Consumers Enrolling Online with Covered California Say There’s Room for Improvement – CHCF.org

February 9th, 2016 No comments

CHCF retained gotoresearch, a division of the San Francisco-based user experience and design agency gotomedia, to conduct this research over each of the last three open enrollment periods. The findings are based on unscripted, real-time observation of people applying for or renewing coverage online, and they capture sources of consumer satisfaction, knowledge, confusion, and frustration.Like Anthony, most other participants in the CHCF-sponsored research were confronted with problems with the online enrollment process. Of 31 people eligible to enroll in or renew a Covered California health plan in the second (2014-15) and third (2015-16) open enrollment periods, only one was able to complete the task during the observed research session. Sessions lasted 45-90 minutes for renewals and 90-120 minutes for new enrollees.Today, CHCF released Room for Improvement: Consumers’ Experience Enrolling Online with Covered California, which describes this user testing in further detail, discusses common problems experienced by participants, and offers recommendations for improving the online enrollment process.

Source: Consumers Enrolling Online with Covered California Say There’s Room for Improvement – CHCF.org

This report shows how a combination of factors can deter online enrollments — this one involving the nation’s largest state-based health benefit exchange. Many consumers have low levels of health insurance literacy, unable to fully take into account premiums, deductibles, co-pays, co-insurance and annual out of pocket maximums when selecting a plan. Even when benefits are standardized as they for California exchange plans.

As the CHCF report and video illustrates, in order to self enroll consumers must also possess a degree of income tax literacy that many — particularly the younger adults the plans hope to attract — may lack. Then there are complex family situations and sporadic, unpredictable incomes of those participating in the “gig” economy that exponentially increase the challenge of online self-enrollment. If an online enrollment portal adds to the burden by being less than user friendly as reported here, it’s no wonder many are flummoxed by the enrollment process and simply throw up their hands and log out.

Shopping online for plans is one thing. But enrolling in an individual health plan offered on a state health benefit exchange can be like filing an income tax return — and a relatively complex one at that for many. Call center support can only go so far. Imagine trying to file an income tax return by phone. That makes the role of insurance agents and in person assisters just as vital as that of tax preparers for many income tax filers during the current tax filing season.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Indication of trouble with ACA’s individual mandate compliance

February 4th, 2016 1 comment

Stung by losses under the federal health law, major insurers are seeking to sharply limit how policies are sold to individuals in ways that consumer advocates say seem to discriminate against the sickest and could hold down future enrollment.In recent days Anthem, Aetna and Cigna, all among the top five health insurers, told brokers they will stop paying them sales commissions to sign up most customers who qualify for new coverage outside the normal enrollment period, according to the companies and broker documents.The health law allows people who lose other coverage, families with new children and others in certain circumstances to buy insurance after enrollment season ends. In most states the deadline for 2016 coverage was Jan. 31.Last year, these “special enrollment” clients were much more expensive than expected because lax enforcement allowed many who didn’t qualify to sign up, insurers said. Nearly a million special-enrollment customers selected plans in the first half of 2015, half of them after losing previous coverage.In addition, Cigna and Humana, another big health insurer, have ceased paying brokers to sell many higher-benefit “gold” marketplace plans for individuals and families while continuing to pay commissions on more-profitable, lower-benefit “bronze” plans, according to documents and interviews.

Source: Licking Wounds, Insurers Accelerate Moves To Limit Health-Law Enrollment | California Healthline

This is a development that should be followed closely because it hints at fundamental problems with the implementation of the keystone policy bargain of the Affordable Care Act’s individual market reforms. Health plan issuers agreed to forgo medical underwriting and accept all applicants regardless of health status and medical history. Provided everyone not covered by an employer or government-paid health plan have continuous, year round coverage.

This story suggests that at least some consumers aren’t keeping up their end of the policy bargain to be continuously covered and are gaming the rules that allow enrollment outside of three-month-long annual open enrollment period for those who lost employer-sponsored coverage, moved or had a change in family status and other life circumstances. They are effectively using coverage actuarially designed for annual enrollment terms as short term coverage of less than one year since according to some insurers, they’re dropping their coverage soon after signing up under the special enrollment provisions. And since they’re only in for the short term, they’re inclined to select plans that have the lowest out of pocket cost sharing: gold and platinum plans. (Plans sold as short term coverage aren’t covered by the Affordable Care Act’s individual market reforms. Pre-existing conditions can be excluded and they typically offer a much narrower scope of benefits than ACA-compliant plans).

The Obama administration apparently recognizes this issue undermines the individual market reform framework. Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, told a J.P. Morgan health-care conference in San Francisco last month that CMS will tighten up its rules governing special enrollments outside of the annual open enrollment period, according to The Wall Street Journal.

Clearly, more information is needed to better understand this phenom. For example, are peoples’ lives so subject to changing life circumstances that most anyone can qualify for special enrollment, mooting the annual enrollment periods? Does “waiting to get sick” as reported in mainstream media as a driver for special enrollments really mean getting high cost elective procedures given that most people aren’t able to time when they will develop a serious illness or be injured in an accident? If consumers are defrauding the special enrollment rules by falsely claiming a life event, is part of the “culture of coping” the Affordable Care Act is intended to reduce, with consumers too financially pinched to pay their premiums for the entire year, even with advance premium tax credits?

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Head Of California Exchange Scolds UnitedHealth For Blaming Woes On Obamacare | California Healthline

February 3rd, 2016 No comments

Amid growing questions over the future of insurance exchanges, the head of California’s marketplace said the nation’s largest health insurer should take responsibility for nearly $1 billion in losses and stop blaming the federal health law.In a blistering critique, Covered California’s executive director, Peter Lee, said UnitedHealth Group Inc. made a series of blunders on rates and networks that led to a $475 million loss last year on individual policies across the country. The company estimates a similar exchange-related loss of $500 million for this year.

Source: Head Of California Exchange Scolds UnitedHealth For Blaming Woes On Obamacare | California Healthline

This story reflects the natural tension that exists in the state health benefit exchange marketplace. Health plan issuers are subject to competitive market forces as well as pressure from active purchaser exchanges like Covered California to keep premium rates down while offering provider networks that adequately serve the needs of plan members. But if they set premiums too low or create provider networks that are too large, plan issuers can suffer losses.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

One year after jettisoning single payer, Vermont now looks to control medical costs via expanded “all payer” ACO

January 28th, 2016 No comments

One year after Vermont abandoned its plan to move to a single payer health finance framework amid concerns over the ability of tax revenues to cover rising medical utilization costs under that payment model, the state is rolling out an alternative aimed at reining in those costs. It would do so through a proposed “all payer model.” The model builds on the Patient Protection and Affordable Care Act’s Medicare Shared Savings Program Accountable Care Organizations (ACO) model in which providers share risk with reimbursements tied to the overall cost and quality of care provided rather than discrete medical procedures under the traditional fee for service model. Reflecting the pervasiveness of costly, chronic health conditions no longer largely confined to the Medicaid eligible population, the Vermont proposal would expand that model to all forms of reimbursement, including Medicaid and commercial plans:

The State would agree to coordinate with Medicaid and commercial insurers, and in return the federal government would allow Medicare to participate in the ACO value-based payment model. As is true today, health care providers’ participation in ACOs is voluntary; the ACO must be attractive to providers and offer an alternative health care delivery model that is appealing enough to join.

The goal of the proposed all payer model is to limit the annual growth of statewide medical spending to 3.5 percent with a maximum spending growth of 4.3 percent:

The goal of this financial target is to bring health care spending closer to economic growth. When health care costs grow faster than Vermont’s economy, Vermont families find their premiums rising faster than wages. This is also true in the state’s Medicaid budget, which grows faster than the revenue sources used to fund it.

The board’s authority to regulate reimbursement rates exists under current state law, according to a term sheet outlining the proposal. Vermont will seek any necessary waivers from the federal government to operate the all payer model, noting the state has jointly developed a policy framework and the needed waivers in consultation with the federal Health and Human Services Department’s Center for Medicare & Medicaid Services.

The fee for service reimbursement model is no longer suitable and is “antiquated” according to the Vermont proposal:

When the fee-for-service health care payment model was devised over 50 years ago, the average life expectancy of Americans was significantly shorter than it is today, and the burden of chronic disease was smaller. The Centers for Disease Control and Prevention (CDC) reports that treating people with chronic diseases accounts for 86 percent of our nation’s health care costs. Health care reimbursement was designed to pay for acute medical conditions that required a single visit to the doctor or a single hospitalization. By contrast, persons with chronic conditions require regular, ongoing care across the continuum of traditional medical services and community-based services and supports. Fee-for-service reimbursement makes it difficult for innovative health care providers to adapt to the changing needs of the population that they serve. The antiquated system provides clear financial incentives to order additional tests and procedures, yet it does not reward doctors and other health care professionals for providing individualized and coordinated care for complex chronic conditions. In the end, patients may receive care that is expensive, fragmented, and disorganized.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

San Francisco offers additional subsidization for exchange plans

January 25th, 2016 No comments

Covered California premiums are relatively affordable. The cheapest one for single San Franciscans earning $58,850 — the cutoff for the new city subsidy — would cost roughly $202 a month. But the cheapest plans have the highest deductibles, out-of-pocket expenses for doctor visits, hospital stays and drug prescriptions, potentially totaling thousands of dollars per year. And the subsidies for these expenses that are available in states with market exchanges, like California, come only with plans on the costlier “silver” tier. As a result, many residents choose to remain uninsured, said Colleen Chawla, deputy director of health at the San Francisco Public Health Department. This means people eligible for Covered California are turning to clinics intended for people who can’t get insurance at all or who have Medi-Cal, the state’s version of free medical insurance for very low-income residents.

Source: San Francisco to Expand Health Insurance Support – New America Media

In high cost areas like the San Francisco Bay Area, the Affordable Care Act’s advance premium tax credits and subsidies for out of pocket costs for silver tier qualified health plans aren’t enough of a positive incentive to encourage people to sign up for coverage.

The implication is in these very expensive localities, the cost of housing and other necessities of life simply leave no room to pay for health care and insurance. Since going without coverage subjects medically uninsured San Franciscans to the ACA’s federal income tax penalties, the city’s Bridge To Coverage rolling out this year provides an additional local government subsidy to defray the cost of plans purchased on the Golden State’s health benefit exchange, Covered California, for households below 500 percent of federal poverty level — a multiple higher than the ACA’s 400 percent cutoff for advance premium tax credit subsidies.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Direct primary care finding potential market among employers, Medicaid managed care plans

January 13th, 2016 1 comment

Direct primary care is much less pricey. Patients pay $100 a month or less directly to the physician for comprehensive primary care, including basic medication, lab tests and follow-up visits in person, over email and by phone. The idea is that doctors can focus on treating patients, since they no longer have to wade through heaps of insurance paperwork. They spend less on overhead, driving costs down. And physicians say they can give care that’s more personal and convenient than in traditional practices.It’s legal under the Affordable Care Act, which identifies direct primary care as an acceptable option. But since it doesn’t cover specialists or emergencies, consumers still need a high-deductible health plan. Still, the combined cost of the monthly fee and that plan is often still cheaper than traditional insurance.

Source: Concierge Medical Care Comes To the Middle Class : Shots – Health News : NPR

This is an interesting trend that could at least in theory coincide with the shift back to the “major medical” model common in the 1950s and 1960s where people paid out of pocket for primary care, using health insurance for high cost, major medical care events.

But whether pre-paid primary care bundled with a high deductible plan ends up costing less than, say, a gold or platinum rated Obamacare individual plan designed for the frequent user of primary care (such as families with young children) looking to minimize out of pocket costs is an open question. Unless perhaps monthly cost of pre-paid medical care falls to $40 as discussed in this analysis, which sees that as unlikely to pencil out for direct primary care practices. And as a practical matter as suggested in the analysis, not many people visit primary care docs frequently enough to make the arrangement worthwhile.

Where direct primary care makes better sense financially and where it has gained traction is among employers who offer it as part of their health benefit package. These employer groups can bring more belly buttons to the table in negotiating rates with direct primary care providers. Even larger economies of scale can be had with Medicaid managed care plans, where direct primary care practices offer Medicaid beneficiaries who typically bounce among various providers and emergency rooms much needed medical homes. From the NPR article:

In Seattle, a company called Qliance, which operates a network of primary care doctors, has been testing how to blend direct primary care with the state’s Medicaid program. They started taking Medicaid patients in 2014. So far, about 15,000 have signed up. They get a Qliance doctor and the unlimited visits and virtual access that are hallmarks of the model.

“Medicaid patients are made to feel like they’re a burden on the system,” said Dr. Erika Bliss, Qliance’s CEO. “For them, it was a breath of fresh air to be able to get such personalized care – to be able to talk to doctors over phone and email.”

The article goes on to report that Qliance contracts with Medicaid managed care provider Centene. Other states including North Carolina, Idaho and Texas are keeping an eye on the Washington arrangement and considering similar programs, according to the article.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

States that opted not to set up exchanges have opportunity to go their own way in 2017

January 12th, 2016 No comments

Nearly three dozen states opted not to operate their own health benefit exchanges serving the individual and small group markets starting in 2014. In these states, the federal government became the default exchange operator under a provision of the Patient Protection and Affordable Care Act that’s invoked if states decline to establish an exchange. Typically red states hostile to the health reform law, these states also aren’t keen on other provisions of the law such as the individual and employer mandates. An Affordable Care Act provision that takes effect next year allows them to apply to the federal government to dispense with these mandates and the individual and small business exchanges as well as other major ACA health insurance market reform elements.

Section 1332 of the law affords states broad latitude to create their own health insurance programs serving individuals and small employers for coverage beginning in 2017. Section 1332 waivers even provide states federal funding for them, paying states what they would otherwise receive in the form of advance tax credit premium assistance payments to state residents to subsidize premiums for coverage purchased through exchanges.

The freedom and the federal funding come with some important provisos. According to federal guidance issued in December 2015, states must provide coverage for a comparable number of their residents and on terms that are as comprehensive and affordable as would be the case without the waiver. Funding for the states also cannot increase the federal deficit. The waivers would be for renewable five year periods.

While health plan issuers would still be barred from medical underwriting, states could even do away with foundational insurance market reforms such as those defining small and large employer group markets and those that affect rating such as a single statewide risk pool, rating territories and limited annual enrollment periods.

For those states that defaulted to the federal government to operate their exchanges, the guidance makes clear that if they want a Section 1332 waiver to set up their own state programs, they will be making a clean break with any federal government involvement other than monitoring to ensure they comply with the major waiver provisos. They would not be permitted, for example, to continue using the federal eligibility and enrollment portal, healthcare.gov, or to receive some modified form of advance premium tax credits in support of their programs. Nor could they mix Section 1332 funding with any federal Medicaid funding received under a state Section 1115 Medicaid waiver, according to the guidance.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Concern arises over effectiveness of ACA’s individual risk pool integrity mechanisms

January 12th, 2016 No comments

To restore the dysfunctional individual health insurance market, the Patient Protection and Affordable Care Act took risk pooling and medical underwriting away from health plan issuers and created single statewide individual risk pools. The law also put in place mechanisms to ensure the reforms work as intended.

Two of those mechanisms are designed to preserve the spread of risk in statewide individual risk pools and ward off adverse selection that crippled the pre-2014 market so the pools contain enough people who don’t use a lot of medical services to pay in premium dollars to cover the care of those who do. One such device is limiting enrollment in individual health plans to set time of year to reduce churn and keep the pool population relatively stable. There are exceptions to these limited enrollment periods such as when people lose employer-sponsored coverage, change their place of residence or their family status such as getting married for having a child.

Health plan issuers are concerned these exceptions are being gamed in the majority of states where the federal government operates health benefit exchanges to effectively enable people to obtain short term coverage of less than a year to cover needed medical care – contrary to the Affordable Care Act’s policy intent to require continuous annual enrollment. That degrades spread of risk and increases the likelihood of adverse selection, which in turn will require higher premiums. That was the fundamental, fatal problem facing individual health plan issuers before the law overhauled the individual and small group health insurance market segments. In response to their concerns, Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, told a J.P. Morgan health-care conference in San Francisco this week that CMS will tighten up its rules on exceptions for enrollments outside of the annual open enrollment period, The Wall Street Journal reported.

Another device to ensure the integrity of the state risk pools is federal income tax penalties assessed on those who opt to go without health coverage, particularly if they believe they are unlikely to need medical care over the near term. They act as a stick to nudge people into the pools if they don’t have coverage through an employer or government program. As with the limited open enrollment periods, they are designed to ward off adverse selection and preserve the risk spreading function of the pools. Here too, there are concerns they may not be working as intended. Some individuals – especially those earning more than 400 percent of federal poverty and thus ineligible for tax credits to offset individual health plan premiums – are doing back of the envelope calculations and opting to go uninsured and pay the penalty if their annual premium exceeds the penalty amount, according to The New York Times.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Do You Speak Health Insurance? It’s Not Easy : Shots – Health News : NPR

January 4th, 2016 No comments

“We’ve created a monster, and it’s not surprising to me that there’s literacy issues,” says Kathleen Call, a professor in the University of Minnesota School of Public Health. “I’ve studied this stuff, and sometimes I make mistakes.”Call has grown increasingly concerned that the complexity of insurance could compromise public health by keeping people away from the doctor.”People are treating it more like car insurance: You don’t use it until something happens,” she says. “You have an accident, then you use it. Otherwise you’re trying not to use it. And that’s not the way we want health insurance to be used.”

Source: Do You Speak Health Insurance? It’s Not Easy : Shots – Health News : NPR

Call’s comment concerning people not wanting to use their health insurance coverage touches upon a deep philosophical split over what it should be in the Affordable Care Act era. In the age of the health maintenance organization that came about in the 1970s and 1980s, HMOs were a hybrid product consisting pre-paid primary care and protection for high cost care such as major accidents and medical events. Before the HMO, there was major medical coverage that covered only the latter with the patient paying out of pocket for the former.

Today, the United States is shifting back to pre-HMO days. Instead of major medical coverage as it was called in the 1950s and 1960s, we now have high deductible or consumer driven plans. With rising health care costs, the all inclusive HMO plans with little in the way of out of pocket costs are no longer feasible. The problem is people still remember these rich HMO plans of the recent past and see high deductible plans as a poor value by comparison — or even valueless as they were described in a recent New York Times story.

The NPR item featured here makes the case for a simplified high deductible policy resembling the major medical coverage of the past, with a flat deductible of say $2,500 and a 20 percent coinsurance level. And automatically health savings account compatible.

That would be a true insurance product since it would cover large, unexpected medical expenses. Since patients would be responsible for care costs incurred below the deductible, these plans would reduce health plan issuer administrative costs involved in processing reimbursements for lower cost care events and the burden of keeping practitioner directories updated. It also dovetails with the consumer trend of convenience-oriented primary care delivered at retail and employer-sponsored clinics, online and through pre-paid arrangements.

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Numerous tweaks to ACA’s health insurance reforms add to law’s complexity

December 21st, 2015 No comments

Most everyone would agree the Patient Protection and Affordable Care Act’s health insurance market reforms are complex. Adding to the complexity is their staggered, stop and go implementation as Congress and the administration apply various changes and adjustments. It also demonstrates the iterative nature of the law that continues to evolve nearly six years after it was enacted in March 2010.

The most recent addition comes in the federal budget measure signed into law late last week to fund the federal government though the end of the current fiscal year ending next fall. The measure suspends for 2017 the health insurance provider fee levied on health insurers under Section 9010 of the statute. It also pushes out the effective date of the 40 percent excise tax on high cost employer-sponsored group health plans – known as the “Cadillac tax” – to apply to plans effective in 2020 versus 2018 and makes the tax deductible. That gives unions and state and local governments that offer relatively generous plans and most likely to feel the effects of the tax more time to determine their compliance or avoidance strategies. The bill also requires a review of the suitability of indexing the tax adjustment amount to the Blue Cross/Blue Shield standard benefit option of the Federal Employees Health Benefits Plan.

The budget bill also extends a pre-existing budget provision barring the administration from allocating funds to bail out one of the Affordable Care Act’s premium stabilization programs designed to minimize premium volatility for plans sold on state health benefit exchanges. The risk corridors program levels loss experience among health plan issuers so that issuers with lower than expected claims make payments to issuers with higher than expected claims. Problem is, as this Milliman analysis explains, the playing field isn’t level. That’s because of a tweak applied in late 2013 delaying another provision of the Affordable Care Act under transitional regulatory relief. It authorized states to temporarily allow individual and small group plans to offer coverage not compliant with minimum benefit designs mandated by the law – which some states opted to do. That in turn affected claims experience among health plans, throwing the risk corridors mathematics out of whack and substantially shorting plan issuers expecting risk corridor payments. The one year suspension of the fee assessed on health plans offers plan issuers suffering higher than expected claims costs on plans written in 2014 through 2016 some offsetting financial relief before the risk corridors and reinsurance premium stabilization programs expire in 2017.

Last week’s budget bill is the third legislatively enacted change to the Affordable Care Act’s insurance market reforms in 2015. It closely follows another that allows states to elect to define their small group health insurance markets as those serving employers with 50 or fewer employees rather than 100 beginning in 2016 as the law originally required as well as the repeal of ACA Section 1511 in November’s Bipartisan Budget Act of 2015. Section 1511 requires large employers of more than 200 full time employees to automatically enroll new full time employees in one of the employer’s health plans.

(This updated version corrects and expands on a previous version of this post that incorrectly referenced ACA Section 4375)

 


The Affordable Care Act is the most comprehensive overhaul of America’s health care payment and delivery system since the enactment of Medicare and Medicaid more than 50 years ago, posing significant challenges for public policymakers and health system stakeholders. Pilot Healthcare Strategies can help with insightful policy research and analysis, strategic consulting and project management services. For an initial consultation, email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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