Five Things You Don’t Know About Health-Care Reform

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Insurance sign-ups are just around the corner for millions of Americans under health-care reform, yet there’s still much people don’t know about this landmark legislation, particularly those changes occurring over the next decade inside hospitals, clinics, and doctors’ offices.

It’s a workforce thing. All the attention is on politics, or who will receive what benefits and where the money will come from. But the most important question is who will deliver the care and how it will be done. Most of the change will be accomplished by the health-care workforce. Transforming health care is a huge management challenge. Many clinicians and staff will have to fundamentally change their professional objectives and standards, daily routines, compensation, patient relationships, and employer relationships. The scope of health-care reform and current market pressures are unparalleled in any other industry; the re-engineering of health-care workforce roles now underway may completely change relationships between patients and clinicians in the next decade.

Biggest long-term problem: clinician shortages.An additional 30 million Americans will receive health-care coverage by the end of the decade, during a time when a further 15 million patients will become eligible for Medicare. Who will take care of all those people? By 2020, a shortage of 91,500 primary care and specialist physicians is predicted. Shortages of nurse practitioners and physician assistants, who could help fill in the gaps in primary care, also are predicted. Without enough clinicians, effective health-care reform could be stifled.

Getting paid to keep you well, rather than cure your illness. Changes in compensation for doctors and nurses will dramatically transform from quantity of work to quality of work. Until very recently, compensation and reimbursement were entirely based on the volume of patients and treatments. Now they’re beginning to reflect value-based benchmarks that will increase every year. Some of these include patient satisfaction, readmission rates, health risk assessments, and patient wellness, among other benchmarks. For hospitals, making sure patients are satisfied will become a pocketbook issue. For clinicians, careful disease management and preventive care to keep patients out of the hospital could directly affect how much they are paid.

Independent doctors’ practices are quickly fading. Physicians who hang a shingle outside a private office are becoming rarer. A recent survey showed that 55 percent of practicing physicians work for someone else, usually a hospital or a practice owned by a hospital or health system. That figure grew 8 percent in one year. Meanwhile, nearly 40 percent of physicians younger than 45 have never worked in private practice. Doctors are moving to employed positions in hospitals and health systems in search of greater stability in the rapidly changing health-care environment.

Your doctor may not be a doctor. One of the most striking changes for consumers may be team-based care, with physicians, nurse practitioners, physician assistants, psychologists, pharmacists, and others working together to improve quality of care and lower costs. If your health-care provider employs a team approach, when you make an appointment with your doctor you may instead see a nurse practitioner or physician assistant, depending on a quick assessment of your health status. In more than a dozen states, nurse practitioners can diagnose, treat, or prescribe with no physician involvement. Laws and regulations on the scope of practice for these clinicians are changing rapidly.

Health-care reform isn’t just about getting coverage for millions of people who don’t have it. It’s also about changing the way health care is delivered to reduce costs and improve patient care. Unless we can accomplish those two goals, increasing coverage will become prohibitively expensive. Transforming health-care delivery requires the active participation of America’s 16-million member health-care workforce.

Salka is President and CEO of AMN Healthcare, one of the nation’s largest health care staffing companies.

Branding Obamacare: ‘New York State of Health’

WebMD News from Kaiser Health News

By Phil Galewitz

 

Some folks like to get away, Take a holiday from the neighborhood. Hop a flight to Miami Beach or to Hollywood. But I’m takin’ a Greyhound on the Hudson River line. I’m in a New York state of mind

… er … make that “New York State of Health.”  Playing off the title of Billy Joel’s iconic 1976 song, the officials running New York’s health insurance exchange announced Tuesday that they have chosen New York State of Health as the brand name of their new onlinemarketplace.

“We wanted a name that was distinctive and unique to New York and is emotional and not just functional description,” said Leo Mamorsky, executive group account director with DDB New York  which is handling advertising  for the exchange.

In their first YouTube ad, there are scenes of Manhattan, Niagara Falls and people in rural and suburban settings. Joel’s song, though, is not on the video. Joel grew up in Hicksville, N.Y., and lives in the Hamptons.

New York is the latest state attempting to brand the new marketplaces. The marketplaces, one of the key ways the health care law extends coverage to the uninsured, open for enrollment Oct. 1, selling policies that will take effect Jan. 1. New York exchange officials announced last month that average premiums sold on the exchange would be about half the price they are today for individuals who buy their own insurance.

“In creating a name, we wanted it to be meaningful, memorable and capture the essence of what it is to be a New Yorker – that unique ‘can do’ attitude and state of mind,” said Donna Frescatore, New York  State of Health’s executive director. “We’re confident the ‘NY State of Health’ name and campaign will inspire New Yorkers who are uninsured or underinsured to explore the options and choose the plan that fits their needs.”

Despite being a fan favorite for decades, “New York State of Mind” was never a hit song and was never released as a single. Joel famously played the song at The Concert For New York City, the October 2001 benefit for the New York City Fire and Police Departments and the loved ones of first responders killed during the terrorist attack on Sept 11. He reprised that theme, playing it during his Dec. 12, 2012 concert at Madison Square Garden to raise money for victims of Hurricane Sandy, where he changed the lyrics to include places like “Breezy Point.”

New York officials said Joel was not consulted about their marketing effort. They said they had no plans to use Joel or his song in their ads.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Source Link:  http://www.webmd.com/health-insurance/ny/20130820/with-a-nod-to-billy-joel-ny-brands-obamacare-marketplace?src=RSS_PUBLIC

 

IRS website offers information about Affordable Care Act

Posted: Monday, August 19, 2013 7:07 pm

Richard Craver/Winston-Salem Journal

The Internal Revenue Service has create a website – www.irs.gov/aca — aimed at providing information about how the implementation of the federal Affordable Care Act will affect individuals, families and businesses from a tax provision perspective.

The home page has three sections, which explain the tax benefits and responsibilities for individuals and families, employers and other organizations, with links and information for each group. The site provides information about tax provisions that are in effect now and those that will go into effect in 2014 and beyond.

Topics include premium tax credits for individuals, new benefits and responsibilities for employers, and tax provisions for insurers, tax-exempt organizations and certain other business types.

Incoming Med School Students to be Well-Versed in Affordable Care Act

By Jeff Saperstone

|  Tuesday, Aug 20, 2013  |  Updated 7:28 PM EDT

You could call them the Affordable Care Act class. Incoming medical students at Quinnipiac University’s new medical school will graduate when the new law is fully in effect.

While they are beginning their studies they’re also very aware about the changes coming to the nation’s health care system.

“It’s opportunities as well as challenges,” said Benjamin Cramer, a Quinnipiac University medical student.

Cramer said a lot of questions remain about how ACA will impact patient care. He wants to open a clinic in a rural community, a region he sees as the most in need.

“Financially I’m not extremely concerned about how it will affect me personally but I am concerned about how it will affect my patients,” Cramer said.

He is concerned about patients who will still have a hard time accessing affordable insurance.

Students believe there are a lot of unknowns when it comes to the new law but some say it’s good thing to expand coverage.

“It’s very complex,” Daniell Vottalico said. “I think that some sort of change is needed and we have to start somewhere.”

Over the years, medical students nationwide have opted to enter into higher paying specialties, which has created a shortage of primary care doctors.

One of the missions at the new medical school at Quinnipiac University is to graduate more primary care doctors.

That happens to be the same goal of the Affordable Care Act. Supporters of the law believe that if there are more primary care physicians that could mean more patients will be able to get preventative care rather than expensive trips to the emergency room.

“The hope is for those of us who go that route is that there will be more support in general for primary care through the Affordable Care Act,” William Berger said.

Source Link:  http://www.nbcconnecticut.com/news/local/Incoming-Med-School-Classes-to-be-Well-Versed-in-Affordable-Care-Act-220430251.html

Low prices seen luring young adults to Obamacare: study

By Sharon Begley

NEW YORK | Wed Aug 21, 2013 12:03am EDT

(Reuters) – If uninsured young Americans shun the new health plans offered under President Barack Obama’s healthcare reform law, it will be because the insurance costs too much and not because they don’t expect to need much medical care, according to a study released on Wednesday.

What uninsured young adults do when state exchanges created under “Obamacare” open on October 1 will be one of the most important factors in determining the success of the president’s signature domestic policy achievement. If too few young people, who tend to be relatively healthy, sign up for coverage, then premiums might not cover the medical costs of sicker people who do enroll.

“Contrary to commonly held beliefs, young adults do want affordable health coverage,” said Dr. David Blumenthal, president of the nonpartisan Commonwealth Fund. The group’s study dispels the notion that young adults don’t think they need coverage because they feel invincible, said lead author Sara Collins.

Up to 82 percent of nearly 16 million uninsured young U.S. adults would qualify for federal subsidies or Medicaid under Obamacare, meaning that affordability is less likely to impede enrollment in health insurance via state exchanges, the study concludes. Those ages 19 to 29 will eventually enroll in large numbers, it predicts, without specifying how many years it could take.

That optimistic conclusion comes from what young adults do when offered an opportunity to buy health insurance through their jobs. In such cases, 67 percent took the coverage.

For those who declined, the chief reasons were that they were covered by a family member (54 percent) or couldn’t afford the premiums (22 percent). Only 5 percent turned down coverage because they felt they were unlikely to need much medical care.

That price, not feeling they will never get sick, is the main barrier to young adults buying health insurance, said Aaron Smith, co-founder of Young Invincibles, a non-profit that runs education campaigns and conducts research on issues important to 18-to-34-year olds. “Price is the biggest hurdle.”

The group was not involved in the Commonwealth study but has received government funding to help people enroll in Obamacare insurance.

THE MASSACHUSETTS EXAMPLE

The Commonwealth study also pointed to what happened when Massachusetts institutedhealthcare reform in 2007, requiring -like Obamacare – that everyone have insurance or pay a penalty. In the first year, the uninsured rate for 19-to-26-year olds fell from 21 percent to 8 percent.

“Based on Massachusetts, there is reason to believe young adults will come to the (state insurance) marketplaces and sign up,” said the Commonwealth’s Blumenthal.

A greater barrier than affordability may be that very few young adults are aware that the new coverage will be an option in less than six weeks.

Confirming other surveys, a Commonwealth poll found that only 27 percent of the 19-to-29-year olds were aware of the state health insurance marketplaces. Awareness was lowest among the uninsured (19 percent knew about the marketplaces) and people with low to moderate incomes (18 percent).

Those groups are most likely to benefit from the federal subsidies available to help people with incomes less than four times the poverty level ($45,960 for an individual) buy policies on the exchanges.

The survey, with 1,885 respondents, was done in March, and young adults’ awareness may be higher now since several states as well as the federal government have begun advertising andmarketing campaigns to tell the uninsured about the exchanges. The survey has a margin of sampling error of 3.2 percentage points.

The report also found that 15 million adults ages 19 to 25 (half of this age group) were on a parent’s health insurance policy in the prior 12 months, up from 13.7 million in 2011. Of the 15 million, an estimated 7.8 million got that coverage through the 2010 Patient Protection and Affordable Care Act, which requires insurers allow children up to age 26 to stay on a parent’s policy.

Partly as a result, the number of uninsured young adults dropped from 18.1 million in 2011 to 15.7 million in 2013.

(Reporting by Sharon Begley; Editing by Michele Gershberg and Lisa Shumaker)

Source Link:  http://www.reuters.com/article/2013/08/21/us-usa-healthcare-youth-idUSBRE97K03S20130821?feedType=RSS&feedName=healthNews