Changes Coming in 2013 under the Affordable Care Act

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The Affordable Care Act (ACA) continues to transform America’s healthcare system, and new changes are on the horizon for 2013.  They include improvements to preventive health coverage, increases in Medicaid payments for primary care doctors (PCPs), improved coordination of patient care in the form of “bundling,” and additional funding for the Children’s Health Insurance Program (CHIP).

Improvements to Preventive Health Coverage- Effective January 1, 2013

In an effort to expand the number of Americans receiving preventive care services, the law will provide new funding to Medicaid programs in the states that choose to cover preventive services for patients at little or no cost.

Increases to Medicaid Payments for PCPs- Effective January 1, 2013

The ACA will require states to pay primary care physicians no less than 100% of Medicare payment rates in 2013 and 2014 for primary care services.  The aim is to grow and strengthen primary care, the backbone of preventive health care.  Federal funding will support physician assistant training, increase the number of nurse practitioners trained and encourage States to plan for and address health professional workforce needs, among other improvements.

Expanded Payment “Bundling”- Effective January 1, 2013

The ACA will establish a national pilot program to encourage hospitals, doctors and other providers to improve coordination of payment care through the “bundling” of payments. For example, typically a surgical procedure generates multiple claims from the different providers involved.   Under the new program, the entire team involved in the surgery will be compensated with a “bundled” payment at a flat rate to help eliminate the current fragmented system. The aim is to improve efficiency and patient care.

Additional Funding for CHIP- Effective October 1, 2013

Under the ACA, states will receive two years of additional funding to continue coverage for children whose families don’t qualify for Medicaid but who can’t afford health insurance. CHIP provides low cost-health insurance for children eligible for the CHIP program.

The ACA continues to transform healthcare, and in 2014 health insurance exchanges will emerge on the scene to help those who don’t receive employer-sponsored health insurance. The experienced agents at Benefit Packages can help you find affordable health insurance with some of the most well-known and reputable insurance companies like Blue Cross of California.  Call us for a quote today, or visit our website here.