Tag Archives: Affordable Care Act

Future of primary care: Who will take care of you?

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Amy Jeter

About Amy Jeter

Amy Jeter is a health journalist at The Virginian-Pilot. She attended Health Journalism 2013 on an AHCJ-Rural Health Journalism Fellowship, which is supported by The Leona M. and Harry B. Helmsley Charitable Trust.

The list of problems with primary care today is long and long-standing. Patients are frustrated and confused. Providers feel pressure to see more patients even as their reimbursements go down. Medical schools push students toward hospital-based sub-specialties. And for those who choose primary care, the training neglects important new skills, such as working in a team and engaging patients in their own care.

Resource

A new tip sheet from Felice J. Freyer, a medical writer at The Providence (R.I.) Journal and a member of AHCJ’s board of directors, addresses the changes in primary care and offers a number of story ideas and resources for reporters to cover primary care in their communities.

All this as the nation prepares for a spike in demand for primary care providers – fueled by millions of patients newly-insured through the Affordable Care Act – and a drop in supply due to retirements in the aging physician workforce and the unpopularity of the specialty, according to four panelists at Health Journalism 2013.

“I hate to be a downer,” said Andrew Morris-Singer, M.D., president and principal founder of Primary Care Progress. “We do have profound problems in the primary care pipeline.”

Solving the problem boils down to making essential changes to the way primary care providers do business, the panelists agreed.

These practices of the future – some of which already are operating – emphasize engaging patients, using technology, and distributing patient care across a primary care team. Continue reading →

New tip sheet breaks down how ACA applies to immigrants

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

We’ve posted a tip sheet from the National Immigration Law Center on how the Affordable Care Act affects immigrants. They let us put their guide on the  site with one request – that we include their website and suggest that you check their site if you write on this topic in case there are updates.

There’s no sense in repeating what you can find on the tip sheet (undocumented immigrants don’t get covered, documented ones do under  the circumstances described – generally, they can go in the exchanges with subsidies if they qualify but still face a wait to get into Medicaid). But it is worth addressing the nexis between the health law and the current debate over helping immigrants become documented.

The bill will go through changes before it passes – IF it passes (a big question mark, particularly in the House). But the key message from our perspective as health reporters: Given what’s been said so far by Democrats and Republicans alike, it is highly unlikely that undocumented immigrants will get health benefits WHILE they are going through what looks to be a multi-year process of becoming documented. However, once they are documented they will be treated like the rest of the documented immigrant population.

Addiction treatment options expand under health law – but will needs be met?

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Affordable Care Act could transform addiction care and make it go much more mainstream.

Photo by Thomas Marthinsen via Flickr

Here’s a great piece by Carla Johnson, an Associated Press medical writer and AHCJ board member. She highlights a little-known element of the Affordable Care Act and pulls together many strands of policy, hard numbers and real people’s needs. 

The story addresses how the health law will expand access to treatment for addiction and substance abuse – but that the system may not be up to meeting a backlog of unmet human need.

Her vivid opening sentence sets the stage:

 It has been six decades since doctors concluded that addiction was a disease that could be treated, but today the condition still dwells on the fringes of the medical community.

Continue reading →

Industry group concerned parents may drop dental coverage

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Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Once the ACA covers children's dental care, will parents drop their dental insurance?

Photo by ianus via Flickr

An estimated 5.3 million children are expected to get dental coverage next year through the Patient Protection and Affordable Care Act.

But will up to 11 million parents decide to drop their own dental benefits when their kids get covered separately?

It’s one of the still-unanswered questions surrounding the health care reform law and it worries Evelyn Ireland, executive director of the National Association of Dental Plans, the trade association representing the dental benefits industry.

The problem is this, according to Ireland: Continue reading →

Snapshot of state health spending yields some surprises

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

The Wall Street Journal and Louise Radnofsky did a nice package of interactive graphics and maps on state health spending. As Radnofsky noted, the high spenders are in the Northeast – but not only the Northeast. They are some rural states – but not all rural states. And Florida is up there.

It’s a fun and useful tool that gives you a snapshot of your state – and let you compare it with neighboring states or states with similar demographics.

But if you follow the work of the Dartmouth Atlas folks you’ll also know that spending doesn’t just vary by state – it varies by county, city – sometimes even neighborhood. Payment incentives is part – but only part – of the story. (They don’t explain why two hospitals in Manhattan may have such different utilization patterns, for instance). Local practice patterns, training, traditions, patient demographics all play a role.

Answering the big questions about insurance exchanges, states to watch

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

We write a lot on this blog about state developments, the exchanges and Medicaid expansion, as that’s a huge part of the local health policy beat. Here’s a helpful detailed guide to covering exchanges from CJR’s  Second Opinion.

It suggests Five Big Questions and gives some advice on how to think about each of them

  • Will policies be affordable
  • Who influences the exchange boards?
  • Which policies can be sold?
  • Do the networks have enough doctors and hospitals?
  • How will the exchange sell its policies?

And it includes this basic advice:

For starters, look beyond the easy sources – those academics and think tank experts always eager to dish out a quote. In fact, don’t even worry about quotes at this point. The trick is to understand what’s going on, who are the players and their special interests, what are the nuts and bolts of how these exchanges work. And then: What big questions need to be addressed. Therein lie your stories.

The exchanges are a local, ongoing story, and the best sources will be the ones on the ground in your state. That means advocacy groups, local foundations, local stakeholders like insurance brokers and agents, medical societies, hospital associations, the head of the local exchange board, the staff at the exchange board, insurance regulators, consulting actuaries, and insurance companies (whose websites can be helpful even when their PR folks are not). In other words, good coverage of the biggest health story in decades requires old-fashioned reporting—schmoozing, cultivating sources, reading reports and testimony, even attending meetings of your local exchange board. That’s how you’ll find the dots to connect.

I would add that California is a good state for you to watch to see how some of these questions get asked, and answered. California is ahead of many states in setting up the exchange; they are already thinking about marketing and messaging and outreach, officials (including those who favor the Affordable Care Act) are having frank public conversations about affordability, and there is a lot of good reporting coming out of the state.  CJR’s Second Opinion also has been tracking Connecticut’s exchange pretty closely.

Quick lessons for covering state implementation of the health care law

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

At Health Journalism 2013, I led a panel about state implementation of  the health law (Angie Drobnic Holan of the Tampa Bay Times  blogged about the session). Later that day, I asked some of the reporters – part of the group of AHCJ Regional Health Journalism Fellows and all from conservative states that have opposed the Affordable Care Act – for some takeaways that will help them cover the topic. Here’s some of what they shared: Continue reading →

Timeline shows upcoming developments in exchanges

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

As many of you know, Gary Cohen, the head of the Center for Consumer Information and Insurance Oversight (the HHS office that is spearheading the exchanges) was a last-minute no-show at our Health Journalism 2013 panel on state implementation of the Affordable Care Act.

Whether it was budgetary (CCIIO is setting up WAY more federal exchanges than it anticipated and hasn’t pried more money out of Congress, as you can imagine) or whether somebody decided it wasn’t really such a good idea for Cohen to face a whole room of inquisitive journalists for whom CCIIO might not yet have answers was a subject of much speculation in Boston.

However, even if Cohen didn’t join us, his team did send us a timeline. (Before you get confused looking at it, QHP stands for “qualified health plans” – health plans that live up to the new rules for participation in exchanges). Here it is. You can use it to help track what’s ready, what’s lagging, what’s going through dry runs before being opened to consumers in your state.


(Click on the image to enlarge it.)

Writing about co-ops: A taste of the complexity

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

I wrote about co-ops as an undercovered health reform topic last month and provided some resources about how to cover them, either from a big-picture perspective about their role in the exchanges across the country next year or if you are looking at co-ops in your state or region – if they exist.

Health Affairs and RWJF have published a brief that explains in more detail about how they are set up, and the challenges they face. The brief  gives a  description of several of the co-ops – here are the top three on the list to give a taste of the variety. (There  are more in the brief and the National Alliance of State Health Cooperatives has a full list (PDF).

  • Evergreen Health Cooperative, established by Peter Beilenson, a former Baltimore City health commissioner, intends to provide high-quality care to members throughout Maryland with premiums costing 20-30 percent less than those of traditional insurance to help keep people from developing more serious illnesses. It has been awarded $65 million in loans.
  • HealthyCT is a nonprofit health plan sponsored by the Connecticut State Medical Society (CSMS) and CSMS-IPA, a statewide independent practice association of providers. HealthyCT will focus on encouraging members to use patient-centered medical homes. It has been awarded $76 million in loans.
  • Compass Cooperative Health Network in Arizona is sponsored by local experts in insurance, chronic disease coordination, use of health information technology, and business formation. It will begin on a regional basis within Arizona and then expand statewide over time. It has been awarded $93 million.

Premium shock: The story isn’t as simple as it seems

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

You’ve seen lots of stories – and you may well have written some – about how much the cost of insurance is going to rise for younger people in the exchanges next year – the so-called “premium shock” or “price shock.”

This is a fair concern – but be careful that you handle it fairly. Continue reading →