Archive: April 2011

Dental Health Workforce

Posted on April 27, 2011

Providing access to high quality oral health care is an important component to improving the health of people in the United States. A person’s oral health is connected to that person’s overall well-being, and can be an indicator of serious health problems. Often, symptoms of disease first show up in the mouth, and certain infections in the mouth, if untreated, can spread to other parts of the body. However, the current supply of dentists, particularly in medically underserved areas, is inadequate. As of September 2009, there were 4,230 dental health professions shortage areas, within which more than 42 million people live. The U.S. Health Resources and Services Administration (HRSA) estimates that it would take an increase of more than 9,500 dental professionals in order to reduce the ratio in shortage areas to 1 dental professional for every 3,000 individuals.

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Supreme Court Rejects Expedited Review Request in Virginia’s Health Reform Challenge

Posted on April 26, 2011

On April 25, the U.S. Supreme Court rejected Virginia Attorney General Ken Cuccinelli’s request for an expedited review in Virginia v. Sebelius, a decision by Judge Henry Hudson (E.D. Va.) invalidating the Affordable Care Act’s individual requirement to maintain health insurance coverage. The Department of Justice appealed Judge Hudson’s decision and the U.S. Court of Appeals for the 4th Circuit is expected to begin oral arguments as early as May 10, 2011.

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New analysis examines ACOs and medically underserved populations

Posted on April 21, 2011

A recent analysis, funded by the RCHN Community Health Foundation and authored by researchers from the Geiger Gibson Program in Community Health Policy at the George Washington University, examines Medicare Accountable Care Organizations (ACOs) and their effect on community health center patients. The analysis finds that rules requiring ACO services to be provided by a physician only, may effectively exclude from ACO participation certain underserved populations who use non-physician providers for their primary care.

Sara Rosenbaum, lead author of the study, is a frequent contributor to HealthReformGPS.

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Medicare Accountable Care Organizations

Posted on April 20, 2011

An earlier Implementation Brief provided an overview of the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs), which was established by §3022 of the Affordable Care Act (ACA) by adding §1899 to the Social Security Act. On April 7, 2011, the federal Centers for Medicare and Medicaid Services (CMS) published a proposed rule implementing the MSSP. This proposed rule was accompanied by several additional policy documents:

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Commonwealth report provides recommendations for ACO implementation

Posted on April 14, 2011

A key provision of the Affordable Care Act (ACA) is the establishment of the Medicare Shared Savings Program, which provides incentives for improved quality and efficiency in a new category of provider–the accountable care organization (ACO). The ACO program is slated to begin in January 2012 and will reward groups of providers who agree to collaborate and offer more accountable, effective, and efficient care with a share of the savings that they achieve. The Commonwealth Fund Commission on a High Performance Health System’s report “High Performance Accountable Care: Building on Success and Learning from Experience,” provides recommendations for ensuring effective, efficient implementation and growth of the ACOs. Specifically, this report 1) sets forth the rationale for creating ACOs; 2) describes several promising types of ACO models that should be considered and evaluated as part of an effort to facilitate adaptability and spread of accountability for quality and cost; and 3) concludes with a set of Commission recommendations on what ought to be expected from ACOs and how to ensure their successful implementation and spread.

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Disclosure and Review of Unreasonable Premium Increases

Posted on April 14, 2011

Over the past decade, health insurance premiums have doubled (with particularly sharp increases in the small group and individual markets), making insurance coverage unattainable for millions of Americans. News stories have reported that some health insurers have sought to increase premium rates as much as 50 percent.

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HHS Provider Conscience Regulation

Posted on April 12, 2011

Abortion was a controversial aspect of the health reform debate and attention focused on both payment for abortions and the applicability of existing laws governing abortion practices by the federal and state governments. In final form, the Affordable Care Act (ACA) included a new “conscience” provision that prohibits qualified health plans offered through state health insurance Exchanges from “discriminating against” a provider or facility “because of its unwillingness to provide, pay for, provide coverage of, or refer for abortions.

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House Budget Committee’s FY2012 Budget Resolution proposes repeal of ACA

Posted on April 10, 2011

“The Path to Prosperity: Restoring America’s Promise” is the House Budget Committee’s Fiscal Year (FY) 2012 budget resolution. The sections “Strengthening the Social Safety Net,” and “Fulfilling the Mission of Health and Retirement Security for All Americans,” encourage government to repeal and defund the Affordable Care Act (ACA), offering instead a reform proposal that builds upon the Rivlin-Ryan Medicare reform plan advanced in the President’s Fiscal Commission in 2010. The FY2012 budget resolution proposes to 1) convert state Medicaid funding into a block grant, 2) offers Medicare beneficiaries the same health care options as members of Congress, 3) calls for the advance of social security solutions.

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Medicaid Benefit Changes

Posted on April 6, 2011

Medicaid provides health insurance to the poorest and most medically vulnerable populations. Low-income pregnant women, children, and very poor parents of minor children are the majority of beneficiaries; Medicaid also provides coverage for children and adults with severe disabilities, as well as “wrap-around” coverage for low-income Medicare beneficiaries who cannot pay for services and cost-sharing that Medicare does not cover, particularly institutional and home- and community-based long-term care. Medicaid is jointly funded by states and the federal government and administered by states under broad federal standards.

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Heritage web memo calls for aligned tax relief, entitlement reform

Posted on April 1, 2011

A new web memo from the Heritage Foundation calls for tax fairness and the promotion of choice through market reforms as the way toward true health reform.

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