Navigating the FOG of Health Care Reform
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- Gerard Osborne
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1 Navigating the FOG of Health Care Reform with Stephen Tweed CEO Leading Home Care a Tweed Jeffries company (c) 2010 Leading Home Care - 1
2 How many of you have been lost in the fog? What do you do when you are lost in the fog? (c) 2010 Leading Home Care - 2
3 How many feel that dealing with Health care Reform may be like being lost in the fog? Health Care Reform The Patient Protection And Affordable Care Act of 2010 Political Discussion (c) 2010 Leading Home Care - 3
4 To Cut Through the Fog of Health Care Reform, you must understand The Patient Protection and Affordable Care Act The Manager s Amendment Title X The Health Care and Education Reconciliation ACT of 2010 Executive Order Abortion restrictions The Social Security Act The Employee Retirement Income Act The Internal Revenue Code I m here to help. I stayed up late reading these laws so you don t have to. The new law consists of Ten Titles (c) 2010 Leading Home Care - 4
5 PPACA I. Quality, Affordable Health Care for All Americans II. Role of Public Programming III. Improving Quality and Efficiency of Health Care IV. Prevention of Chronic Disease and Improving Public Health V. Health Care Work Force PPACA Cont. VI. Transparency and Program Integrity VII.Improving Access to Innovative Medical Therapies VIII.CLASS Act IX. Revenue Provisions X. Strengthening Quality, Affordable Health Care for All Americans We ve organized the provisions that will have the greatest effect on home health care, hospice, and private duty homecare around Five Elements: (c) 2010 Leading Home Care - 5
6 Five Elements of Health Care Reform Universal Coverage Reimbursement Regulation Innovation Economic Impact Universal Coverage Individuals must purchase health insurance Employers must offer coverage or pay a penalty Insurance companies must offer revised coverage States must set up health benefit exchanges Universal Coverage Federal Judge Rules Against Individual Mandate Individuals must purchase health insurance Employers must offer coverage or pay a penalty Insurance companies must offer revised coverage States must set up health benefit exchanges (c) 2010 Leading Home Care - 6
7 Reimbursement Reform Revision to market basket adjustments for most providers Value-based purchasing for hospitals, home health, physicians\ Accountable Care Organizations Independence at Home demonstration Home Health Payment reductions Hospice Care Payment reforms Medicare Advantage payment freeze Care Management and Quality Performance bonuses Regulation The Secretary Shall Promulgate regulations Review and update Make reports on the Internet Establish uniform definitions Award grants Carry out a program 135 times in Title I alone, the law says The secretary shall Innovation Preventive services Creating Healthier Communities Health Care Workforce Improvement Training for Direct Care Workers Center for Medicare and Medicaid Innovation Independence At Home Demonstration Hospital Readmission Reduction Program (c) 2010 Leading Home Care - 7
8 Innovation (cont.) Community Based Transitions program Community Health Teams for Support of Patient Centered Medical Home Medication Management Services for Treatment of Chronic Conditions Patient Navigator Program Economic Impact Fees on Manufacturers and Importers of Prescription Drugs Fees on Health Insurance Providers Excise Tax on Sales of Medical Devices Change in Itemized Deduction for Medical Expenses Addition of Medicare Tax on wages and selfemployment Income Excise Tax on Indoor Tanning Salon Services Corporate Estimated Tax Payments Miscellaneous Provisions Exclusion of Qualified Health Care Benefits for Indian Tribe Members Credit for Therapy Discovery project Adoption Credit and Adoption Assistance Programs Black Liquor Carve-out for Cellulose Biofuel Producer Credit Economic Substance Doctrine Prohibition on Discrimination against Assisted Suicide. (c) 2010 Leading Home Care - 8
9 We ve surveyed the Home Care & Hospice Industry to identify the sections of the law that leaders are most concerned about Survey Participants Participants by Auspice (c) 2010 Leading Home Care - 9
10 Level of Awareness Methods for Learning Sources of Information (c) 2010 Leading Home Care
11 Biggest Opportunities Top Five Opportunities Remove Barriers Protect Benefits Hospital Readmissions Number Insured Independence at Home Other Big Positives (c) 2010 Leading Home Care
12 Top Five Positives Physician Assistants Remove Barriers to Preventive Services Preventive and Wellness Services Small Employer Credit Demonstration Project Biggest Threats Top Five Threats Increased Employer Responsibility Home Health Payment Adjustments Physician Face to Face Physicians in PECOS Market Basket Adjustments (c) 2010 Leading Home Care
13 Navigating the FOG Of Health Care Reform What Do I Need to Do First To Build My Organizational Road Map to Success? Anchor yourself on solid ground Your Leadership Team Your Mission and Values Your Business Model Your Financial Plan (c) 2010 Leading Home Care
14 Watch the Weather Forecast Attend conferences like this one Read analysis of the law Participate in your state and national associations Pay attention to new legislation and regulations Discuss the changes with your leadership team Assign Team Members to follow specific provisions of the law Focus your beacon Focus on Your Story Your Expertise Your Strengths Your Competitive Advantage Shine your light brightly Our Top Five Business Development Tools: Direct Sales Networking Public Relations Public Speaking Web Site (c) 2010 Leading Home Care
15 Be a port in the storm To be successful in home care, the services you provide and the experiences you create must Solve a problem Multiply Performance Create Peace of Mind and Quality of Life?? Questions???? Your Questions to Stephen@leadinghomecare.com Keepers (c) 2010 Leading Home Care
16 What Ever Happened To the Sunday Sailors Lost in the FOG? (c) 2010 Leading Home Care
17 Stephen C. Tweed, CSP CEO Leading Home Care a Tweed Jeffries company 9750 Ormsby Station Road, Suite 205 Louisville, KY (c) 2010 Leading Home Care
Advanced Strategic Planning in Home Health Care
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