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Initiatives

Research

HAP Overview
Insurers on PA federal marketplace


HAP/DVHC Overview
Pennsylvania rating areas and premiums


Talking Points: Pennsylvania’s Health Insurance Marketplace
Ten things hospitals should explain to patients, communities, and reporters


Comment Letter to CMS
On health plan payment for services during grace period for nonpayment of premiums


Comment Letter to CMS
Proposed rule implementing ACA aggregate reductions to state Medicaid DSH allotments


Comment Letter to IRS
Proposed rule on community health needs assessments for charitable hospitals


Letter to PA Insurance Dept
On three-month grace period


Q & A on Designation of Certified Application Counselor
Questions and answers on becoming a certified application counselor


Timeline for Major Provisions in Health Care Reform
HAP timeline overview of health care reform provisions impacting hospitals


CFO Memo 13-15
Hospitals can apply to be certified application counselors for the federally facilitated marketplace


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.

Resources

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

April 22, 2014

Study of Accountable Care Organization Outpatient Care Suggests Accountability Challenges

About one-third of Medicare beneficiaries assigned to accountable care organizations during 2010 or 2011 were not assigned to the same accountable care organization in both years, and much of the specialty care received was provided outside the patients’ assigned accountable care organization, suggesting challenges to achieving organizational accountability, according to a study by JAMA Internal Medicine.


April 18, 2014

White House Reports Enrollment in Health Insurance Marketplace Reached 8 Million

The White House released updated enrollment numbers during a press conference this week, reporting that 8 million people signed up for health coverage through the health insurance marketplace.


April 04, 2014

Insurance Enrollment through Marketplace Decreased Pennsylvania Uninsured

With the institution of the insurance marketplace and other Affordable Care Act provisions, the goal of expanding coverage to the uninsured is being achieved according to a recent report from the Urban Institute.


View all Health Care Reform News

Related Blogs

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.

January 10, 2014

New Future for Behavioral Health Care—Where Are We Headed?

The health care community has long-struggled to find the best way to effectively care for behavioral health patients.

View All Health Care Reform Blogs

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