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HCFO's Year in Review: 2010

January 2011

When historians write about the significant events of 2010, the passage of health reform legislation will certainly be featured prominently. Enactment of the Patient Protection and Affordable Care Act (ACA) was just step one. The work of implementing the ACA began in 2010 and will continue over the next several years. 

Access to Emergency Services

November 2010

The passage of the Patient Protection and Affordable Care Act (Affordable Care Act or ACA) has put a spotlight on the use of the nation’s emergency departments (EDs). There is a public perception that the uninsured are heavy and frequent users of EDs, and expanding insurance coverage under the ACA will relieve ED crowding.


Making the Value Proposition in Benefit Design

June 2010

In a perfect world, consumers would act rationally, seek high-value medical services, comply perfectly with prescribed medications, and avoid care that offers them little or no benefit. Consumers would have clear evidence of the relative value of all medical therapies. Although our world is imperfect, certain benefit design strategies may help guide consumers in making medical decisions.

Value-Based Insurance Design (VBID)

Changes to and Opportunities for the Medicare Part D Prescription Drug Program

May 2010

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark law provides seniors and individuals with disabilities with a prescription drug benefit and more choices in health plans as well as with expanded benefits under Medicare.

“The Secretary Shall….:” The Challenge of Implementing Health Reform’s Affordability Provisions

April 2010

After some collective breath-holding, health reform is now law. On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act. Action now shifts from developing the legislation to implementing the law’s provisions. Some provisions take effect immediately while others will be phased in over time. The phrase “the Secretary shall” appears regularly throughout the reform law, often followed by a directive to take immediate action, particularly with respect to developing regulations designed to ensure the affordability of health care coverage.

Rewarding Accountable Care

March 2010

The health reform bills passed by the U.S. Senate and House of Representatives include provisions aimed at improving the value of health care delivery through the development of accountable care organizations (ACOs). Accountable care organizations are defined as groups of providers that take responsibility for the cost and quality of care provided to a panel of Medicare patients. Both bills would allow ACOs to share in the cost-savings that accrue from providing more efficient health care or provide partial capitation. The Senate bill, The Patient Protection and Affordable Care Act (H.R.

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