Articles for the Topic "Health Care Reform"

"Ask the Expert" Welcomes Dr. Mark McGovern

2010-12-20T12:36:26

We are pleased to welcome Dr. Mark McGovern, an Associate Professor of Psychiatry and of Community and Family Medicine at Dartmouth Medical School in Lebanon, New Hampshire. He is based at the Dartmouth Psychiatric Research Center, which specializes in the design, development, testing and dissemination of evidence-based treatments for persons with co-occurring disorders. Dr. McGovern is a practicing clinician, conducts treatment and services research with co-occurring substance use and psychiatric disorders, and is the Editor-In-Chief of the Journal of Substance Abuse Treatment.

A snapshot of health insurance after reform

2010-12-20T02:11:44

In mid-September 2009, the U.S. Census Bureau reported that the number of people without health insurance increased in 2009 to an all-time high of 50.7 million. Much of this increase can be attributed to the loss of employer-sponsored health coverage as the recession worsened during 2009—but even before the recession, the number of uninsured had reached a crisis point.

Health Care Reform Implementation

2010-12-20T02:26:44

Broaden health coverage to increase access to appropriate high quality care, and to reduce disparities that currently exist between the availability of services for substance abuse, mental disorders, and other medical conditions.

Health Reform Hits Main Street

2011-03-02T03:41:41

The workings of the new health reform law can be very confusing. This 9-minute, animated short, is not only entertaining, but also very informative. The video explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014.

Healthcare.gov

2011-03-02T03:35:04

The Federal Government's official Web site regarding health care reform. Here you can find an interactive time line of the Affordable Care Act, as well as information on its specific provisions.

Implementing health care reform--an interview with HHS Secretary Kathleen Sebelius

2011-03-02T04:00:03

Kathleen Sebelius was sworn in as Secretary of Health and Human Services (HHS) on April 28, 2009. HHS administers Medicare and Medicaid and oversees the FDA, NIH, and other agencies, HHS spends about 25% of the Federal budget. Sebelius took command of HHS during a tumultuous period, as Congress debated the sweeping health care reform bill that HHS must now administer. This interview was conducted by John Iglehart, a national correspondent for the New England Journal of Medicine, on December 21, 2010.

Implementing healthcare reform: First steps to transforming your organization

2011-03-02T03:43:25

As a result of the recent passage of parity and healthcare reform legislation, a group of addiction services leaders recognized the tremendous challenges and opportunities facing the addiction services field. This group of field leaders and national organziations began to meet informally. The purpose of their meeting was two-fold: To share the latest information on implementation activities related to this ground-breaking legislation; and to explore opportunities for cooperation and collaboration to ensure that effective policies are in place and that addiction services providers are prepared for healthcare reform and parity implementation. This guide is a product of those discussions.

Issues in health reform: How changes in eligibility may move millions back and forth between medicaid and insurance exchanges

2011-03-02T03:59:36

The Affordable Care Act will extend health insurance coverage by both expanding Medicaid eligibility and offering premium subsidies for the purchase of private health insurance through State health insurance exchanges. But by definition, eligibility for these programs is sensitive to income and can change over time with fluctuating income and changes in family composition. The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, the authors estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the Federal poverty level will experience a shift in eligibility from Medicaid to an insurance exchange, or the reverse; within a year, 50 percent, or 28 million, will. To minimize the effect on continuity and quality of care, States and the Federal Government should adopt strategies to reduce the frequency of coverage transitions and to mitigate the disruptions caused by those transitions. Options include establishing a minimum guaranteed eligibility period and "dually certifying" some plans to serve both Medicaid and exchange enrollees.

Medicaid benchmark benefits in health reform: Improvements and exemptions

2010-12-03T02:52:06

Recent regulations issued by CMS allow children with serious emotional disturbances, individuals with disabling mental disorders, and individuals with mental disabilities that prevent them from performing tasks of daily living to be exempted from enrolling in Medicaid benchmark plans. While most individuals who are newly eligible for Medicaid under health reform will be enrolled in benchmark coverage, these individuals with severe needs may instead be enrolled in standard comprehensive Medicaid. The National Council fact sheet, “Medicaid Benchmark Benefits in Health Reform: Improvements and Exemptions,” describes the differences between benchmark and standard coverage, the improvements to benchmark coverage under health reform, and the implications of these changes for individuals with disabilities. States will need to develop processes to identify which individuals meet the criteria of having a disabling mental disorder or functional impairment. These processes will have to incorporate both those applying for Medicaid for the first time as well as those who are currently enrolled. The National Council encourages community behavioral health organizations to work with their state Medicaid departments to ensure that the needs of individuals with mental illness and substance use disorders are addressed throughout this process.

Medicaid expansion — The soft underbelly of health care

2011-01-18T04:36:00

The authors believe that the most critical objective of the recently enacted health care reform legislation is expanding health insurance to cover Americans who are currently uninsured, with the ultimate goal of improving access to care. It is their argument that, in large part, the success or failure of health care reform will hinge on the achievement of this goal.

National Council for Community Behavioral Healthcare

2006-12-26T01:39:17

The National Council is an association of 1,300 organizations that help people in trouble — adults and children with mental illnesses or addiction disorders. The people our members treat live with their families or alone; some are in hospitals, jails, or juvenile detention facilities and others are in residential programs, foster care, or group homes. Each year, our member organizations give nearly 6 million children, adults, and families in communities across the country the chance to recover and lead productive lives. We’re proud of our member organizations. Our job is to help members do their jobs. As a not-for-profit 501(c)(3), the National Council advocates for policies that ensure that people who are ill can access services. And we offer state-of-the-science education and technical assistance so that services are efficient and effective. (NCCBH)

Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers

2011-03-02T03:55:07

Primary care is fundamental to health system performance, but the United States has undervalued and underinvested in primary care for a long time. This brief describes how the Affordable Care Act will begin to address the neglect of America's primary care system and, wherever possible, estimates the potential impact these efforts will have on patients, providers, and payers. The health reform law includes numerous provisions for improving primary care: temporary increases in Medicare and Medicaid payments to primary care providers; support for innovation in the delivery of care, with an emphasis on achieving better health outcomes and patient care experiences; enhanced support of primary care providers; and investment in the continued development of the primary care workforce.

Rethinking safety-net access for the uninsured

2011-03-02T03:37:41

Health insurance reform has begun, but safety-net programs that support the uninsured throughout the United States are struggling to adapt their missions to suit the post-reform composition of the uninsured population. Many programs are organized at the local level, with funding largely determined on their serving low-income uninsured residents. Examples of these programs include well-structured comprehensive care programs in major cities, more than 1,000 limited-service free clinics, and dozens of volunteer physician referral programs.

SAMHSA's Webinar Series on Health Reform Continues Through October

2010-10-14T08:31:20

SAMHSA’s fall webinar series, Health Reform 101, which touches on different aspects of the Affordable Care Act, continues. Please join the three new webinars.

The Affordable Care Act and the future of clinical medicine: The opportunities and challenges

2011-03-02T03:38:52

The Affordable Care Act is a major change to the U.S. health care system. Among other things, it guarantees access to health care for all Americans, creates new incentives to change clinical practice to foster better coordination and quality, and alters the payment system to reward value. The Act and the health information technology provisions in the American Recovery and Reinvestment Act remove many barriers to delivering high-quality care, such as unnecessary administrative complexity, inaccessible clinical data, and insufficient access to primary care and allied health providers.

The States' next challenge - securing primary care for expanded medicaid populations

2011-03-02T03:54:11

Many of the U.S. States with the largest slated Medicaid expansions are also the States that have less primary care capacity. These States could see a surging demand from the newly insured population without having sufficient primary care resources in place.

Underinsurance in the United States: An interaction of costs to consumers, benefit design, and access to care

2011-03-02T03:36:52

Underinsurance is most commonly defined as the state in which people with medical coverage are still exposed to financial risk. This article argues that suitable health insurance coverage should also be assessed in terms of the adequacy of specific benefits coverage and access to care. Underinsurance can be understood conceptually as comprising three separate domains: (a) the economic features of health insurance, (b) the benefits covered, and (c) access to health services. The literature provides ample evidence that people who are underinsured face the same access to care barriers and have high financial risk as those who are completely uninsured. In response to the growing recognition of the problems associated with underinsurance, the Obama Administration's Patient Protection and Affordable Care Act of 2010 includes a multitude of provisions designed to enhance access to care (especially primary care), limit costs to consumers, and to assure a minimum set of benefits.

Universal Health Insurance and Health Care Access for Homeless Persons

2010-07-08T02:15:10

Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto’s general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Conclusions. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

Who are the uninsured eligible for premium subsidies in the health insurance exchanges?

2011-03-02T04:00:35

Creation of State-based exchanges to provide more affordable insurance options for people, especially the uninsured, is an important provision of the national healthcare reform law. Despite premium subsidies for people with incomes up to 400 percent of the poverty level, or $88,200 for a family of four in 2010, and an individual requirement to enroll in coverage, it is unknown who will enroll in the exchanges and who will not. According to a new national study by the Center for Studying Health System Change, nearly 40 percent of uninsured people eligible to receive subsidies through the exchanges have chronic conditions or report fair or poor health, and another 28 percent report recent problems with access to care or paying medical bills. However, about one-third of uninsured people eligible for subsidies have had no recent problems with their health, access to medical care or paying medical bills. Enrolling these apparently healthy uninsured people is likely to be challenging but essential to avoiding adverse selection, or enrolling sicker-than-average people, in the exchanges. Otherwise, health insurance costs in the exchanges could be higher than expected. Contrary to popular perception, many of these healthy and low-cost uninsured people view themselves as risk-averse, which could motivate them to gain coverage in the absence of health or access problems. Also, most uninsured people believe they need health coverage, although fewer believe that health insurance is currently worth the cost, a situation that could change once premium subsidies are available in 2014.