Industry Updates

How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums.

Click here to download the Congressional Budget Office's January 2017 article discussing the ways that repealing portions of the ACA will affect health insurance coverage and premiums.

TRUMP HEALTH CARE 11/17/16

Client Advisory on what we know so far.

Our Team has sat through several sessions including with members of the Trump transition team, Deloitte, McDermott, Will, and reviewed as many blogs from experts as we could find on both sides of the aisle. While there is definitely an advantage for Trump to not answer definitive questions there are some strategies now moving forward that will change the ACA.

Our conclusion is that Trump will try to repeal the ACA using Reconciliation instead of a vote. A vote requires 60 members of the Senate to agree and the GOP, while dominate, does not have the votes. Reconciliation requires 51 and they already have experience getting this process through the Senate with HR 3752, but it was vetoed by Obama. This represents a blueprint for what will happen. Reconciliation has its limits however, and that is the points in the law that would be changed can only be changed if they are items of current or future revenue.

Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program (Shared Savings Program), the Next Generation ACO Model offers a new opportunity in accountable care—one that sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards of care.

Medicare Accountable Care Organization initiatives to improve how the health system cares for patients

Today, the Centers for Medicare & Medicaid Services (CMS) announced 121 new participants in Medicare Accountable Care Organization (ACO) initiatives designed to improve the care patients receive in the health care system and lower costs. With this announcement, ACOs now represent 49 states and the District of Columbia.

“Americans will get better care and we will spend our health care dollars more wisely because these hospitals and providers have made a commitment to change how they do business and work with patients,” HHS Secretary Sylvia M. Burwell said. “We are moving Medicare and the entire health care system toward paying providers based on the quality, rather than the quantity of care they give patients. The three new ACO initiatives being launched today mark an important step forward in this effort.”

ACOs were created to change the incentives for how medical care is paid for in the U.S., moving away from a system that rewards the quantity of services to one that rewards the quality of health outcomes.

Predictions for 2016

Since Health Reform is the overall driver for many new health care businesses and many new (and needed) health care organizational models, we have made six predictions, prepared some helpful questions to ask, and listed a summary of trends to help you understand that these changes represent opportunities as well as challenges. Let’s look at what the leading issues may be this coming year and going into 2017.