St@teside

 

SCI keeps the Federal Reform Resources web page up-to-date with the most recent information from the states, the federal government, and health policy organizations in an effort to guide our readers through the health reform implementation process. We know there are several places to go for the latest health reform resources, and we thank you for using SCI as one of your trusted sources. Here are some of the most recent resources that can be found on our Federal Reform page:

 

 

The Affordable Care Act (ACA) requires insurers to cover a minimum set of medical benefits, known as “essential health benefits,” and states must select a “benchmark plan” to serve as a reference point. This issue brief examines states' progress in selecting a benchmark plan and the approaches they’ve adopted in making their selection.

 

Portability, in the context of health insurance, describes the ability of an employee to maintain access to health insurance coverage and comprehensive benefits after leaving a job. It also applies to the ability of those purchasing insurance on their own to drop one insurance policy and buy another. This fact sheet explains how portability is regulated under current law and how the Affordable Care Act will affect portability in 2014. 

 

The ACA established a Consumer Operated and Oriented Plan (CO-OP) program to increase competition among plans and improve consumer choice. The CO-OP sponsors—consumer-run groups, membership organizations, and other nonprofit organizations—are now moving forward to offer health insurance coverage to members, but are still likely to face major challenges as they prepare for open enrollment in October. This policy brief describes the CO-OP program and examines issues related to its implementation and likelihood of success.

 

 

This brief explores how states may be able to use CHIP to help meet some of the child-specific requirements for exchanges in the ACA. Options for doing so include: using CHIP as model for pediatric benefits and providers in the exchange; using CHIP funds to provide premium assistance for eligible children to buy exchange coverage that would allow families to be insured by one coverage program; and using CHIP to wrap around Essential Health Benefit benchmark benefits to ensure children’s unique needs are met.

 

 

This brief prepared by Manatt Health Solutions examines some of the legal, policy and operational issues states should contemplate while considering the possibility of using “premium assistance” to purchase coverage for Medicaid-eligible adults in the Exchange. It provides an overview of the benefits of premium assistance along with the logistical challenges of its implementation.  

 

The ACA will expand access to affordable health insurance for millions of Americans. In states that choose to implement the Medicaid expansion for low-income adults, Medicaid will provide an important new pathway to coverage. Yet, even in states that choose to expand Medicaid, a significant proportion of the low-income nonelderly adult population will be excluded from the Medicaid expansion due to their immigration status. This brief provides the first state-specific estimates of the number of uninsured low-income adults that will potentially be excluded from the Medicaid expansion because of their immigration status.

 

 

On March 23, 2010, the Affordable Care Act (ACA) was signed into law. While the date for full implementation of most provisions of the law is January 1, 2014, the impact of the ACA can be seen over the past three years. The brief provides an overview of the ACA’s early impacts on private insurance and exchanges, Medicaid coverage, access to primary and preventive care, Medicare, and dually eligible beneficiaries.

 

In this paper, the Rockefeller Institute examines the difficulty in implementing the Affordable Care Act in the face of so many uncertainties. It proposes the creation of a new institutional mechanism to monitor and react to changing conditions and to provide feedback to Congress and the president on necessary adjustments to meet the goals of the legislation.

 

 

The accountable care organization (ACO) model of health care delivery is rapidly being implemented under government and private-sector initiatives. The model requires that each ACO have a defined patient population for which the ACO will be held accountable for both total cost of care and quality performance. This study examines the two major methods of defining, or attributing, patient populations to ACOs: the prospective method and the performance year method. 

 

The new National Scorecard on Payment Reform released today by Catalyst for Payment Reform is the first effort to measure progress in improving how health care is paid for in the United States. The Scorecard, produced with support from The Commonwealth Fund and the California HealthCare Foundation, finds that only 11 percent of private health care payments to doctors and hospitals are tied to performance or designed to cut waste.

 

This report relays the experiences of seven accountable care organizations (ACOs) based on interviews with clinical and administrative leaders. The most advanced ACOs are seeing reductions or slower growth in health care costs and have anecdotal evidence of care improvements. Some of the ACOs studied have begun or are planning to share savings with providers if quality benchmarks are met.