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While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
News
10-27-11 Affordable Care Act Update
November 8, 2011
Federal Update
Final Accountable Care Organization (ACO) Rule Released
The Centers for Medicare and Medicaid Services (CMS) late last week released the final rule for the Affordable Care Act's key health care delivery reform -- Accountable Care Organizations (ACOs). ACOs are groups of providers and hospitals that agree to come together to deliver higher quality care at a reduced cost. ACOs will be paid bonuses for saving Medicare money and performing well on certain quality measures.
In response to provider concerns that the proposed rule released in March made it too difficult for physicians and hospitals to participate in the program, the Department of Health and Human Services (HHS) simplified the regulation by eliminating penalties and reducing administrative requirements. The rule could spur participation in ACOs among providers, which could lead to more Medicare beneficiaries with cancer being impacted by these new delivery models in the coming years.
ACS CAN submitted comments to HHS acknowledging the potential of ACOs to improve the health and quality of care for cancer patients. Although HHS did not address all of our specific recommendations in the final rule, ACS CAN is pleased that the final regulation supports a strong foundation in primary care; incentives to deliver more coordinated, integrated care to patients with chronic diseases such as cancer; and ongoing performance monitoring to improve quality. ACS CAN will continue to monitor ACOs and other delivery reforms to assess their impact on cancer patients.
$42 million for Community Health Centers Nationwide
Five hundred community health centers in 44 states across the country will receive approximately $42 million over the next three years that was authorized in the Affordable Care Act. The funding will help improve the coordination and quality of care community health centers deliver to people with Medicare. This demonstration project, operated by CMS in partnership with the Health Resources Services Administration (HRSA), will test the effectiveness of doctors and other health professionals working in teams to coordinate and improve care for up to 195,000 Medicare patients. Participating health centers are expected to help patients manage chronic conditions as well as actively coordinate care for patients.
Litigation Update
The Obama Administration and the plaintiffs in five of the six major cases challenging the Affordable Care Act have petitioned the U.S. Supreme Court to consider the law's constitutionality during the current term. The justices will meet in conference Nov. 10 and could accept, defer, or deny the petitions at that time. Their decision is likely to be announced Nov. 14, and court watchers predict that they will agree to hear the case during this term to resolve inconsistent rulings throughout the country. The crux of each challenge is that Congress exceeded its constitutional authority in requiring individuals to purchase or obtain health insurance (the so-called "individual mandate"). Some lower courts have upheld the mandate while others have struck it down. This split, coupled with the importance of the constitutional issues at stake, virtually guarantees that the high court will hear it.
State Update
HHS resumes its series of "listening tours" in early November on the topic of the Essential Benefits provision in the Affordable Care Act. The regulation on Essential Benefits has not been released, but the Institute of Medicine recently released recommendations on the issue. The first two meetings are scheduled for Friday, November 4 in Chicago and Tuesday, November 8 in Boston. The format is similar to the listening tours held in September on proposed Health Insurance Exchange regulations, which were released this summer. Formal testimony will not be allowed, but general comments are permitted. ACS CAN will provide staff who are attending these sessions with background material that outlines important issues and topics from a cancer perspective, including prevention, screening, early detection, treatment and survivorship.
Media/Polling
Health Care and You Web Chat Today Featured ACS CAN
Health Care and You, the coalition of national health groups representing seniors, doctors, nurses, hospitals, pharmacists, and patients, held a Web chat today that featured Erin Reidy, associate director of policy at ACS CAN. Erin answered questions about the Pre-Existing Condition Insurance Plan (PCIP), which was created by the ACA to help provide health coverage for people with a pre-existing condition who have been uninsured for at least six months. ACS CAN is a founding member of Health Care and You, which is educating providers, patients, and the public nationwide with straightforward information about the ACA and its provisions. Please encourage your colleagues and volunteers to view the replay. the chat.
New Report Shows Employers Won't Drop Insurance Coverage
The majority of Americans will still receive employer-sponsored health insurance coverage after the Affordable Care Act is fully implemented in 2014, according to a report by the Urban Institute. Despite the belief that many employers will direct their workers to health exchanges, the report indicates that there is no incentive for employers to drop coverage and employers will use the offer of health insurance to entice employees to stay with the company. Read the Politico Pro coverage for more.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)