ACA Health Insurance Marketplace: Michigan overview and operations
On March 31, 2014, the Affordable Care Act’s (ACA) Health Insurance Marketplace officially closed for most people until open enrollment begins for 2015 health plans on November 15, 2014. By the end of the first open enrollment period, 272,539 Michigan residents had signed up for a plan through the ACA marketplace. Assuming that many of these residents complete the enrollment …
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Pain-Related Care and the Affordable Care Act: Summary of Common Practices
This paper provides a brief overview of key findings in the Institute of Medicine (IOM) 2011 report on pain, how public and commercial insurers approach pain management, and the pain-related provisions in the 2010 Patient Protection and Affordable Care Act (ACA). The IOM released a report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, summarizing findings …
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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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Best Practices in Care Management for Senior Populations
Care Management is a service designed to help patients and their caregivers manage medical conditions more effectively, in order to improve health and reduce the need for hospitalizations and emergency department visits. The concept arose in the past decade from disease management programs of the 1990s, which focused on individual diseases rather than more comprehensive consideration of patients’ needs. Care …
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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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Care transitions: Best practices and evidence-based programs
Poorly coordinated care transitions from the hospital to other care settings cost an estimated $12 billion to $44 billion per year. Poor transitions also often result in poor health outcomes. The most common adverse effects associated with poor transitions are injuries due to medication errors, complications from procedures, infections, and falls. Providers are focused on improving transitions, due in part …
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Affordable Care Act funding: An analysis of grant programs under health care reform
This brief examines grant programs funded by the Affordable Care Act (ACA), how funds have been distributed to states and local organizations, and the effects of budget sequestration on future ACA funding. The ACA aims to expand health insurance coverage and introduce health care delivery reforms that improve quality and lower costs. The ACA is designed to reduce the number …
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Access to mental health care in Michigan
One in five Michigan residents report having been diagnosed with depression at some point in their lives. Mental health disorders cause more disability among Americans than any other illness group. Using data from the Cover Michigan Survey and the Michigan Primary Care Physician Survey, both fielded in calendar year 2012, this brief explores issues related to the prevalence of mental …
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