Archive for the ‘Reform’ Category

It’s that time of the year again – leftover turkey and stuffing for lunch at the office, crowded streets around the malls which make afternoon commutes even worse, and the constant bombardment of messages about the latest technology products (on sale). It is also a reminder about the time we get to spend together as families as well as the joyous celebrations of the holidays and their traditions.

Holidays also suggest that there are healthcare related implications too – let’s call it “end-of-the-year planning for healthcare”. Perhaps you might have already gone through your insurance coverage election period known as “Open Enrollment” at work already (these typically occur in the mid-Fall, prior to the holidays).

Continue reading Holidays . . . and Healthcare »

The recent reelection of President Obama solidifies the future of the Patient Protection and Affordable Care Act (PPACA). A number of healthcare providers (hospitals, physicians, post-acute services, etc.) sat on the sidelines awaiting the outcome of the Presidential election to determine if they needed to start rethinking their business model and what changes are required. Now that we have the answer the PPACA is here to stay, healthcare providers are starting to reassess how they need to redefine their businesses and strategic business relationships.

An underlying principle that all healthcare providers will base their strategic planning against is that the demand for healthcare will rise and the level of reimbursement will decline.  Various payment models are being tested by CMS, and we can expect more variations over the next year or two. With the power of the PPACA, CMS can rapidly adopt a payment model that demonstrates effective results reducing costs and make it a …

Continue reading The Affordable Care Act is solidified with the election – Healthcare providers will need to accelerate their plans for payment reform »

This past week held the first presidential debate between President Obama and hopeful Mitt Romney.  While the debate centered on domestic policy, each candidate at points spoke of the role that domestic issues have on U.S. global competitiveness, citing the US economy and unemployment as examples.  I believe that healthcare has an equal standing in this regards; a clear case can be made that our healthcare problems have a direct impact on US foreign policy.  This might be one of the few areas in the healthcare debate that both Mitt Romney and Barack Obama can agree.

Continue reading It is not all politics when talking healthcare »

The Affordable Care Act has many benefits. The costs of some of these benefits will not be known for a while.

Continue reading Tax Implications of the ACA – Just Bad Timing Part II »

Over the past several years, the health care system has been attempting to define and create a “patient-centered model of care.” Most health policy experts, much less health care professionals, can’t seem to agree on what constitutes a patient-centered model of care. I think that a patient-centered model is less about discussing the comprehensive services offered to patients and is more about putting the patient in the middle of the relationship. A true patient-centered model surrounds the patient and provides a true coordinated personalized system of care.

In examining U.S. health care delivery, rarely are the words “coordinated,” “personalized” and “system” used in the same sentence ― much less actually delivered to patients.
Primary care medical homes (PCMH) were first developed several years ago in an attempt to develop a patient-centered experience. Even those physicians currently practicing in the PCMH model indicate that there are issues associated …

Continue reading Building a Patient-Centered Model of Care »

The tax provisions that the press prefers to call the “Bush tax cuts” will sunset and income tax rates (as well as phase-out provisions for itemized deductions and personal exemptions and numerous other provisions) will revert to pre-2001 levels. In addition, the individual income tax provisions contained in the ACA take effect. There are three primary taxes placed directly on individuals contained in the ACA.

Continue reading Tax Implications of the ACA – Just Bad Timing? »

Let me start by using the ole cliché “I’m not a politician”. I don’t profess to be one and have no plans to run for any type office in the future. However, others would say “everybody plays a little politics”. So I will try my best to be “politically correct” with what I am about to say.

Health Reform is what it is and is not what it will be. Today there is a law that is highly debated by the citizens of this country. In March 2012 the Kaiser Family Foundation surveyed US citizens and found that 59% stated that they did not have enough information to understand how they would be impacted by the American Care Act. This number is higher than the same survey number two years ago. I also wonder how many of the folks who say they understand really don’t. Obviously it is a difficult law for the American public to comprehend which contributes to the confusion and the ongoing debate. Only 20% of Americans in the Kaiser study said they have felt any personal impact …

Continue reading A Comment on Health Reform »

It is hard to believe (at least in my mind) that anyone living in the United States today has not heard something from their neighbor, news, radio, etc. on Obamacare or the Affordable Care Act (ACA) as a result of last week’s ruling by the Supreme Court.  And to no surprise, there is roaring approval by some and steep condemnation from others.  Even on HealthFlock, we have bloggers on have differing opinions (pro vs. con).  While no one I can find believes that the the Affordable Care Act is perfect, I personally applaud the decision for what it does to address our “access” problems.

From my vantage point as a practice manager and operations leader working for a large health system, I am encouraged to see that the country is taking steps forward (through the ACA) to address our staggering problems around access to quality medical care, particularly for the poor.  Statistics routinely point to lack of affordability, availability, and acceptable of health services in …

Continue reading Where the Supreme Court Got It Wrong: Access for the Very Poor »

As the country is awaiting the Supreme Court’s ruling on whether they will repeal the healthcare reform law, politics around healthcare policy has continued to swell with speculation, projections and promises from both sides of the political aisle.  Meanwhile, the healthcare industry has mostly remained quiet, waiting for the ruling, which would likely determine the primary driver for future changes to our nation’s healthcare delivery system unlike any other that we have ever seen before in the last half-century.

A mid-June article in the Wall Street Journal noted that, “When the court rules […] the waves it sets off will be tricky for both parties to navigate.” This certainly appeared to be one thing that both Republicans and Democrats could agree on, as the parties’ leadership were trying to develop political strategies for all of the possible outcomes, resulting from the Supreme Court’s decision.

The majority of speculation prior to the ruling was that the …

Continue reading The SCOTUS Ruling and What Happens Next? »

Among the more popular provisions is the extension of health insurance coverage for adult children through age 26.

Continue reading The Affordable Care Act – Beyond the Individual Mandate »