Health Care Reform Update, Part 4: Program Innovations

Health Care Reform Update, Part 4: Program Innovations

Eileen St.Pierre, The Everyday Financial Planner

The Affordable Care Act prompted the government to develop programs to increase health care access, improve quality of care, and reduce costs.  There has been very little discussion about these programs.  This column is the last in a 4-part series providing an update on the health reform law.  It provides a summary of several of these program innovations.

The Community Care Transitions Program (CCTP)

  • This program aims to help high risk Medicare beneficiaries who are hospitalized avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities.  There are currently 82 organizations participating in the CCTP.
  • It was launched in 2011 and will run for 5 years ($500 million in total funding) at which time the Centers for Medicare & Medicaid Services (CMS) will determine its effectiveness.

The Community First Option

  • This program allows states to offer home and community based services to the disabled through Medicaid rather than at nursing homes.  This program is referred to as the Independence at Home Demonstration.
  • There are 15 single practices and 3 consortia participating in the program which runs from June 2012 through May 2015.  HHS is also looking at other options that make it easier for states to provide Medicaid coverage for home and community-based care.

The Medicare and Medicaid Electronic Health Record (EHR) Incentive Program

  • This program provides incentive payments (up to a total of $63,750) to medical providers and hospitals who adopt, implement, or upgrade EHR technology in their first year of participation and demonstrate meaningful use for up to five more years.
  • Providers need to choose which program, Medicare or Medicaid, in which they want to participateIn the first two years of the program, $8.4 million has been paid in incentives to 323,979 medical providers.  
  • This program does not require all medical providers to switch to electronic records.

New Data Collection Standards

  • Any ongoing or new federal health program is required to collect and report racial, ethnic, language, sex and disability status data.  The law requires these data standards to be used in all national population health surveys sponsored by HHS.
  • Visit http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208 for more information.

Other Initiatives

  • At www.healthcare.gov/compare, you can compare physicians, hospitals, nursing homes, home health agencies, and dialysis facilities in your area.
  • The CLASS program, a voluntary long-term care insurance program, was cancelled by HHS when it was determined that the program would be too expensive to implement.

The official government website on the Affordable Care Act is http://www.healthcare.gov. Visit my Health Care Reform page for more information.