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How Does Health Care Reform Impact Hospitals?

Provisions of the Affordable Care Act that most impact hospitals are: 

  • Expansion of health care coverage for uninsured individuals
  • Changes to Medicare and Medicaid payments to hospitals and other providers
  • Establishment of programs to improve the cost-effective delivery of quality care

Helping Pennsylvanians Find Insurance Coverage

Implementation of health care reform is well underway as the health insurance marketplace for individuals and small businesses seeking affordable health insurance is established, and states are allowed to expand eligibility for Medicaid health coverage to low-income working adults and their families.   

As Pennsylvanians shop for coverage through the state’s federally facilitated marketplace, they can get help from a number of organizations designated as navigators, in-person assistance personnel, or certified application counselors.   

HAP and DVHC of HAP are working with the Pennsylvania navigators to educate and assist hospitals and health systems in supporting individuals seeking health insurance coverage through the insurance marketplace.   

HAP continues to monitor the enrollment process for Pennsylvanians, and works with its member hospitals on educating consumers and employers about opportunities to secure affordable health insurance coverage. 

In addition, as the public, policymakers, and the media debate the meaning of Medicaid expansion in the context of the Governor’s Healthy PA initiative to reform the Medicaid program, hospitals remain focused on expanding coverage for more Pennsylvanians.

HAP Working With State Agencies on Health Care Delivery System Reform

An integral part of health care reform is the transformation of the health care delivery system to one that focuses simultaneously on three aims: better health, better care, and lower costs.

In an effort to achieve this objective, many new models of care are being developed and implemented, including accountable care organizations, bundled payment initiatives, patient-centered medical homes, and population health management.

Pennsylvania received a grant to develop a health care plan designed to foster approaches to care and payment that improve access, management of chronic disease, and coordination of care. HAP is working with the Pennsylvania Department of Health and the Department of Public Welfare on the development of the new care model.


Insurance Marketplace Resources:

PA Consumer Marketplace Website
Apply for coverage, compare plans, and enroll

CMS Information and Resources about Health Insurance Marketplace
Resources for professionals to help people apply for coverage

CMS Fact Sheet
Ten things providers need to know

CMS Fact Sheet
Ten Things to Tell Your Patients

Kaiser Family Foundation Issue Brief
Insights for preparing for outreach and enrollment

Certified Application Counselor Resources:

Applications for Interested Organizations
Apply online at CMS website to be a certified application counselor organization

Pennsylvania Navigators:

Resources for Human Development
Provides enrollment assistance in the ten counties in Pennsylvania with the highest rates of uninsured

Pennsylvania Association of Community Health Centers
Coordinates enrollment assistance efforts in underserved areas throughout the commonwealth using a connected and networked approach

Pennsylvania Mental Health Consumers' Association
Provides assistance to people who use or need behavioral health services, particularly those who experience serious mental illness or serious psychological distress

Mental Health America
Targets underserved individuals with behavioral health disorders who are uninsured or underinsured

Implementation Resources:

State Legislative Tracking Database
Legislation related to health care reform tracked by the National Conference of State Legislatures

Healthcare.gov Implementation Center
Highlights key features of the ACA such as coverage, costs, and care

Related News

March 19, 2015

DHS Publishes Notice for New Adult Benefit Plan for Medicaid Expansion

The Pennsylvania Department of Human Services (DHS) posted an advance copy of the public notice it will file with the Centers for Medicare & Medicaid Services (CMS) indicating its intent to submit a state plan amendment to create the new Medicaid Adult benefit plan.

March 17, 2015

U.S. House Majority Releases FY 2016 Budget

The U.S. House Budget Committee unveiled its proposed budget resolution for fiscal year (FY) 2016. The budget would reduce spending by $5.5 trillion during the next ten years to balance the federal budget.

March 11, 2015

HHS Releases Updated Open Enrollment Data

The U.S. Department of Health and Human Services (HHS) issued updated data about the 2015 open enrollment period for the health insurance marketplace (both federal and state).

View all Health Care Reform News

Related Blogs

November 19, 2014

Availability Does Not Ensure Access: Unlocking Pennsylvanians’ Access to Health Insurance

The Affordable Care Act (ACA) has made health insurance available to millions of Americans. But making coverage available to individuals doesn’t ensure access.

August 29, 2014

Let’s Not Wait for Uninsured Young Adults to Grow Up

We all know the data. Adults who are working comprise the majority of uninsured. For Pennsylvania, approximately 20 percent of the uninsured are young adults (ages 19-25) are uninsured.

January 30, 2014

If You Build It…Will They Come?

A new national survey of the uninsured has revealed that creating healthcare.gov––glitches or no glitches––was not a sure bet to getting the uninsured engaged and enrolled.

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