|
|
|
- Pierce Kennedy
- 5 years ago
- Views:
Transcription
1 6th Annual Symposium International Network Health Policy & Reform Impact of the Competition Strengthening Act upon Care Coordination Reinhard Busse, Prof. Dr. med. MPH FFPH FG Management im Gesundheitswesen, Technische Universität Berlin (WHO Collaborating Centre for Health Systems Research and Management) & European Observatory on Health Systems and Policies
2 Risk-structure compensation since 1994/95 Contribution tion Third-party payer collector Ca. 250 sickness funds Wage-related contribution ca. 13.4% (50/50) +0.9% insured since 2005 Strong delegation Choice of fund & limited since 1996 governmental control Population SHI insures 87% (75% mandatorily, 12% voluntarily) Free access with self-government, organised in 7 associations Cost-sharing Contracts, mostly collective Providers Public-private mix, organised in associations ambulatory care/ hospitals The German system at a glance...
3 Federal Ministry of Health Proposals for health reform acts Federal Assembly (Bundestag) Federal Parliament Insuree/ Patient Federal Council (Bundesrat) Representation State Ministries responsible for health Legislative frame Delegation = State only defines legal framework Obligation to secure hospital care Ambulatory Physician 17 (Regional) Physicians Associations Federal Association of SHI Physicians of country-wide funds (via Federal Insurance Office) Valuation Committee & Institute: Setting of relative point values Framework contract Fina ancial negotiation Commissioning Freedom to ch hoose Obligation to co ontract Sectorisation Sickness fund Sickness funds in one region Federal associations of sickness funds Federal Joint Committee on Financial negotiati Hospital Federal Hospital Organization Inpatient t 16 Regional Hospital Organizations of regional funds Committee & Institute for Hospital Reimbursment: DRGs Federal Office for Quality Assurance Institute for Quality and Efficiency (IQWiG) Statutory health insurance early 2007
4 Proposals Federal Ministry Federal Parliament Even of Health though for health reform certain acts regulatory institutions Federal Assembly Federal Council (Bundestag) (Bundesrat) and programmes have become trans-sectoral Legislative frame Representation State Ministries responsible for health Physician 17 (Regional) Physicians Associations Federal Association of SHI Physicians of country-wide funds (via Federal Insurance Office) Valuation Committee & Institute: Setting of relative point values Framework contract Fina ancial negotiation Insuree/ Patient Freedom to ch hoose Obligation to secure hospital care Commissioning Obligation to co ontract Sickness fund Sickness funds in one region Federal associations of sickness funds Federal Joint Committee Institute for Quality and Efficiency (IQWiG) Joint self-government on Financial negotiati Hospital 16 Regional Hospital Organizations Federal Hospital Organization Members: 9 sickness funds 9 providers 3 for neutral Hospital + 9 patients (no Federal voting Office for rights) of regional funds Committee & Institute Reimbursment: DRGs Evaluation of drugs etc. Quality Assurance Statutory health insurance early 2007
5 coordination, quality and cost-effectiveness are problematic Germany always knew that its health care system was expensive, but was sure it was worth hi it ( the best system ) Quality assurance was introduced early but concentrated on structure Increasing doubts since late 1990s: Health Technology Assessment introduced since 1997 World Health Report 2000: Germany only # 25 in terms of performance (efficiency) International comparative studies demonstrate only average quality (especially low for chronically ill)
6 Legal attempts to improve care coordination (selection): Pre- and post- inpatient care in hospitals (1997) Integrated [i.e. transsectoral] care contracts (2000, funded with 1% of expenditure since 2004) Disease Management Programmes (2002) -> next slide Polyclinics (potentially with hospital owners, 2004) GP contracts (insured choose GP as gatekeeper; 2004, have to be offered since 2007) Ambulatory care in hospitals for patients with selected rare/ difficult diseases (2004)
7 Disease Management Programmes (since 2002) Compensate sickness funds for chronically ill better (make them attractive) = reduce faulty incentives to attract young & healthy h Address quality problems by guidelines/ pathways Tackle trans-sectoral problems by integrated contracts = introduce Disease Management Programs meeting certain minimum criteria and compensate sickness funds for average expenditure of those enrolling (new RSC categories) double incentive for sickness funds: potentially lower costs + extra compensation! By early 2007: 3.5 mn enrolled (5% of SHI insured)
8 What has or will be changed by the Competition Strengthening Act and what is the (likely) impact on care coordination? Population Contribution collector Third-party payer Good for the up to 1.5% uninsured, both voluntarily (e.g. selfemployed) and involuntarily (e.g. divorced women, >55 yr-olds with chronic illnesses) Providers PHI remains but: universal coverage + obligation to contract (for a capped premium)
9 Health fund Redesigning the risk-adjusted allocation formula to include supplements for 50 to 80 diseases Uniform contribution rate (determined by government) Population Contribution collector Third-party payer PHI remains but: universal coverage + obligation to contract (for a capped premium) Providers
10 Euro/T Tag 35 Standardised (= avg.) expenditure used for the Standardisierte Leistungsausgaben in Euro pro Tag -Rechtskreis WEST- Risk Structure Compensation Jahresausgleich 2005mechanism (2006) 30 m - kein DMP w - kein DMP 25 m - Diabetes II 20 w - Diabetes II w - Brustkrebs 15 m - KHK 10 w - KHK m - Diabetes I 5 0 Avg / day Alter w - Diabetes I
11 Euro/T Tag 35 Effect of illness by age differs greatly (2006) Standardisierte Leistungsausgaben in Euro pro Tag -Rechtskreis WEST- Jahresausgleich m - kein DMP w - kein DMP m - Diabetes II w - Diabetes II w - Brustkrebs m - KHK 10 w - KHK Alter m - Diabetes I w - Diabetes I
12 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% The well-known 20/80 distribution actually the 5/50 or 10/70 problem , ,6 8,8 5,6 6,9 4 2,5 3,4 % of population % of expenditure
13 % meet threshold h of > 1.5fold avg. expenditure % <
14 55 persons in last year of life; expensive acute diseases without lasting ill-health; extremely rare but expensive diseases Participation in a DMP will not qualify anymore: will reduced incentives lead sickness funds to stop offering them? 16 Or: normal the acute opportunity inpatient stays to concentrate on (cost-)effective programmes with risk-strata, strata for patients 9 with multiple conditions etc.? % <1 We need to identify 50 to 80 diseases explaining these costs!
15 Redesigning the risk-adjusted allocation formula to include supplements for 50 to 80di Problematic diseases as chronically ill will not Health Contribution Third-party benefit (= loose) but fund according to a survey collector payer they don t realise that Uniform contribution rate (determined by government) Extra, community-rated premium (positive or negative) Population No-claim bonuses, individual deductibles es to lower contribution o PHI remains but: universal coverage + obligation to contract (for a capped premium) Providers
16 Redesigning the risk-adjusted allocation formula to include supplements for 50 to 80di diseases Sickness funds, Health fund Uniform contribution rate (determined by government) Population Contribution collector Third-party payer PHI remains but: universal coverage + obligation to contract (for a capped premium) organized in ONE association Still mostly collective contracts, but more selective integrated Probably overrated for care contracts chronic care coordination; mostly used dfor acute carerehab. packages Providers
Preliminary summary the triangle and the building blocks (functions)
Preliminary summary the triangle and the building blocks (functions) Managing and Researching Health Care Systems Reinhard Busse, Prof. Dr. med. MPH FFPH FG Management im Gesundheitswesen, Technische Universität
Health financing in high income countries: lessons for countries in transition Reinhard Busse, Prof. Dr. med. MPH FFPH FG Management im Gesundheitswesen, Technische Universität Berlin (WHO Collaborating
Social Health Insurance countries in western Europe an Observatory study
Social Health Insurance countries in western Europe an Observatory study Reinhard Busse, Prof. Dr. med. MPH Professor of Health Care Management, Technische Universität Berlin Associate Research Director,
Financing II: Pooling and (Re-)Allocation
Financing II: Pooling and (Re-)Allocation Managing and Researching Health Care Systems Reinhard Busse, Prof. Dr. med. MPH FFPH FG Management im Gesundheitswesen, Technische Universität Berlin (WHO Collaborating
Health care reform and pharmaceutical policies in Germany Prof. Dr. med. Reinhard Busse, MPH
Health care reform and pharmaceutical policies in Germany Prof. Dr. med. Reinhard Busse, MPH Department of Health Care Management/ WHO Collaborating Centre for Health Systems, Research and Management,
Health Service Reimbursement: Early Benefit Assessment of New Drugs in Germany. Conflict of interest. Nothing to disclose
Health Service Reimbursement: Early Benefit Assessment of New Drugs in Germany 19th Congress of the EAHP Barcelona, 26-28 March 2014 Katrin Nink Conflict of interest Nothing to disclose (Research Associate
Apps and other Mobile Health Solutions
German Managed Care Association / Bundesverband Managed Care e.v. Apps and other Mobile Health Solutions GTAI Webinar Succeed in Germany s Healthcare Market Prof. Dr. Volker Amelung, President, German
Movement of patients
Movement of patients Reinhard Busse, Prof. Dr. med. MPH Professor of Health Care Management, Technische Universität Berlin Associate Research Director, European Observatory on Health Care Systems Three
DRG in Europe, esp. Germany
DRG in Europe, esp. Germany System overview and consequences for coding--- DRG-konferansen 5. 6. mars 2007 Oslo Dr. Michael Wilke Agenda 1 Rambøll Management 2 The German HealthCare System 3 4 DRG in Europe
Figure ES-1. Major Features of Health Insurance Expansion Bills and Impact on Uninsured, National Expenditures
Figure ES-1. Major Features of Health Insurance Expansion Bills and Impact on, National Expenditures President Bush s Tax Reform Plan Healthy Americans Act 2 Federal/State Partnership 15 States AmeriCare
http:mig.tu-berlin.de Innovations in sickness funds management: a three country study European Health Management Association Annual Conference, Potsdam 1st July 2005, Barcelona Dr. Jonas Schreyögg, Dpt.
HiT summary. Germany. Health Care Systems in Transition. Introduction. Observatory. Government and recent political history.
Health Care Systems in Transition HiT summary European Observatory on Health Systems and Policies Germany Fig. 1. Total health care expenditure as % of GDP, comparing Germany, selected countries and EU
OECD Health Committee Survey on Health Systems Characteristics 2016 ROUND
OECD Health Committee Survey on Health Systems Characteristics 2016 ROUND PART I. HEALTH CARE FINANCING Section 1: Characteristics of basic health care coverage Section 2: Regulation of health insurance
Simple Facts About Medicare
Simple Facts About Medicare What is Medicare? Medicare is a federal system of health insurance for people over 65 years of age and for certain younger people with disabilities. There are two types of Medicare:
The German NUB Regulation A Gateway for. German Inpatient Reimbursement System?
EHMA Annual Congress, Innsbruck The German NUB Regulation A Gateway for Introducing Innovative Medical Devices into the German Inpatient Reimbursement System? Cornelia Henschke Michael Bäumler Sabrina
Following is a list of common health insurance terms and definitions*.
Health Terms Glossary Following is a list of common health insurance terms and definitions*. Ambulatory Care Health services delivered on an outpatient basis. A patient's treatment at a doctor's office
Managed competition in the Netherlands
Stephanie Heinemann, MPH Prof. Dr. Stefan Greß Managed competition in the Netherlands DGSMP Conference in Essen September 12, 2012 Managed competition goals In a system of managed competition, all individuals
2.05 Predictive Modeling P4P and Physician Engagement. Pay for Performance Summit February 7, 2006
2.05 Predictive Modeling P4P and Physician Engagement Pay for Performance Summit February 7, 2006 1 Agenda Three Key Healthcare Trends About Predictive Modeling About Reporting Business and Clinical Outcomes
Thomas Rousseau NIHDI - COOPAMI 2. Ulla Cahay NIHDI - COOPAMI
11-05-2017 Thomas Rousseau NIHDI - COOPAMI 2 Ulla Cahay NIHDI - COOPAMI Agenda Characteristics of the Belgian health care system Standard procedure : reimbursement NIHDI? Questions? Characteristics of
Financial Protection and Equity in Financing
Financial Protection and Equity in Financing Managing and Researching Healh Care Systems Wilm Quentin, Dr. med. MSc HPPF FG Management im Gesundheitswesen, Technische Universität Berlin (WHO Collaborating
A Belgian cooperation platform Thomas Rousseau NIHDI - COOPAMI. Thomas Rousseau NIHDI - COOPAMI 2
A Belgian cooperation platform www.coopami.org Thomas Rousseau NIHDI - COOPAMI Thomas Rousseau NIHDI - COOPAMI 2 24-10-2013 The Belgian health insurance I. Basic principles of the Belgian health insurance
GLOSSARY. MEDICAID: A joint federal and state program that helps people with low incomes and limited resources pay health care costs.
GLOSSARY It has become obvious that those speaking about single-payer, universal healthcare and Medicare for all are using those terms interchangeably. These terms are not interchangeable and already have
The Path to Integrated Insurance System in China
Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Executive Summary The Path to Integrated Insurance System in China Universal medical
Exhibit ES-1. Total National Health Expenditures (NHE), Current Projection and Alternative Scenarios
Exhibit ES-1. Total National Health Expenditures (NHE), 2009 2020 Current Projection and Alternative Scenarios NHE in trillions $6 $5 Current projection (6.7% annual growth) Path proposals (5.5% annual
HEALTH CARE MODELS: INTERNATIONAL COMPARISONS
HEALTH CARE MODELS: INTERNATIONAL COMPARISONS Dr. Jaime Llambías-Wolff, Ph.D. York University Based and adapted from presentation by : Dr. Sibu Saha, MD, MBA Professor of Surgery University of Kentucky
Exhibit 1. Availability of Public Information
Exhibit 1. Availability of Public Information In your view, how important do you think it is to have information about each of the following available to the public? Clinical quality health outcomes (e.g.,
Checkup on Health Insurance Choices
Page 1 of 17 Checkup on Health Insurance Choices Today, there are more types of health insurance, and more choices, than ever before. The information presented here will help you choose a plan that is
Diagnosis Related Groups (in Europe): Moving towards transparency, efficiency and quality in hospitals
Presentation at the World Bank, Washington DC, Diagnosis Related Groups (in Europe): Moving towards transparency, efficiency and quality in hospitals Reinhard Busse, Prof. Dr. med. MPH FFPH Department
Consumer-Driven Health Plans:
Consumer-Driven Health Plans: Early Evidence about Utilization, Spending and Cost Stephen T Parente Roger Feldman Jon B Christianson September 15, 2003 Presentation Objectives Questions to be Addressed
Patient Membership Agreement. Wellscape Direct MD, LLC
Wellscape Direct MD, LLC This is an Agreement between you, the Member, and Wellscape Direct MD, LLC, a Massachusetts limited liability company located at 30 Lancaster Street in Boston, Massachusetts. Wellscape
INTERNATIONAL HEALTH SYSTEMS: THE ASIAN (TAIWAN, JAPAN, SINGAPORE,)
INTERNATIONAL HEALTH SYSTEMS: THE ASIAN (TAIWAN, JAPAN, SINGAPORE,) Presented by: Ms. Nuanthip Tangsitchanakun 5749173 Ms. Nan Nin Shwe Yi Lin 5849104 HEATH CARE SYSTEMS JAPAN IN OVERVIEW OF JAPAN HEALTHCARE
Health Insurance Glossary of Terms
1 Health Insurance Glossary of Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should
The reform experience of Estonia
The reform experience of Estonia Dr. Ewout van Ginneken Department of Health Care Management Berlin University of Technology WHO Collaborating Centre for Health Systems, Research and Management European
Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER
Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER Percent saying very or somewhat difficult 1 53 56 6 59 32 32 42 44 7 * 6 * Significant difference between below and
POLITICAL ECONOMY OF SOCIAL HEALTH INSURANCE REFORM IN TUNISIA
POLITICAL ECONOMY OF SOCIAL HEALTH INSURANCE REFORM IN TUNISIA VIEWS PRESENTED ARE THOSE OF THE AUTHOR AND DO NOT REPRESENT THE MOPH S S VIEWS Dr H. ACHOURI Ministry of Public Heath Tunis 1030 Tunisia
114.6 CMR: DIVISION OF HEALTH CARE FINANCE AND POLICY MEDICAL SECURITY BUREAU
114.6 CMR 14.00: HEALTH SAFETY NET PAYMENTS AND FUNDING Section 14.01: General Provisions 14.02: Definitions 14.03: Sources and Uses of Funds 14.04: Total Hospital Assessment Liability to the Health Safety
The Affordable Care Act: Healthcare Reform 101. Gail R. Wilensky Project HOPE April 4, 2014
The Affordable Care Act: Healthcare Reform 101 Gail R. Wilensky Project HOPE April 4, 2014 1 Wide Agreement on the Challenges Long-term spending growth Problems with patient safety Problems with quality/clinical
OVERVIEW OF THE AFFORDABLE CARE ACT. September 23, 2013
OVERVIEW OF THE AFFORDABLE CARE ACT September 23, 2013 Outline The New Continuum of Coverage Medicaid and CHIP Are Changing The New Marketplaces Insurance Affordability Programs Shared Responsibility Requirement
Optimum HealthCare H5594_VideoScript_CMS Approved
Optimum HealthCare H5594_VideoScript_CMS Approved 2012-2013 Hello I m
Medicare Supplement Insurance (Medigap) Review
Medicare Supplement Insurance (Medigap) Review 1 Medicare Part A (Hospital Insurance) Part A Covers: Inpatient hospital care Care in a skilled nursing facility (SNF) Home health care Hospice care Blood
Dr. rer. soc. Luis Carlos Escobar Pinzón Prof. Dr. oec. troph. Eva Münster, MPH. Institute for work, social and environmental medicine
IPP-aMSD Work package 3 Documentation of indices and indicators concernig the effects of particular musculoskeletal disorders (MSD) when determining prioritization of relevant prevention topics Dr. rer.
GOVERNMENT HEALTH CARE PROGRAMS
GOVERNMENT HEALTH CARE PROGRAMS CHAPTER 23 CHAPTER OUTLINE MEDICAID MEDICARE CHILD HEALTH INSURANCE PROGRAM PATIENT PROTECTION AND AFFORDABLE CARE ACT 2 YOU ARE HERE 3 MEDICAID covers health care for the
Are you due to go to hospital? What you need to know before you go.
Are you due to go to hospital? What you need to know before you go. The essentials Your hospital stay is covered Do you need inpatient treatment? This brochure explains the factors you should consider
The Health Care Law and
The Health Care Law and Office of the Regional Director Community Resource California-Based, extensive travel to AZ, NV, Indian Country, and HI. Day-to-day, week-to-week, month-to-month Educate the public
Making Medicare Select Real
A roadmap for reform to put people at the centre of health care November 2009 A paper by: Mary Foley Christine Bennett Just Stoelwinder Authors Mary Foley Mary Foley is National Health Practice Leader
Building Actuarial Cost Models from Health Care Claims Data for Strategic Decision-Making. Introduction. William Bednar, FSA, FCA, MAAA
Building Actuarial Cost Models from Health Care Claims Data for Strategic Decision-Making William Bednar, FSA, FCA, MAAA Introduction Health care spending across the country generates billions of claim
Session 1: Mandated Report: Medicare Payment for Ambulance Services
Medicare Payment Advisory Committee Meeting, Nov. 1 2 Session 1: Mandated Report: Medicare Payment for Ambulance Services Session 2: Reducing the Hospitalization Rate for Medicare Beneficiaries Receiving
An integrated wellness and insurance model. Dr Dawn Richards, Medical Affairs Director, VitalityHealth
An integrated wellness and insurance model Dr Dawn Richards, Medical Affairs Director, VitalityHealth The genesis of Vitality, and the need to make people healthier: Overview of the South African healthcare
The Role of the Actuary in Employee Benefits
The Role of the Actuary in Employee Benefits Topics to Cover Healthcare Review Underwriting Review Funding Mechanisms in Employee Benefits Fully Insured Self Insured Actuarial Practice Overview Role of
CHAPTER 2. THE UNINSURED ACCESS GAP AND THE COST OF UNIVERSAL COVERAGE
CRS-4 CHAPTER 2. THE UNINSURED ACCESS GAP AND THE COST OF UNIVERSAL COVERAGE THE GAP IN USE BETWEEN THE UNINSURED AND INSURED Adults lacking health insurance coverage for a full year have about 60 percent
1-866-COVERTN LAUNCHING MARCH
Affordable, portable, basic health coverage for small business. www.covertn.gov or 1-866-COVERTN LAUNCHING MARCH 2007 Affordable Premiums shared by employer, employee and the state, each paying 1/3 Individual
17th EHFG Electing Health The Europe We Want!
01 03 October 2014 17th EHFG Electing Health The Europe We Want! For more information about the final programme, speakers or the EHFG conference please contact us directly! Follow us on our social media
4/8/17. The Changing Nature of Physician Payment and Health Care Reform in The AMA A Unifying Voice for Physicians
The Changing Nature of Physician Payment and Health Care Reform in 2017 U of Mo Family Medicine Update April 7, 2017 David Barbe, MD MHA President-elect American Medical Association VP Regional Operations
The Under Age 65 Project
Medicare for Individuals Under Age 65 Webinar Series Choosing Traditional Medicare or Medicare Advantage: Pros and Cons for Individuals Under Age 65 October 20, 2016 Presented by Kathy Holt, M.B.A., J.D.,
THE AFFORDABLE CARE ACT...2
Table of Contents THE AFFORDABLE CARE ACT...2 Health Insurance Marketplace (Exchange)...3 Metallic Levels...4 Catastrophic Plans...4 Individual Mandate...5 Subsidies...5 Open Enrollment Period...6 Special
MINISTERIAL STATEMENT TO THE HOUSE OF ASSEMBLY BY THE HONOURABLE KIM N. WILSON, JP, MP MINISTER OF HEALTH HEALTH FINANCING REFORMS
MINISTERIAL STATEMENT TO THE HOUSE OF ASSEMBLY BY THE HONOURABLE KIM N. WILSON, JP, MP MINISTER OF HEALTH HEALTH FINANCING REFORMS Friday 6 th July 2018 I m pleased to give this statement today to update
INFORMATION ABOUT YOUR OXFORD COVERAGE
OXFORD HEALTH PLANS (CT), INC. INFORMATION ABOUT YOUR OXFORD COVERAGE PART I. REIMBURSEMENT Overview of Provider Reimbursement Methodologies Generally, Oxford pays Network Providers on a fee-for-service
COVERED CALIFORNIA: THE GOOD, THE BAD & THE UNDEFINED FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS
1 COVERED CALIFORNIA: THE GOOD, THE BAD & THE UNDEFINED FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS Ann-Louise Kuhns President & CEO California Children s Hospital Association Health Care Reform: The Basics
REPORT CONVENTION (NO. 130) CONCERNING MEDICAL CARE AND SICKNESS BENEFITS, 1969
NORWAY REPORT for the period ending 30 June 2016 made by the Government of Norway, in accordance with article 22 of the Constitution of the International Labour Organisation, on the measures taken to give
Medicare Spending Per Beneficiary (MSPB) Measure
Medicare Spending Per Beneficiary (MSPB) Measure Audio for this event is available via INTERNET STREAMING. No telephone line is required. Computer speakers or headphones are necessary to listen to streaming
Initiative Options for Simulation Scenarios
Initiative Options for Simulation Scenarios The following options are in version 2h of the ReThink Health simulation model. Enable healthier behaviors Promote healthy behavior and help people to stop behaviors
Update on Implementation of the Affordable Care Act
Update on Implementation of the Affordable Care Act Yvonne Knight, J.D. ADEA Senior Vice President Advocacy and Governmental Relations ADEA Policy Center The Affordable Care Act On March 23, 2010, President
Fee for Service: Paying for Volume, Not Value
Payment Reform 1 Fee for Service: Paying for Volume, Not Value Most healthcare services are reimbursed with a fee-for-service model. Pay regardless of quality, outcomes Pay for every test and procedure
SECTION II PATIENT CENTERED MEDICAL HOME (PCMH) CONTENTS 200.000 DEFINITIONS 210.000 ENROLLMENT AND CASELOAD MANAGEMENT 211.000 Enrollment Eligibility 212.000 Practice Enrollment 213.000 Enrollment Schedule
Seventh Floor 1501 M Street, NW Washington, DC Phone: (202) Fax: (202) MEMORANDUM
Seventh Floor 1501 M Street, NW Washington, DC 20005 Phone: (202) 466-6550 Fax: (202) 785-1756 MEMORANDUM To: ACCSES Members cc: John D. Kemp, CEO From: Peter W. Thomas and Theresa T. Morgan Date: Re:
Health Care Reform: Chapter Three. The U.S. Senate and America s Healthy Future Act
Health Care Reform: Chapter Three The U.S. Senate and America s Healthy Future Act SECA Policy Brief Initial Publication September 2009 Updated October 2009 2 The Senate Finance Committee Chairman Introduces
ObamaCare What Does the Affordable Care Act Mean For You?
ObamaCare What Does the Affordable Care Act Mean For You? After tonight, you will: Understand key aspects of the ACA Private Health Insurance Consumer Protections Medi-Cal Expansion Health Benefit Exchange
Kansas Health Policy Authority State of Health Reform in Kansas Kansas Economic Policy Conference October 30, 2008
Kansas Health Policy Authority State of Health Reform in Kansas 2008 Kansas Economic Policy Conference October 30, 2008 Marcia Nielsen, PhD, MPH, Executive Director How We Get Health Care Private Insurance:
AFFORDABLE CARE ACT FAQ
AFFORDABLE CARE ACT FAQ What is the Healthcare Insurance Marketplace? The Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now or if you have it but want
State Health Care Reform in 2006
January 2007 Issue Brief State Health Care Reform in 2006 Fast Facts Since the mid-1970 s state governments have experimented with a wide variety of initiatives to expand access to health care for the
What Risk Adjustment Looks Like Today
What Risk Adjustment Looks Like Today The Start Of Risk Adjustment In 1997, the Balanced Budget Act (BBA), was the first year that Risk Adjustment methodology for Medicare Advantage (formerly Medicare
Slovenia. Health Care & Long-Term Care Systems
Slovenia Health Care & Long-Term Care Systems An excerpt from the Joint Report on Health Care and Long-Term Care Systems & Fiscal Sustainability, published in October 2016 as Institutional Paper 37 Volume
Health Care Access Law: Frequently Asked Questions. The Individual Mandate
Health Care Access Law: Frequently Asked Questions The Individual Mandate What is the individual mandate going to mean for me? How much will I have to pay? Residents of Massachusetts will be required to
What you need to know
Exploring The Affordable Care Act What you need to know Maternal Child Adolescent Health Advisory Board Meeting August 1, 2013 Vanessa Raditz, vraditz@berkeley.edu Why do we need this training? Many people
THE AFFORDABLE CARE ACT AN OVERVIEW FOR HUMAN RESOURCE & FINANCE PROFESSIONALS AT MID-SIZED COMPANIES
THE AFFORDABLE CARE ACT AN OVERVIEW FOR HUMAN RESOURCE & FINANCE PROFESSIONALS AT MID-SIZED COMPANIES 1 Mid-Sized Retirement & Healthcare Plan Management Conference San Francisco, CA March 17, 2014 GOALS
The Affordable Care Act: Opportunities to Influence Implementation
The Affordable Care Act: Opportunities to Influence Implementation Dylan H. Roby, PhD Assistant Professor of Health Policy and Management UCLA Fielding School of Public Health Director of Health Economics
Health Insurance Terms You Need To Know
From [C_Officialname] Health Insurance Terms You Need To Know The health care system in the United States can be confusing. In order to get the most out of your health care benefits, you need to understand
CHFP. Certified Healthcare Financial Professional (CHFP) Exam.
HFMA CHFP Certified Healthcare Financial Professional (CHFP) Exam TYPE: DEMO http://www.examskey.com/chfp.html Examskey HFMA CHFP exam demo product is here for you to test the quality of the product. This
ALLIANCE HMO WITH HRA MEDICAL PLAN
ALLIANCE HMO WITH HRA MEDICAL PLAN What is the Plan? This is a health plan that offers access to physicians selected based on their ability to guide their patients to the care and resources that help promote
HEALTH POLICY & EDUCATION SERIES
HEALTH POLICY & PAYMENT EDUCATION SERIES Medicare s Bundled Payment Initiatives The information in this document is based off of policy information available as of August 2016. Updated information may
Figure ES-1. International Comparison of Spending on Health,
Figure ES-1. International Comparison of Spending on Health, 198 24 Average spending on health per capita ($US PPP) Total expenditures on health as percent of GDP 7 6 5 4 United States Germany Canada France
RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF TENNCARE CHAPTER COVERKIDS TABLE OF CONTENTS
RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF TENNCARE CHAPTER 1200-13-21 COVERKIDS TABLE OF CONTENTS 1200-13-21-.01 Scope and Authority 1200-13-21-.02 Definitions 1200-13-21-.03
Risk, Capitation, and
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
Insurance 101: Understanding your Rights and Responsibilities
Insurance 101: Understanding your Rights and Responsibilities Village Pediatrics recognizes that health care costs are significant, and insurance premiums (though not reimbursements) have risen rapidly
Guidance on blended payment for emergency care. A joint publication by NHS England and NHS Improvement
Guidance on blended payment for emergency care A joint publication by NHS England and NHS Improvement January 2019 Guidance on blended payment for emergency care A joint publication by NHS England and
ALLIANCE HMO WITH HRA MEDICAL PLAN
ALLIANCE HMO WITH HRA MEDICAL PLAN What is the Plan? This is a health plan that offers access to physicians selected based on their ability to guide their patients to the care and resources that help promote
Bipartisan Budget Act of 2013
Summary of Medicare and Medicaid Provisions included in the Bipartisan Budget Act of 2013 and the Pathway for SGR Reform Act of 2013, as passed by the House (12/12/13) and the Senate (12/18/13) On December
Provision Description Implementation Date Establishing a Patient Centered Outcomes Research Institute Excluding from Income Health Benefits Provided
Establishing a Patient Centered Outcomes Research Institute Excluding from Income Health Benefits Provided by Indian Tribal Governments Non Profit Hospitals Cracking Down on Health Care Fraud Ensuring
Protecting Against Catastrophic Loss Post-Health Care Reform Legal Aspects
Protecting Against Catastrophic Loss Post-Health Care Reform Legal Aspects IFEBP Annual Conference Session 214 November 16, 17, 2010 Presented By Paul A. Green Mooney, Green, Washington, DC Statutory Restrictions
The HPfHR 3-Tier System
The HPfHR 3-Tier System The basic level (Tier 1) of the new healthcare system would cover the entire population- from cradle to grave and would include, based on evidenced based data, all medical, surgical
No An act relating to health care financing and universal access to health care in Vermont. (S.88)
No. 128. An act relating to health care financing and universal access to health care in Vermont. (S.88) It is hereby enacted by the General Assembly of the State of Vermont: Sec. 1. FINDINGS * * * HEALTH
Medicare in Ryan s 2014 Budget By Paul N. Van de Water
820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org March 15, 2013 Medicare in Ryan s 2014 Budget By Paul N. Van de Water The Medicare proposals
Medicare Advantage vs. Medicare Supplement: Philosophical Differences that Impact Coverage
Medicare Advantage vs. Medicare Supplement: Philosophical Differences that Impact Coverage Rose Cook Blue Cross Blue Shield of Michigan Y0074_S_AAApresentation FVNR 1 Michigan Medicare Market There are
New York Makes Work Pay
1 New York Makes Work Pay Title: 1619b (Best Kept Secret) Presenter: Edwin J. Lopez-Soto New York Makes Work Pay is a Comprehensive Employment System Medicaid Infrastructure Grant (Contract No. #1QACMS030318)
Introduction to UnitedHealthcare Community Plan of California/Medi-Cal
Introduction to UnitedHealthcare Community Plan of California/Medi-Cal Welcome/Agenda: Mission/Vision UnitedHealthcare Community Plan of California/Medi-Cal Member Eligibility and Benefits Notification
Trends in West Michigan Healthcare Mercy Health Saint Mary s. Bill Manns President Mercy Health Saint Mary s
Trends in West Michigan Healthcare Mercy Health Saint Mary s Bill Manns President Mercy Health Saint Mary s Being a healthcare executive is like.. It was the best of times and it was the worst of times.
License Coach Health Section Live Cram Course Handout
License Coach Health Section Live Cram Course Handout 174) Health Insurance Slide 175) Health insurance policies that provide specialized limited coverage, such as AD&D and dread disease. 176) In health
Payer Research Germany. Reference Studies
Payer Research Germany Reference Studies Market access & reimbursement group Market Access Environment Hereditary angioedema, adrenal insufficiency, epilepsy, Association of Statutory Health, Federal Joint
Foresight Future of an Ageing Population - International Case Studies
Centre for Policy on Ageing, January 2016 Foresight Future of an Ageing Population - International Case Studies Case Study 8: Long term care insurance in Germany Foresight Theme: Adapting financial systems
The one travel product you ll ever need.
manulife Travel80 term travel insurance The one travel product you ll ever need. MANULIFE Term Travel Insurance manulife Travel80 term travel insurance The one travel product you ll ever need. Now you