Congress recently passed a bill to combat opioid abuse (although it’s still fighting over funding it), and there’s a good chance lawmakers also will pass legislation updating a lot of the federal mental health programs in the fall – although lack of bipartisanship has reduced the scope of what could pass.
We all hear stories (and perhaps have personal experience) of people having trouble accessing one of their regular physicians or having trouble getting a desired specialist because of “narrow networks” that offer a more limited choice of doctors and hospitals.
In some states, such as Texas, there has been a significant shift in the individual market to narrow network plans, and away from preferred provider organizations (PPOs) and similar networks providing broader choice and more out of network options. Continue reading
One clear lesson that health law advocates have drawn during the first two enrollment seasons under the Affordable Care Act is that many, many people need help sorting through their health plan choices as they try to enroll.
Among the many ways to get that assistance is by consulting a government-funded navigator or in-person assister (IPA), who must have training in the health law and enrollment procedures. Continue reading
The U.S. Department of Health and Human Services reported this fall that the number of people covered – that is, enrolled and paid up – in the ACA exchanges had dipped to 9.9 million as of June 30.
The drop off was similar to what occurred the prior year and was in keeping with expectations. Earlier in the year, 10.2 million were fully covered – and 11.7 had initially signed up but, as expected, not all had paid their premiums. Continue reading
Even as the Affordable Care Act (ACA) extends public and private health benefits to millions of Americans, the new beneficiaries may still face challenges finding the services they need.
But now there is money in the nation’s health care reform law to help address such shortages.
Last week, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced almost $500 million in new ACA funding to assist public and private nonprofit health centers across the country to provide more primary care to their communities.
The funding includes roughly $350 million in awards that will enable 1,184 centers to increase dental, medical, behavioral, pharmacy and vision services. Another $150 million is targeted to 160 centers with plans to renovate or enlarge their facilities in order to see more patients or offer more services.
“These awards will give 1.4 million more Americans across every state access to comprehensive quality health care,” said Burwell in her September 15 announcement. Continue reading
The ACA made many changes to Medicare. One of them involves linking part of hospital pay to patient satisfaction.
In an Atlantic magazine essay adapted from her new book, “The Nurses: A Year of Secrets, Drama, and Miracles With the Heroes of the Hospital,” Alexandra Robbins argues that hospitals are missing the point: the way hospitals are defining, measuring and achieving patient “satisfaction” is not advancing the quality of care.
Robbins overstates that the amount of Medicare payments tied to patient satisfaction and understates the role of outcomes (more on Medicare’s Hospital Value-Based Purchasing later). But her essay is provocative and worth thinking about for those of you who cover the hospital industry or your local hospitals, and how they are changing under the Affordable Care Act. Continue reading