Dr. Ravi Raheja is COO and Medical Director of the TriageLogic Group.
The URAC Annual Quality Summit was held from Sept 30th to Oct 2nd 2013. The event was especially memorable because of the Government shut down at the same time. Fortunately, none of the organizers or key speakers were government employees, so the meeting proceeded without interruption.
The Patient Protection and Affordable Care Act of 2010 (PPACA) is driving sweeping changes in how health care is organized, delivered, and reimbursed.
URAC’s 2013 Quality Summit was designed to help individuals navigate this changing environment.
One of the many notable speakers was former Senator, Tom Daschle. Since leaving the Senate, he has distinguished his expertise in health care through the publication of Critical: What We Can Do About the Health-Care Crisis, and the recently published, Getting It Done: How Obama and Congress Finally Broke the Stalemate to Make Way for Health Care Reform. Daschle has continued to lead on climate change and renewable energy, as well as a variety of other public policy challenges. In 2007, he joined with former Majority Leaders George Mitchell, Bob Dole, and Howard Baker to create the Bipartisan Policy Center, an organization dedicated to finding common ground on some of the pressing public policy challenges of our time.
One of the main topics that Tom Daschle spoke about was the importance of finding common ground between different parties on the new health care reform. He explained how both majority parties actually agree on several of the challenges that the health care system is facing today. However many leaders feel that changing their stance is in some way a sign of weakness, or compromising their principles. He emphasized that working together to find a common solution takes strength and will be necessary to resolve the budget issues, as well as the difference on the health care reform.
Another notable speaker was Rita Landgraf – the secretary of the Delaware Health and Social Services who discussed her experience about the new health insurance exchange. Delaware has put a lot of thought and effort into planning the roll out of the new exchange. Rita reported that State officials have been working with the marketplace guides, and in recent weeks hired consultants to reach out to the estimated 90,000 people in the state who currently don’t have health insurance. Officials hope to enroll as many as 35,000 state residents through the health insurance exchange. The exchange includes subsidies for those with incomes up to 400 percent of the federal poverty level — about $46,000 a year for an individual or about $94,000 for a family of four. They also say up to 30,000 residents will be eligible for expanded Medicaid under the Affordable Care Act, which will cover those with incomes up to 138 percent of the federal poverty level.
One of the important points that Rita Landgraf made was that they had to enroll enough young, healthy people to make the system work. Options for those young people include low-premium, high-deductible catastrophic plans to cover accidents and injuries.
“In order to make it affordable, you need to get that economy of scale that includes people who are healthy,” Landgraf said in a recent press release.
At the URAC conference, she shared some examples of ads that would appeal to the young, healthy people. It was refreshing and exciting to see a government organization in touch with technology and the different demographics that they are approaching.
In sum, the URAC quality summit held last week in Washington D.C. covered some important issues about the changing health care environment and the new laws. There are still a lot of questions that need to be resolved and patients and providers are still trying to understand the implications and the requirements of the new regulation.