Q: How Can I Navigate Through Health Care Reform?

With the passage of the Patient Protection and Affordable Care Act (PPACA) in March 2010, health care reform is now the law of the land — or at least it will gradually become the law of the land, unless it is changed or repealed. If the bill remains relatively intact many of the most sweeping changes won’t take effect or be fully implemented until 2014, with some aspects of the legislation not taking effect until 2020.

As Armada’s head of PR and lead medical writer, I have done my best to follow Congress and its health care reform progress. Along this perilous journey, I have found the act to be a confusing maze of directives, provisions, stipulations, addendums, exceptions and references to other legislation and programs. I’m not alone.

Unless you are a lawyer, bureaucrat, policy wonk and tax accountant all wrapped up in one, trying to read and understand the comprehensive legislation is an effort in futility. However, it’s our responsibility to stay as informed as possible about the broad, sweeping changes that most directly impact our clients and our industry, including the:

  • Medicare Physician Fee Schedule (MPFS) changes – The MPFS is a complete listing and valuation of physician and clinician services used by Medicare and health plans to pay doctors or other providers. More than 1 million physicians and non-physician practitioners are paid under the MPFS.
  • Medicare sustainable growth rate (SGR) formula, a complicated (no surprise) formula that attempts to control costs for services provided to Medicare patients. Congress continues to grapple with how to deal with a more than 20 percent planned cut.
  • Meaningful use electronic health record (EHR) program – a program that encourages the adoption of electronic health records though the payment of bonuses to physicians, clinicians and hospitals that adopt the “meaningful use” of EHRs.

Here are the best resources I have found for tracking health care reform implementation. Listing these resources in no way implies that I support the manner in which the information is presented.

Healthcare.gov

The Healthcare.gov website managed by the U.S. Department of Health & Human Services has a visual, big-picture timeline of what happens and when regarding the new health care reform law.

The ABCs of PPACA

For a good dose of governmental alphabet soup that gets granular with the MPFS Final Rule, review this article from the American Association of Professional Coders (AAPC). They cover the Sustainable Growth Rate (SGR) formula, MPFS conversion factors, relative value units (RVUs), incentive payments, misvalued codes and more.

Health Care Reform Passed – Now What?

Physicians Practice Magazine has a good overview article on the impact of health care reform legislation. They also have a Health Care Reform Resource Center that includes a more health care-focused timeline of health reform milestones.

Kaiser Foundation

If you’re looking for a public policy perspective, The Henry J. Kaiser Family Foundation offers the Health Reform Source that details research, opinion and the impact of health care reform on a variety of economic sectors, industries and demographic groups.

Digging Deeper

You could practically become a health care reform junkie by checking out Health Care Reform Resources on the Alan Katz Health Care Reform Blog. He also has a great post called “Adapt or Die” about the new realities we all now live with.

The Red Pill

If you’ve ever seen “The Matrix,” there’s a scene where Morpheus tells Neo he can take the blue pill and stay in his artificial dream world (the matrix) or “take the red pill…and I show you how deep the rabbit hole goes.” If you really want to see how deep the rabbit hole goes, read the complete text of HR 3590 on GovTrack.us.

Finally, remember that most medical professional organizations, from the Heart Rhythm Society to the American Medical Association and American College of Radiology to the American Physical Therapy Association are tracking and following health care legislation. Many of these organizations provide e-mail updates related to health care law changes and developments that impact their specific profession or health care business.

Dan is Armada’s Vice President and PR Supervisor.



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