An in-depth look at six cost containment programs in the Affordable Care Act
This paper describes six cost-containment policies or initiatives included in the Affordable Care Act (ACA) that target how health care is delivered and the growth of health care costs. A summary of the implementation occurring in Michigan is also provided. The policies or initiatives explored in depth here are: Accountable Care Organizations Hospital-Acquired Conditions Value-Based Purchasing Hospital Readmission Reductions Program …
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Cost containment in the Affordable Care Act: An overview of policies and savings
While there has been considerable media coverage about the insurance impacts of the Affordable Care Act (ACA), there has been less discussion of the law’s changes to provider reimbursement policy, reforms to the delivery system, and investments in programs to improve the quality of care and constrain long-run growth in health care expenditures. And yet, the elements included in the …
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Premium cost changes attributable to the Affordable Care Act
The Affordable Care Act (ACA) expands health insurance coverage to millions of uninsured Americans and introduces several reforms to the health insurance market, particularly for people who purchase coverage on their own or receive it through employment at a small business. These reforms standardize benefits, limit insurance rating practices, prohibit coverage denials, limit out-of-pocket costs, and levy new taxes on …
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Medicaid and Medicare Disproportionate Share Hospital programs
Congress created the Disproportionate Share Hospital (DSH) program in the early 1980s to help hospitals offset the costs of providing care to low-income individuals. Medicaid and Medicare each have a distinct DSH program, with a unique structure and financing mechanism. In addition to giving a brief overview of the Medicaid and Medicare Disproportionate Share Hospital programs, this document will: Discuss …
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An introduction to health care payment reform: Research foundations, implementation, operational strengths and challenges
Policymakers across the country are currently engaged in discussions on how to improve the way that health care providers are paid for the services they deliver. These discussions involve how to shift payment systems away from traditional fee for services and toward rewarding providers that achieve excellent outcomes and deliver value to their patients. While both private and public payers …
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Emerging health insurance products in an era of health reform
At least in part in response to the health coverage changes of the Affordable Care Act (ACA), many health plans are making significant changes to products that they plan to offer in the employer and individual market. While insurers were already moving away from paying for volume and toward paying for value prior to health reform, the ACA has been …
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Employee cost-sharing for health insurance in Michigan and the United States
This brief reports on trends in health insurance premiums and cost-sharing among private-sector employers in Michigan and the United States from 2002 to 2012, and provides a focused look at high-deductible health plans by employer size. From 2002 through 2012, average total premiums in the United States increased by approximately 80 percent. While employer cost-control efforts in the 1990s could …
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Private health insurance in Michigan and the U.S.: Declines in employer-sponsored insurance
More than 500,000 people in Michigan lost their private health insurance from 2008 to 2011. The primary reason for the decline in private insurance in Michigan and in the nation was the erosion of employer-sponsored insurance (ESI), the most common way that Americans get private coverage. From 1999 to 2011, the proportion of individuals covered by ESI decreased by approximately …
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Federally qualified health centers: Are they effective?
In 1964, the Office of Economic Opportunity established federally qualified health centers (FQHCs), which were initially called neighborhood health centers, as part of President Lyndon B. Johnson’s “War on Poverty.” The legislative goals for neighborhood health centers were to: Provide comprehensive, high-quality health services. Be accessible to low-income residents. Be responsive to patient needs. Offer employment, education and social assistance. …
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Affordable Care Act funding: An analysis of grant programs under health care reform
The Patient Protection and Affordable Care Act (ACA) is a comprehensive law with the potential to affect the health of Americans in many ways. This issue brief focuses on ACA grants that were awarded during a shortened fiscal year 2010 (March 23, 2010 to September 30, 2010) and fiscal year 2011 (October 1, 2010 to September 30, 2011). This brief …
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