to buy health insurance based on preexisting medical conditions.
  2. Individuals who can afford it must either buy health insurance or pay a tax penalty.
  3. Low income individuals receive support in the form of federal tax credits to help buy insurance.
  4. Medicaid has been expanded in half of the states in the union — the other half have not implemented this option.

Source: McDonough, J.E., and Adashi, E.Y.  Realizing the promise of the Affordable Care Act: January 1, 2014.  JAMA, Jan. 2, 2014.  Click here for full text: http://jama.jamanetwork.com/data/Journals/JAMA/0/jvp130192.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Exchange market first mover strategy for hospitals

An overview of public and private health insurance exchanges is provided in this short white paper by financial consultants Kaufman Hall.   These exchanges are likely to accelerate the movement to a retail insurance model–a more open marketplace–and to high-deductible health plans.  Hospitals are likely to benefit from previously uninsured patients who enroll in exchanges.  On the other hand, hospitals are likely to be hurt by the movement of individuals who are currently insured by their employers to the exchanges.  Considerations in developing a go-to-market strategy for hospitals are reviewed.  Advantages and disadvantages of being a first mover are explored.

Source: Health insurance exchanges: what’s your strategy?  KaufmanHall Report, Fall 2013.  Click here for full text: https://www.kaufmanhall.com/SitePages/DocumentDetails.aspx?did=8284aa31-06fd-4312-b8d9-d936a7a607bd  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

ACOs: Should you include a ‘surgical home’?

The American Society of Anesthesiologists (ASA) has proposed a coordinated perioperative, or surgical home, model which would give anesthesiologists a leadership role in the development of an important component of accountable care organizations (ACOs).  This is a counterpart to the medical home model (which focuses on primary care and patients with chronic disease).  ASA envisions that anesthesiologists would evolve into “perioperative physicians” in this model.

Interesting fact: An estimated 60 to 70 percent of hospital expenses are related to patients who have surgery or undergo procedures.

Sources:  American Society of Anesthesiologists.  The Perioperative or Surgical Home, Aug. 21, 2011.  Click here for full text: http://www.saaahq.org/ThePerioperative_orSurgicalHome.pdf;  Warner, M.A.  The surgical home.  Newsletter. American Society of Anesthesiologists;76(5):30-32, May 2012; and, ASA responds to accountable care organization proposed rule.  Press Release, June 3, 2011.  Click here for full text: http://www.asahq.org/For-Members/Advocacy/Washington-Alerts/ASA-Responds-to-Accountable-Care-Organization-Proposed-Rule.aspx  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Health Policy Issues 101

The Alliance for Health Reform has released a new 2011 edition of its Covering Health Issues publication. While journalists are the target audience, it is a useful non-partisan resource for anyone wanting some fast facts, quick background information, and highlights of debate issues surrounding each topic. Separate chapters are available on these health policy issues:

  • Health reform
  • Cost of health care
  • Quality of care
  • Employer-sponsored health coverage
  • Individual health coverage
  • Children’s health coverage
  • Medicare
  • Medicaid
  • Long-term care
  • Disparities
  • Mental health and substance abuse
  • Public health

Also included are a list of acronyms and glossary of terms, a contact list of experts and stakeholders, and information on where to find public poll data on health issues.

Source: Covering health issues. 6th ed. Washington, DC: Alliance for Health Reform, 2011. http://www.allhealth.org/sourcebookTOC.asp?SBID=5