Adirondack Health Institute News

Affordable Care Act Fact of the Day – Providing New Voluntary Options for Long-Term Care Insurance

The Affordable Care Act creates a voluntary long-term care insurance program – called CLASS.  CLASS will provide cash benefits to adults who become disabled. 

Note:  On October 14, 2011, Secretary Sebelius transmitted a report and letter to Congress stating that the Department does not see a viable path forward for CLASS implementation at this time.


Affordable Care Act Fact of the Day – Encouraging Integrated Health Systems

The new law provides incentives for physicians to join together to form “Accountable Care Organizations”. These groups allow doctors to better coordinate patient care and improve the quality, help prevent disease and illness, and reduce unnecessary hospital admissions.  If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save.  Effective January 1, 2012.

Affordable Care Act Fact of the Day – Reducing Paperwork and Administrative Costs

Heath care remains one of the few industries that relies on paper records. The new law will institute a series of changes to standardize billing and requires health plans to begin adopting an implementing rules for secure, confidential, electronic exchange of health information.  Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care. First regulation effective October 1, 2012.

Affordable Care Act Fact of the Day – Linking Payment to Quality Outcomes

The law establishes a hospital Value-Based Purchasing program in Traditional Medicare. This program offers financial incentives to hospitals to improve the quality of care.  Hospital performance is required to be publicly reported, beginning with measures relating to heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients’ perception of care. Effective for payments for discharges occurring on or after October 1, 2012.

Affordable Care Act Fact of the Day – Addressing Overpayments to Big Insurance companies and Strenthening Medicare Advantage

Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than is spent per person in Traditional Medicare. This results in increased premiums for all Medicare beneficiaries who are not currently enrolled in a Medicare Advantage plan.  The law levels the playing field by gradually eliminating this discrepancy.  People enrolled in a Medicare Advantage plan will still receive all guaranteed Medicare benefits, and the law provides bonus payments to Medicare Advantage plans that provide high quality care. Effective January 1, 2011.

Affordable Care Act Fact of the Day – Bringing Down Health Care Premiums

To ensure premium dollars are spent primarily on health care, the Affordable Care Act generally requires that at lest 85% of all premium dollars collected by insurance companies for larger employer plans are spent on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80% of the premium must be spent on benefits and quality improvement.

If insurance companies do not meet these goals, because their administrative costs or profits are too high, they must provide rebates to consumers. Effective January 1, 2011.

Affordable Care Act Fact of the Day – Increasing Access to Services at Home and in the Community

The Community First Choice Option allows states to offer home and community based services to disabled individuals through Medicaid rather than institutional care in nursing homes.  Effective beginning October 1, 2011.



Affordable Care Act Fact of the Day – Introducing New Innovations to Bring Down Costs

The Independent Advisory Board will begin operations to develop and submit proposals to Congress and the President aimed at extending the life of the Medicare Trust Fund.  The Board is expected to focus on ways to reduce costs, improve health outcomes for patients, and expand access to high-quality care.  Administrative funding becomes available October 1, 2011.

Affordable Care Act Fact of the Day – Improving care for seniors after they leave the hosptial

Effective January 1, 2011, the Community Care Transitions Program will help high risk Medicare beneficiaries who are hospitalized, avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities.

Affordable Care Act Fact of the Day – Improving Health Care Quality and Efficiency

The law establishes a new Center for Medicare and Medicaid Innovation that will begin testing new ways of delivering care to patients.  These methods are expected to improve the quality of care, and reduce the rate of  growth in health care costs for Medicare, Medicaid, and the Children’s Health Insurance Progrm.  Additionally, on or before January 1, 2011, Health and Human Services will submit a national strategy for quality improvement in health care, including these programs.