Health Care Reform
An ACO is a collection of physicians who join together to coordinate care, share clinical information and report on quality measures.
Under the new federal health reform law, groups of physicians who see Medicare patients and agree to work together - meeting certain government requirements to qualify as an ACO - would be eligible for bonuses if they meet spending benchmarks for caring for their patient population and other criteria.
Many in the health care industry see ACOs as an opportunity to capitalize on health reform, realign and boost overall cost effectiveness, but exactly how ACOs will work remains unclear, as the federal government still must spell out regulations.
Physicians need to make prudent decisions in the near future about their interest in participating, if they are to take advantage of the opportunities created by new health care reform laws and regulations.
Read Q&As (PDF document) or visit CMAs website for more information..
Federal Health Reform - Health Insurance Exchange
More Americans are forced to purchase insurance in the individual market. In this market, patients often get coverage that is more expensive and less comprehensive than what they could receive through an employer-sponsored plan. In order to address this inequity, federal health care reform creates Health Insurance Exchanges. These state-based exchanges will be marketplaces for individuals and small businesses to purchase standardized health insurance products. California must design and implement its exchange by January 1, 2014. Health reform legislation orders the federal government to define the requirements for the exchanges by March 2011. Read more...(PDF format)
Federal Health Reform - Expansions of Insurance Coverage
In recognition of the two-year anniversary of the Patient Protection and Affordable Care Act (ACA), the California Medical Association is launching its Reform Essentials newsletter, a regular publication designed to provide readers with the latest developments of California's implementation of federal health care reform. Future installments will include updates from California's Health Benefit Exchange Board, information on Essential Health Benefits and other topics related to the ACA. Read current issue...(PDF format)
Federal reform mandates that everyone purchase health insurance or have it through employers. The individual mandate, as it is known, and most coverage expansions start in 2014.
Learn more about private insurance market changes that increase access to insurance; coverage through Medi-Cal, Healthy Families and Medicare; and the next steps for California lawmakers.
The Pros and Cons of Health Care Reform
An overview of the pros (ending insurance industry abuses, Medicare, Medicaid, and other issues) and the cons (no repeal of the Medicare SGR, no Medicaid rate increase, no CA GPCI fix, Indepent Medicare Payment Advisory Board - IPAB, Medicare, and other provisions) of health care reform - HR 3590 and HR 4872. All provisions take effect in 2014, unless otherwise indicated. Read more...(PDF format)
What CMA did for Physicians in Health Care Reform
Your SBCMS/CMA dues dollars benefit your profession, your practice and your patients. The health care reform legislation is enormous, and without your membership we could not accomplish what we have so far. The following document identifies our advocacy, amendments and successes. SBCMS/CMA will continue to vigilantly press Congress to address "unfinished business." Read more...(PDF format)
