As most of you know (probably ad nauseam at this point), the Supreme Court of the United States delivered their ruling today on the constitutionality of the Affordable Care Act (ACA).
Q. So what happened this morning?
A. Ultimately, the ACA was upheld. Likely the most controversial component, the requirement that every American buy insurance, was upheld. But there was a twist; the Supreme Court said it does not violate the commerce clause because the mandate doesn’t regulate existing commercial activity. Instead, it compels individuals to become active in commerce by purchasing a product. Therefore, Americans can choose not to buy health insurance, but will instead pay a tax. The expansion of the Medicaid program up to 133% of the Federal Poverty Level (FPL) was also among the top controversies in the law. The Supreme Court ruled that states will have a choice about whether or not to participate in the expansion. So if states choose not to participate, they will not be penalized by losing their current Medicaid dollars (as written in the ACA). If states opt for the expansion, they will get money to participate, but they must comply with the conditions attached to the new expansion funds.
Q. What position did CRHC take on the ACA?
A. The Colorado Rural Health Center did not take a position on the Affordable Care Act. Our policy agenda is directed by our membership, and the membership did not come to consensus on all provisions of the ACA. However, membership supported the rural provisions which contribute to CRHC’s vision to ensure that all rural Coloradans have access to comprehensive, affordable, high quality healthcare.
Q. What happens with the rural provisions in the law?
A. Given the decisions made this morning, it means that all rural provisions included in the ACA were upheld in entirety. As a reminder, some of the rural provisions included additional funding for the National Health Service Corps program, residency allocation, and creation of Rural Physician Training grants, as well as establishment and funding for the Centers for Medicare and Medicaid Services (CMS) Innovation Center, Primary Care Incentive payments, “Extenders,” and modification of the low volume hospital adjustment. So the workforce modifications, innovation dollars and payment modifications will be administered as outlined in the law.
Q. Does this mean it’s all over?
A. Not at all. There will be additional legal challenges concerning implementation and regarding Medicaid participation, and the political mudslinging has already begun!
CRHC will continue providing training and technical assistance to Critical Access Hospitals and Rural Health Clinics, offering workshops and conferences, administering grant programs, offering the Colorado Provider Recruitment Program and advocating on behalf of rural facilities and communities. We will be in Washington, D.C. at the end of July to fight against the cuts that will disproportionality impact rural and to provide Congress with a real picture of rural health in Colorado.
And we will work with rural communities and facilities on creative solutions that will continue to improve patient health, improve community health, and contain cost, all the while ensuring hospitals and clinics in rural areas remain viable practices that ensure access to their communities.
Thursday, June 28, 2012
Guide to Opinions on the Supreme Court Ruling
In advance of today's Supreme Court ruling on the Affordable Care Act, the SCOTUSblog offers up a digest of opinions and predictions. See the digest here or to access their liveblog.
Monday, June 25, 2012
Colorado's Essential Health Benefits Benchmark Plan
The Governor’s Office, the Division of Insurance, and the Colorado Health Benefit Exchange will convene a public webinar on Friday, June 29 from 10:00 - 11:00 AM to discuss the process of selecting an Essential Health Benefits (EHB) benchmark plan for Colorado. Colorado will choose an EHB benchmark plan in the coming months, which will establish minimum health benefits required for many health insurance plans beginning in 2014. The webinar will provide an introductory overview of a chart that details Colorado’s options for an EHB benchmark plan, in addition to answering common questions about the process. Click here to sign up for the webinar.
Thursday, June 21, 2012
Applications for HB12-1052 Advisory Group Due June 22nd
HB12-1052 charges the Colorado Primary Care Office, in the Prevention Services Division of the Colorado Department of Public Health and Environment, with designating an Advisory Group composed of representatives of "the affected health care professions and individuals with expertise in health care workforce research, analysis and planning." Members of the Advisory Group will serve without compensation or reimbursement for actual or necessary expenses for their participation. The Advisory Group will consider, but is not limited in using, the Division of Registration's existing data fields as a structure for a robust statewide health care license data collection and reporting system including:
1. Each practice address of the health care professional;
2. The number of hours the health care professional provides direct patient care at each practice location;
3. Any specialties of the health care professional if applicable;
4. Information about each practice setting;
5. The health care professional's education and training related to his or her profession and;
6. The year of birth of the health care professional.
This link will take you to an electronic nomination form which, when completed, will transmit directly back to the Primary care Office. The Primary Care Office kindly asks for your assistance in distributing this email through your networks, clinics, facilities or contacts. You are welcome to self nominate as well. The Primary Care Office will begin reviewing completed nomination forms on June 22nd. The Advisory Committee will meet several times beginning in late July and intend to complete the work as quickly as possible and do not expect more than a few months of total effort.
Additional information regarding the scope and intent of HB12-1052 including the Advisory Group is available here.
1. Each practice address of the health care professional;
2. The number of hours the health care professional provides direct patient care at each practice location;
3. Any specialties of the health care professional if applicable;
4. Information about each practice setting;
5. The health care professional's education and training related to his or her profession and;
6. The year of birth of the health care professional.
This link will take you to an electronic nomination form which, when completed, will transmit directly back to the Primary care Office. The Primary Care Office kindly asks for your assistance in distributing this email through your networks, clinics, facilities or contacts. You are welcome to self nominate as well. The Primary Care Office will begin reviewing completed nomination forms on June 22nd. The Advisory Committee will meet several times beginning in late July and intend to complete the work as quickly as possible and do not expect more than a few months of total effort.
Additional information regarding the scope and intent of HB12-1052 including the Advisory Group is available here.
New MedPAC Report Could Prove Harmful to Rural Patients and Providers; Your Voice is Needed to Tell the Real Story of Rural Health.
The Medicare Payment Advisory Commission (MedPAC) is an independent Congressional agency established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare Program, including analyzing access to care, quality of care, and other issues affecting Medicare.
MedPAC released a report to Congress this week, Medicare and the Health Care Delivery System, which examines issues central to the beneficiaries’ experience of the Medicare program. One chapter specifically examines care for beneficiaries in rural areas, including access to care for rural beneficiaries, the quality of the care they receive, special rural payments, and the adequacy of payments for rural provides.
The Commission reported there is little differences in health care service use by Medicare beneficiaries between rural and urban areas, patient satisfaction is similar, there are no major differences in quality between urban and rural providers, and rural hospital payments and financial margins are ample.
Rural health advocates are concerned that inaccuracies in the report could be harmful to rural Americans. We know access to care and inadequate reimbursement rates in rural Colorado and across America are problematic and programs and policies aimed at fixing these issues are crucial and cannot be allowed to expire. A report released in April by iVantage Health Analytics, Inc. (which also used Medicare data), found that Medicare spending is 3.7% less per beneficiary in rural markets than in urban markets, even though this spending includes “special payments” provided to rural hospitals and practitioners. The report found that rural hospitals nationally have equal or better quality outcomes, and cost less per Medicare beneficiary than their urban counterparts confirming rural hospitals and clinics are a good value for patients and for taxpayers.
Rural providers, patients and communities will pay the price if Congress acts based on information found in the MedPAC report, so we need your voice. We need data, stories, and examples to paint the real picture of rural health. CRHC staff will be traveling to Washington, D.C. in July to participate in NRHA’s March for Rural Hospitals and will be meeting with Colorado’s members of Congress. It is our chance to make your voice heard, so please contact Alicia Haywood or Jen Dunn with any questions you might have, as well as any information to illustrate the access and the financial challenges facing rural providers and patients.
MedPAC released a report to Congress this week, Medicare and the Health Care Delivery System, which examines issues central to the beneficiaries’ experience of the Medicare program. One chapter specifically examines care for beneficiaries in rural areas, including access to care for rural beneficiaries, the quality of the care they receive, special rural payments, and the adequacy of payments for rural provides.
The Commission reported there is little differences in health care service use by Medicare beneficiaries between rural and urban areas, patient satisfaction is similar, there are no major differences in quality between urban and rural providers, and rural hospital payments and financial margins are ample.
Rural health advocates are concerned that inaccuracies in the report could be harmful to rural Americans. We know access to care and inadequate reimbursement rates in rural Colorado and across America are problematic and programs and policies aimed at fixing these issues are crucial and cannot be allowed to expire. A report released in April by iVantage Health Analytics, Inc. (which also used Medicare data), found that Medicare spending is 3.7% less per beneficiary in rural markets than in urban markets, even though this spending includes “special payments” provided to rural hospitals and practitioners. The report found that rural hospitals nationally have equal or better quality outcomes, and cost less per Medicare beneficiary than their urban counterparts confirming rural hospitals and clinics are a good value for patients and for taxpayers.
Rural providers, patients and communities will pay the price if Congress acts based on information found in the MedPAC report, so we need your voice. We need data, stories, and examples to paint the real picture of rural health. CRHC staff will be traveling to Washington, D.C. in July to participate in NRHA’s March for Rural Hospitals and will be meeting with Colorado’s members of Congress. It is our chance to make your voice heard, so please contact Alicia Haywood or Jen Dunn with any questions you might have, as well as any information to illustrate the access and the financial challenges facing rural providers and patients.
Wednesday, June 20, 2012
March for Rural Hospitals
NRHA is hosting a free education and advocacy event July 30 – 31st in Washington, D.C.
Join experts in D.C. to learn how to save Medicare Dependent Hospitals (MDHs) and the Low-Volume Hospital (LVH) program, and take this important message to Capitol Hill:
If congressional action is not taken by Oct. 1, millions of dollars in reimbursements to these facilities will be lost, hospital services will be reduced, and rural hospital doors will close.
Participation in the March for Rural Hospitals is free, but you must register. NRHA members register here. All other participants register here. For more information on MDHs and LVHs, click here.
Join experts in D.C. to learn how to save Medicare Dependent Hospitals (MDHs) and the Low-Volume Hospital (LVH) program, and take this important message to Capitol Hill:
If congressional action is not taken by Oct. 1, millions of dollars in reimbursements to these facilities will be lost, hospital services will be reduced, and rural hospital doors will close.
Participation in the March for Rural Hospitals is free, but you must register. NRHA members register here. All other participants register here. For more information on MDHs and LVHs, click here.
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