Population health was a term that became popular as Congress was passing the Affordable Care Act in 2010. In the seven years since then, hospitals and health systems have struggled to define the term consistently.
For example, you see from this article by Tamara Rosin for Becker’s Hospital Review that health system administrators use the terms “population health” and its twin “population health management” to describe what they do to keep patients healthy and out of the hospital. The problem is that settling on one definition is a challenge, Rosin wrote. Continue reading
Before the Affordable Care Act, health insurance regulation in the individual market largely was managed by the states. The ACA saw a shift to a greater federal role. Now under the Trump administration, some responsibilities are going back to the states.
In a new tip sheet for AHCJ, Louise Norris, whom many AHCJ members know as a contributor to healthinsurance.org, explains the new responsibilities. One significant area is network adequacy – whether a plan has enough doctors, hospitals and other providers to meet the needs of beneficiaries. Continue reading
Photo by Sean Stayte via flickr.
If Senate Republicans were hoping that this week’s new CBO score of their revamped House health bill was going to make life easier for them … Not so much.
House leaders had worked hard to revise American Health Care Act when they couldn’t get the votes. But the Congressional Budget Office found that the projected impact of the amended version, which narrowly passed the House in early May, wasn’t all that different than the original.
The old bill would have led to 24 million fewer Americans having coverage in a decade. The new bill, according to CBO, would mean 23 million would not be covered. Continue reading
The Congressional Budget Office released its analysis of the latest version of the American Health Care Act on Wednesday. There is a lot of uncertainty in implementation of the bill and what decisions each state would make so, of course, these are just estimates. But we’ve collected some of the coverage and statements about the CBO score to help our readers make sense of the key points. Continue reading
The future of Medicaid – the health program for low-income adults, children and seniors – is now in the hands of the Senate. The American Health Care Act, as passed by the House, would convert the program from an open-ended one to block grants, providing a fixed amount per recipient, regardless of health costs. The bill also caps future program spending. If the bill passes, Medicaid faces more than $800 billion in cuts over 10 years.
That’s bad news for the 70 million people enrolled in the program, including about 9 million dual eligibles – those covered by both Medicare and Medicaid. These are the most vulnerable, often sickest older adults, who struggle to afford food, medicine, and manage their chronic conditions. Continue reading