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Health Reform and the Health Care Manager

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by

Kim Dauner

on 5 September 2012

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Transcript of Health Reform and the Health Care Manager

Key Provisions of the
ACA for Health Care Managers
Health insurance reforms
Medicaid expansion and Community Health Center (CHC) funding
Accountable Care Organizations (ACOs) and payment reform
Quality improvement
Public health and workforce training Removal of lifetime caps
Removal of pre-existing condition clauses
Administrative burden caps Link between payment reform and qualilty
Payment for quality outcomes in Medicare
ACOs and Medicare shared savings program demonstrations
National strategy to improve service delivery, patient outcomes, and population health Access to care only accounts for about 10% of disease burden
Community-level prevention pilot programs address the need to deal with upstream causes of disease
Obesity epidemic
National support and strategy
Link to primary care Evaluation
Quality improvement
Performance management
Health outcomes Issues on the Horizon:
The election
Medicare, Medicaid, and CHC provisions likely to remain
Exchange development People
Communication
Data
Technology Most salient parts of the ACA now
Effect on health care management workforce
What you will be doing and how to prepare yourself Implementation
Integration between payer and multiple types of providers
Processes More specifically (Kocher, et. al., 2010)...
Focusing care around shared clinical outcomes and patient experience
Expanding EHR capacity for decision support
Involving physicians and non-physician providers such as dietitians, PAs, and care coordinators in care teams
Managing bundled payments and incentive programs
Redesign medical offices and processes to simplify and streamline administration
Engage patients outside the office
Tailor good quality care to specific patient
populations http://www.bls.gov/ooh/management/medical-and-health-services-managers.htm#tab-6 "The only constant in life is change"
Heraclitus The Health Care Management Workforce, the ACA and Career Prospects Overview Health Insurance Reform Medicaid Expansion and CHC Funding Increased federal support
133% FPL inclusion
CHC funding of $11B over 5 years
Newly insured may be less healthy
Increases demand for chronic disease mangement and prevention ACOs and Bundled Payment Public Health Workforce Issues Primary care physicians
Nursing shortage
Rural
Caregiver training
Mental health The Effect on the
HCM Workforce Your Role Will Include Skills Required
Full transcript