While the 2nd year of the Affordable Care Act was not as much of an overhaul as the first. Year two focused on a lot of wellness, education and community programs.
Consumer Assistance Program (CAP)
The Consumer Assistance Program was established in 2011 on a state level. The program provide grants to help state establish independent offices to help support the Health Insurance Exchange. The Consumer Assistance program will help individuals file complaints and appeals; enroll in health coverage; and get educated about their rights and responsibilities in group health plans or individual health insurance policies. Below is map that shows what states currently have a CAP program in Operations.
Prevention & Wellness Investment
Obamacare established a $15 billion Prevention and Public Health Fund with the sole purpose of investing in proven prevention and public health programs to help keep American citizens healthy
Support Rural Health Care Providers
This program establishes a plan to repays loans and provide education scholarships to primary care providers (PCP) who work in areas of the country with too few health professionals or deemed rural where individuals have limited access to quality health care providers. These areas usually have challenges finding and retaining medical professionals. The program will be expanded over time to provide more resources to medical schools to train future physicians to work in rural areas.
Medicare Prescription Drug Coverage (Cont.)
In 2010 individuals who reached their Medicare Drug Coverage received a rebate check for 250 dollars. Starting January 1, 2011, individuals who reached the coverage gap in Medicare Part D coverage, will automatically get a 50% discount on covered brand-name drugs. This is applicable until you reach the catastrophic coverage phase
Preventative Service Coverage for seniors
Starting January 1, 2011 Medicare will provide preventive health care benefits to seniors including a yearly wellness visit, tobacco use cessation counseling, additionally other preventative services such as screenings for cancer, diabetes, and other chronic diseases will be at no costs.
Medical Loss Ratio MLR
The Medical loss ratio refers to the percentage of your premium dollars that a health care plan or insurer can spends on providing you with medical care compared to what it spends on administrative, overhead, and marketing costs. The Affordable Care Act limits the percentage of you premium insurers can spend on non-medically relate items. If your health insurance provider surpasses the MLR, it must provide a rebate of the portion of premium dollars that exceeded this limit. This has proven effective in saving over a billion dollars to date.
The Center for Medicare & Medicaid Innovation
The CMS was established in 2011 to begin testing new ways of delivering care to patients, in addition to researching ways to decrease the growth in Medicare, Medicaid and Chip. This research is focused on also finding new methods to improve the quality of care in those systems.
The federal government is working with various groups to research various method to reduce errors within the Medicare system that results in payment errors, waste, fraud, and abuse in Medicare, to help extend the life of the Medicare program. Additionally the Medicare Program Trust Fund was extended to at least 2024 as a result of reducing waste, fraud, and abuse, and decreasing the cost growth in Medicare.
Establishment of Various Community Programs
- Community First Choice Option allows states to offer home and community based services to disabled people through Medicaid rather than institutional care in nursing homes.
- The Independent Payment Advisory Board will begin operations to develop and submit proposals to Congress and the President aimed at extending the life of the Medicare
- The Community Care Transitions Program helps high-risk Medicare beneficiaries who are hospitalized avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities.