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Health Reform is More Than “Obamacare”. Getting Hit From All Sides.

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Presentation on theme: "Health Reform is More Than “Obamacare”. Getting Hit From All Sides."— Presentation transcript:

1 Health Reform is More Than “Obamacare”

2 Getting Hit From All Sides

3 Senate Could Turn

4 Name of The Game Employer Mandates Minimum Essential Benefits ICD-10 Meaningful Use Stage 2 Physician Payment (SGR) Cuts

5 SGR Permanent Fix Proposal Rates Steady 2014 – 2023 Budget Neutral VBP model for providers starting in 2017 –4% in 2017 –6% in 2018 –8% in 2019 –10% in 2020 –Capped at 12% in 2021 and beyond

6 SGR Permanent Fix Proposal (Cont.) Professionals participating in APMs will receive 2% updates (2023), not subject to VBP and will receive 5% bonus each year (2017-2022) Current Law program penalties would end –2% PQRS Penalty –3-5% EMR MU Penalty

7 How Did Obamacare Enrollment Go? LocationMarketplace Type Number of Individuals who have Selected a Marketplace Plan Estimated Number of Potential Marketplace Enrollees Percent of Potential Marketplace Population Enrolled 1. VermontState-based38,04845,00085.2% 2. CaliforniaState-based1,405,1023,291,00042.7% 3. Rhode IslandState-based28,48570,00040.6% 4. FloridaFederally-facilitated983,7752,545,00038.7% 5. IdahoState-based76,061202,00037.7% 6. MichiganPartnership272,539725,00037.6% 7. ConnecticutState-based79,192216,00036.7% 8. MaineFederally-facilitated44,258122,00036.3% 9. North CarolinaFederally-facilitated357,5841,073,00033.3% 10. WashingtonState-based163,207507,00032.2%

8 How Did Obamacare Enrollment Go?

9 NC Short Session… Living Up to Name Thom Tillis (R) Kay Hagan (D)

10 Medicaid ACOs

11 Benefits Provider led Creates budget certainty for state government Aligns incentives to get to value-based care Negatives Shifts risk Moves very fast

12 Senate Budget is Bad News Stops work on Medicaid ACOs Makes permanent 3% “Withold” on all Medicaid payments Explores the idea of a provider assessment on physicians

13 Questions?

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