U.S. On Target For Healthcare Reform

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imageThe nation remains on track to implement healthcare reform by 2014, a top Centers for Medicare and Medicaid Services (CMS) executive tells healthcare officials in Tennessee this week.

“In the year since passage of the Affordable Care Act, we’ve had some ups and downs,” says Marilyn Tavenner, CMS’ principal deputy administrator and COO, in addressing the Nashville Health Care Council. “But the sky didn’t fall and government didn’t take over healthcare. And we’ve earmarked billions of dollars to help them make the transition as smooth as possible.”

Tavenner points to several programs intended to assist states, providers, and employers and, as such, serve as a “bridge” to full implementation of healthcare reform by 2014. She cites new legislation that provides $5 billion to help unions, state and federal governments, and private employers offer health insurance to employees who retire early. Other programs involve $2 billion in training funds to help address the anticipated doctor/nurse shortage, with a goal of bringing 30,000 new primary care providers into the system; $2.8 billion to enable states to create their own Primary Care Incentive Programs (PCIPs) or exchanges; and federal funding that covers most of the cost of expanded Medicaid in 2014-2019, thereby keeping the state share small by design.

“We’re also excited about the strides we’ve made in preventive care,” Tavenner observes. “This year, we’ve eliminated co-pays for preventive screenings – and soon there will be no co-pays for smoking cessation programs and pneumonia vaccines.” Regulations for accountable care organizations (ACOs) will soon be available, she adds, noting that CMS has worked closely with the Federal Trade Commission and the Justice Department to reach a consensus on these rules. Over the next two years, CMS plans to thoroughly evaluate ACOS to determine whether adjustments of the regulations are warranted.

Moreover, Tavenner reports, CMS has established an office to help monitor the costs of covering the nearly 10 million Americans eligible for Medicare and Medicaid alike. “We foresee plenty of opportunities to work with managed care companies on cost-containment,” she says.