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Prevention/
Wellnes
Individuals
Employers
Cost Containment
Quality of Care
100
Cost-sharing for Medicare and qualified health plan-covered preventive services shall be eliminated if recommended by this task force.
What is U.S. Preventive Services Task Force?
100
These will be granted to individuals for financial hardships, religious objections, American Indians, those without coverage for less than 3 months, undocumented immigrants, incarcerated individuals and finally those for whom the lowest cost plan exceeds 8% of their income.
What are exemptions?
100
This special group is exempt from paying a premium tax credit fee if they have less than 50 employees.
What are employers/small businesses?
100
They have the authority to approve generic versions of biologic drugs and can grant biologics manufacturers 12 years of exclusive use before generics can be developed. (Effective upon enactment)
What is the Food and Drug Administration?
100
The new Healthcare Reform bill allows children/young adults to remain on their parent's insurance until this age, increasing the access and affordability of health coverage to one of the most underinsured age groups.
What is Age 25
200
Incentives shall be provided to Medicare and Medicaid beneficiaries who complete these programs.
What are behavior modification programs?
200
This program will be expanded to non-Medicare eligible individuals with incomes up to 133% of the Federal Poverty Level (about $18,000 for a family of 3 in 2009).
What is Medicaid?
200
This is given to employees with incomes less than 400% of the federal poverty level.
What are free choice vouchers?
200
They must document compliance with these standards or face a penalty of no more than $1 per covered life. (Effective April 1, 2014)
What are Health plans?
200
Reform will eliminate any deductibles, copayments, or other cost-sharing for Medicaid clients to obtain these, making them affordable and accessible.
What are Preventive Services?
300
Grants for up to five year to small employers shall be provided for what programs?
What are wellness programs?
300
These will be offered in 2014 to US citizens and legal immigrants who meet income standards and are not eligible for Medicaid/Medicare, and these will not cover abortion expenses.
What are subsidies?
300
This amount is equal to what the employer would have paid to provide coverage to the employer under the employer's plan and will be used to offset the premium costs for the plan in which the employee is enrolled.
What does the free choice voucher represent?
300
It is simplified by adopting a single set of operating rules for eligibility verification and claims status, electronic funds transfers and health care payment and remittance, and health claims or equivalent encounter information, enrollment and disenrollment in a health plan, health plan premium payments, and referral certification and authorization.
What is health insurance administration cost containment?
300
While healthcare technology has improved, this has kept many Americans from accessing high levels of quality care.
What is cost of health care?
400
The reward amount employers will be permitted to offer employees for participating in a wellness program and meeting certain health-related standards.
What is a maximum 30% of the cost of coverage/premiums?
400
These subsidies - in the form of tax credits - will be available to those whose income is between 133 and 400% of Federal Poverty Level and are figured on a sliding scale depending on income.
What are premium credits?
400
This is the minimum number of employees that an employer needs to automatically enroll employees into health insurance plans offered by the employer (employees may opt out of coverage).
What is 200?
400
Their payments will be reduced initially by 75% and subsequently increased based on the percent of the population uninsured and the amount of uncompensated care provided (Effective fiscal year 2014)
What is Medicare Disproportionate Share Hospital (DSH) payments?
400
In order to receive certain federal funding hospitals must implement this, which has been shown to improve the quality of care as well as reduce administrative costs.
What are Electronic Medical Records?
500
Established to coordinate federal prevention, wellness and public health activities and to develop a national strategy to improve the nation’s health.
What is the National Prevention, Health Promotion and Public Health Council?
500
These subsidies will make healthcare more affordable for those under 250% of the Federal Poverty Level. If an insurance plan covers 70% of a medical service, these credits will help make up some but not all of the remaining 30% (on a sliding scale depending on income).
What are cost sharing credits?
500
The tax credit fee will be effective on this date.
What is January 1, 2014?
500
Providers in these type of organizations are allowed to share in the cost savings they achieve for the Medicare program when they voluntarily meet quality thresholds
What is accountable care organizations (ACOs)?
500
While Americans currently spend more per capita in health care costs in the world, we also rank at the bottom among developing countries in these two categories.
What are infant mortality and life expectancy?