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Health Reform

Federal health reform — the Affordable Care Act (ACA) — became law in March 2010, and the implementation is reshaping the American health care system.

While there remains considerable controversy — as reflected in the national political debate — the federal government, states and private sector partners including hospitals, physicians and health plans are eager to leverage the opportunities that ACA provides.  As a result, several tectonic shifts in our health care system are under way, setting into motion new federal grants and important new demonstration projects.  Common themes include the alignment of financial incentives with better health outcomes and lower total spending.

The reform debate will continue, and HMA continues to be in the mix and in the know. 

Backed by decades of policy development and program implementation experience — inside and outside government — our health reform team is intimately knowledgeable, highly accomplished and well-positioned to help our clients quickly evaluate and decisively act on emerging new opportunities. 

We are closely monitoring developments at the federal, state and local levels. Some of the trends that we are watching and believe have staying power include:

Value-Based Payment Models

The traditional “piece meal” system of paying providers a fee for each service has rewarded greater volume.  The new approach is to reward greater value.  Delivery systems that achieve better health outcomes per dollar spent will share in the savings with payers.  HMA is helping providers — large and small — capitalize on these new incentives to elevate the quality of care while boosting their bottom line.  Learn more

Health Insurance Reforms

States are adopting various health insurance market reforms stipulated by ACA to ensure that people with high health risks and complex medical needs are not denied coverage or priced out of health insurance. HMA is assisting states in re-writing regulations and supporting providers as they navigate the new rules of the road.  Learn more

Integrated Systems of Care

Among other innovative approaches, the ACA calls for demonstrations related to accountable care organizations, bundled payments, patient-centered medical homes and provider incentives to lower hospital readmission rates.  Working in partnership with our clients, HMA is pioneering the development and implementation of innovative, integrated health care delivery models nationwide.  Learn more

Health Insurance Exchanges

States are designing health insurance exchanges, which will provide a marketplace where people without job-based or public coverage have a choice of health plans with subsidies based on financial need.  HMA is partnering with states and providers to design, develop and launch these creative new purchasing models.  Learn more

Medicaid Expansion and Flexibility

States are evaluating the likely health care needs of individuals who will be newly eligible for Medicaid in 2014 under ACA, including low-income adults without dependent children.  HMA is working with states to explore their options and is helping providers optimize the resulting new business opportunities.  Learn more

Information Technology

There is no stopping information technology.  Electronic health records, decision support for physicians, electronic prescribing and social media are changing the health care delivery system.  HMA is tracking the rules, evaluating the tools and knows what’s hot and what’s not.  Learn more.

HMA knows health reform.

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