Sunday, January 2, 2011

What's In It For Me? The Health Care Reform Bill in 2011

Since it is now officially 2011, here are some of the new laws from the The Health Care Reform Bill that are being implemented:
  1. Prescription Drug Discounts: Seniors who reach the coverage gap will receive a 50 percent discount when buying Medicare Part D covered brand-name prescription drugs. Over the next ten years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is closed in 2020.
  2. Free Preventive Care for Seniors: The law provides certain free preventive services, such as annual wellness visits and personalized prevention plans, for seniors on Medicare.
  3. Bringing Down Health Care Premiums: To ensure premium dollars are spent primarily on health care, the new law generally requires that at least 85% of all premium dollars collected by insurance companies for large 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.
  4. Addressing Overpayments to Big Insurance Companies and Strengthening Medicare Advantage: Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than is spent per person in Original Medicare. This results in increased premiums for all Medicare beneficiaries, including the 77 percent of beneficiaries who are not currently enrolled in a Medicare Advantage plan. The new 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. Learn more about improvements to Medicare (pdf).
  5. Improving Health Care Quality and Efficiency: The law establishes a new Center for Medicare & Medicaid Innovation that will begin testing new ways of delivering care to patients. These new methods are expected to improve the quality of care and reduce the rate of growth in costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). By January 1, 2011, HHS will submit a national strategy for quality improvement in health care, including these programs.
  6. Improving Care for Seniors after They Leave the Hospital: 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.
 You can also see specific health care implementations for your state by visiting the Implementation Center on the healthcare.gov website.

1 comment:

  1. Ugh... band-aid on a bullet wound. You forgot to mention the mandate, which is only going to line the pockets of the authors of this bill, the insurance companies.

    I was all juiced thinking about the successes in December, then you reminded me what was done the previous 23 months. Oh well, it will be hilarious watching Republicans futilely try to repeal the healthcare bill. It will be nice watching someone else fail for a change.

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