Aca Provisions Could Signal Sobering Start to 2013

Medical Economics, December 25, 2012 | Go to article overview
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Aca Provisions Could Signal Sobering Start to 2013


POLICY

In January, 10 of IS Affordable Care Act (ACA) provisions will take effect for 2013. Compiled by the Henry J. Kaiser Family Foundation, here's a snapshot of the key provisions for 2013:

Launch of Medicare bundled payment pilot. The national Medicare pilot program will evaluate bundled payments for acute inpatient hospital services, physician services, outpatient hospital services, and postacute care services for an episode of care.

Increases to Medicaid payments for primary care. Medicaid payments increase to 100% of the Medicare payment rate for 2013 and 2014. The increase is being financed with federal funding.

Medicaid coverage for preventive services. Provision increases federal matching payments of 1% for preventive services in Medicaid for states that offer Medicaid coverage with no patient costs-sharing for services recommended (rated A or B) by the U.S. Preventive Services Task Force and for recommended immunizations.

Closing of the Medicare drug coverage gap. Begin phase-in of federal subsidies for brand-name prescriptions filled in Medicare part D coverage gap (reducing co-insurance from 100% in 2010 to 25% in 2020, in addition to the 50% manufacturer brand-name discount).

States notify feds about exchange participation. State notification of whether they will participate in the American Health Benefit Exchange.

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Aca Provisions Could Signal Sobering Start to 2013
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