Monday, January 7, 2013

ACA Update: What to Expect in 2013

By Emily McKinley, Health Information Specialist

The Affordable Care Act will continue to unfold this year as the law prepares for full implementation in 2014. While consumers may not notice significant changes to coverage or delivery of care, it is important to note that four key provisions of the legislation will be implemented this year.

First, the ACA will continue to promote preventative care by providing additional funding to state Medicaid programs that provide preventative care to consumers at little to no cost. Because preventative care decreases urgent and emergency health care visits as well as lowers overall health care costs, this is an important initiative that may result in lower long-term health care costs to taxpayers as well as individual consumers.

In support of this provision, as well as many that have already been enacted, the second measure that will be implemented in 2013 will be to increase payments to Medicaid providers. Currently, many primary care physicians choose not to accept patients who are Medicaid recipients due to the low reimbursement rates that they receive for the services provided. This provision will ensure that all Medicaid primary care providers receive 100% the Medicare reimbursement rates for like services. The increased reimbursement rate is funded entirely by federal funds.

To further protect consumers, the third 2013 provision is one that encourages doctors, hospitals and other service providers to “bundle” services. Currently, when a patient requires a procedure, such as a surgery or even visits the emergency room, the patient often receives bills from multiple providers, the facility where the patient was seen, and for any ancillary services that were provided. This provision encourages providers and treatment facilities to collaborate in order to provide services at a flat, or “bundled,” rate. This provision is designed to not only improve quality of care but also to lower healthcare and administrative costs, which will hopefully result in consumer savings.

Finally, the ACA will extend Children’s Health Insurance Program (CHIP) funding to states. CHIP is designed to provide low-cost coverage to children who are not eligible for Medicaid or affordable insurance through their parents’ employer. This provision extends funding to CHIP programs for another two years.

For more information about the continued implementation of and additional information about the Affordable Care Act, please visit or contact Family Voices at 317.944.8982 or We wish you the best of health and prosperity throughout 2013!

1 comment:

Anonymous said...

This is excellent news for many families. Many parents were dismayed to find that some insurance companies denied coverage to children with cerebral palsy because they considered it a pre-existing condition. There are many costs associated with cerebral palsy, including physical therapy, surgery, mobility equipment, special vehicles and home modifications. Hopefully the CHIP funding and the bundled services can help these families in need.