Health Care Delivery

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Republican leaders in Idaho on Friday dampened expectations about broadening Medicaid healthcare eligibility this year for poor residents in the state, on the same grounds they balked in 2013: Before taking extra federal money, the existing system should be overhauled to encourage beneficiaries to take personal responsibility for their health.

The Affordable Care Act has been touted as a means to control costs and improve quality of care. One initiative in that effort is to steer patients away from visiting the emergency department (ED). That undertaking may prove to be challenging.

January 2014 has arrived, and with that Affordable Care Act coverage begins. Over the next 12 months, the administration will thoroughly consider the ways in which it can control the rising costs of healthcare in the United States. This is especially true for the nation's Medicare program.

A coverage gap in the Affordable Care Act (ACA) means that many children will not be eligible for dental coverage, which was mandated as one of the 10 essential health benefits for adequate health insurance.

Over two million people have enrolled in health insurance plans through the federally run HealthCare.gov and state healthcare enrollment websites, a US administration official said on Tuesday. HealthCare.gov covers 36 states, and another 14 states have their own websites.

Healthcare reform is already presenting new challenges and opportunities for endocrinology, a specialty that is under significant stress in the United States. A critical workforce shortage has drained the pool of practicing endocrinologists, just as the Affordable Care Act (ACA) is expected to send millions of newly insured people into the system.

The business of treating patients via telehealth in the U.S. will dramatically increase to nearly $2 billion in revenue within five years due to a confluence of events in the health care industry from doctor shortages to provider payment changes under the Affordable Care Act.

Millions of people facing the cancellation of health insurance policies will be allowed to buy catastrophic coverage and will be exempt from penalties if they go without insurance next year, the White House said Thursday night.

The director of Minnesota's health insurance exchange, April Todd-Malmlov, abruptly resigned this week, making the exchange the fourth state program to see a leadership change in the midst of mounting criticism over the rollout of President Obama's new health care law.

In an effort to avoid a coverage gap in health insurance, those covered under the Pre-existing Condition Insurance Plan (PCIP) will get until January 2014 to enroll into a new plan through the state or federal healthcare exchange website.

To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small?

Access is an important component of the Triple Aim (cost, quality, access), and it has also been stressed as a significant factor in health reform initiatives. As the influx of uninsured increasingly seeks care, and if the number of providers available to provide primary care decreases as projected, achieving access to quality and cost-effective care may become more problematic.

Enrollment in new Obamacare exchanges may be lagging, but experts said Thursday that the health law's massive expansion of Medicaid could place more than 8 million low-income people in the program before the first year is up.

The Medicare, Medicaid, and Dual Eligibles programs are on the verge of a significant transition under the Affordable Care Act. Coordinating care and improving population health outcomes will require these federal programs to move away from outdated fee-for-service models to ones that incent better quality and more cost-effective delivery methods. At America's Health Insurance Plans (AHIP) Medicare, Medicaid, and Dual Eligibles conference held on September 23-26 in Washington, DC, the sessions featured discussions that highlighted the role health insurance plans will play as these federal programs continue to evolve under healthcare reform.