Prescription Drug Discounts:
Effective Jan. 1, 2011, under the health care reform legislation, enrollees who fall in the so-called "Part D donut hole," an annual gap in Medicare Part D prescription drug coverage, will get a 50 percent discount on covered non-generic prescription medications. Additional savings on both generic and non-generic prescriptions will be phased in over the next ten years until the "donut hole" is entirely closed by 2020.
Free Preventive Care for Seniors:
Effective Jan. 1, 2011, seniors who receive Medicare will become eligible for additional preventive services at no out-of-pocket cost. These services will include one wellness check each year and the development of personalized plans for preventing illness.
Improving the Quality and Efficiency of Health Care:
Effective Jan. 1, 2011, the legislation provides for a new Center for Medicare & Medicaid Innovation to begin testing ways of delivering care to patients to improve the quality of care and develop ways to reduce the cost of health care for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). By Jan. 1, 2011, HHS will present a national strategy aimed at improving the quality of government health care.
Preventing Unnecessary Hospital Readmissions:
Effective Jan. 1, 2011, the Community Care Transitions Program will aid high-risk Medicare recipients who have been released from the hospital by coordinating care and connecting patients to community services to avoid unnecessary readmissions.
Bringing Down Costs:
Beginning Oct. 1, 2011, the Independent Payment Advisory Board will begin developing and presenting proposals to Congress and the president to protect and improve benefits for enrollees and keep the Medicare Trust Fund alive and well. Its goal is to eliminate waste, find ways to reduce the cost of health care, improve health outcomes and make quality care more accessable for Medicare enrollees.
Increasing Access to Services:
Effective Oct. 1, 2022, the Community First Choice Option will allow states to offer home and community-based services as an alternative to institutional care to the disabled through Medicaid.
Community Health Centers:
Effective 2011, the new legislation allows for new funding to help communities build and expand community health centers and broaden the services they offer, with the aim of providing service to an additional 20 million patients across the U.S.
New Accountability for Insurance Companies
Reducing Premiums:
Effective no later than Jan. 1, 2011, at least 85% of all premiums paid into large employer plans must be spent on health benefits and care quality improvement. At least 80% of all premiums paid into individual and small employer plans must be spent on health services and quality improvement. The Affordable Care Act requires insurance companies to spend more on patients and less on administrative costs or return money to consumers through rebates.
Addressing Overpayments and Strengthening Prescription Drug Coverage
Effective Jan. 1, 2011, the new law will begin gradually eliminating overpayments to companies that provide Medicare Advantage. Currently, insurance companies receive, on average, more than $1,000 more per person than Medicare Part A. This results in increased premiums for recipients as well as increased costs overall. Medicare Advantage recipients will continue to receive their Medicare benefits, while insurance companies that provide high quality care will receive bonus payments.
2012 Health Care Reform Timeline for Improving Quality and Reducing Costs
Linking Quality of Care to Payment:
Effective Oct. 1, 2012, health care reform legislation will require the Value-Based Purchasing program (VBP) to begin offering financial incentives to hospitals to improve the quality of the care they provide. Performance reports will be available to the public and will include measurements of a hospital's effectiveness at treating heart attacks, heart failure and pneumonia. In addition, the reports will include information about a facility's surgical care, their rate of hospital-borne infections and patients' ratings.
Integrated Health Systems:
Effective Jan. 1, 2012, doctors will receive incentives to come together to form "Accountable Care Organizations" that will allow doctors to better coordinate patient care, improve the quality of care they deliver, help prevent illness and reduce unnecessary admissions. Organizations that effectively improve care and save money will be entitled to some of the money they have saved.
Reducing Overhead:
Beginning Oct. 1, 2012, the health care industry must begin working toward standardizing billing and adopting and implementing practices that ensure secure, confidential, electronic exchange of health information.
Narrowing the Health Care Gap:
Effective in March, 2012, federal health programs must begin collecting and reporting racial, ethnic and language data in order to aid in understanding and combating existing health disparities. This data will be reported to the Secretary of Health and Human Services to be used to identify and fight disparities in health care.
Expanding Access to Affordable Care
New Options for Long-Term Care:
Effective Oct. 1, 2012, the new health care reform legislation will create a voluntary long-term care insurance program to be known as CLASS that will provide monthly benefits to adults who become disabled.
For more information in Florida regarding health care and health insurance, click here.
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