Professional Documents
Culture Documents
ACAPROVISIONRELATINGTOCARE
MandatesNationalQualityPlan
ThebillrequirestheHHSSecretarytodevelopa NationalStrategytoImproveHealthCareQuality to improvehealthoutcomesandefficiency,identifyareas forimprovement,addressgapsincomparative effectivenessinformationanddatagathering,and improveresearchanddisseminationofbestpractices. Thenationalhealthcarequalityplanandstrategy mustbeupdatedannually.
ACAPROVISIONRELATINGTOCARE
RequiresQualityMeasurementstoTrack AnnualQualityStrategy
ThebillrequirestheSecretaryinconjunctionwith AHRQandCMStodevelopqualitymeasuresconforming totheNationalQualityStrategy TheSecretarymust develop,andperiodicallyupdateproviderleveloutcome measuresforhospitalsandphysicians,including:
ACAPROVISIONRELATINGTOCARE
AcuteandChronicCareDiseaseMeasures
Billrequiresthedevelopmentof10specifichigh valueoutcomemeasurementsforacutecareand chronicdiseasesbyMarch2012,forthecountry.
ACAPROVISIONRELATINGTOCARE
PrimaryandPreventiveCareMeasures
Billrequiresthedevelopmentof10outcome measurementsforbothprimarycareand preventivecarebyMarch2013forthecountry.
ACAPROVISIONRELATINGTOCARE
ReducesHospitalAcquiredInfections PenalizesWorstHospitals
ReducesMedicarepaymentstohospitalsfor hospitalacquiredconditions,hospitalacquired infections,andpreventablereadmissions;imposes monetarypenaltyonhospitalswiththeworstrates ofhospitalacquiredconditions.
ACAPROVISIONRELATINGTOCARE
CreatesMedicaidHealthQualityMeasures
EstablishesMedicaidQualityMeasurementProgram, requiringstateMedicaidplanstoreportonstate specifichealthqualitymeasures,asdeterminedbythe HHSSecretary;requiresHHSSecretarytotest, validate,anddevelopthequalitymeasures.
ACAPROVISIONRELATINGTOCARE
CreatesQualityMeasuresforLongTerm Care,RehabandHospice
Createsaqualitymeasuresreportingsystemfor longtermcarehospitals,inpatientrehabilitation facilities,cancerhospitals,andhospiceprograms.
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ACAPROVISIONRELATINGTOCARE
CoordinatesQualityWorkfor23Federal Departments
CreatesanInteragencyWorkingGroup onHealth CareQualitytocoordinatequalityactivitiesacross 23federaldepartments.
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ACAPROVISIONRELATINGTOCARE
PaysHospitalsforPerformanceLevelsfor MultipleConditions
PromotesvaluebasedpurchasinginMedicareby payinghospitalsbasedonperformanceonquality measures forcommonandhighcostconditions, includingacutemyocardialinfarction,heartfailure, pneumonia,surgeries,andhealthcareassociated infections.(OnorafterOctober1,2012.)
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ACAPROVISIONRELATINGTOCARE
VariesPhysicianPaymentsBasedonthe QualityofCare
ModifiestheMedicarephysicianfeescheduleto incorporatepaymentsthatvarybasedonthequality ofcareprovided. Themodifierwillbeapplicableto specificphysiciansandphysiciangroups,as determinedbyHHS,beginningJanuary1,2015,and willapplytoallphysiciansandphysiciangroups startingJanuary1,2017.
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ACAPROVISIONRELATINGTOCARE
BestPracticeDisseminationandUse
Developsacollaborativeofhealthcareinstitutions responsiblefordeveloping,documentingand disseminatingbestpractices;implementingbest practiceswithininstitutionstodemonstrate improvedquality,efficiency;andproviding assistancetootherhealthcareinstitutionsonhow toemploybestpracticesandprovencaremethods.
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ACAPROVISIONRELATINGTOCARE
NewModelsforBetterEmergencyCare
DirectstheHHSAssistantSecretaryfor PreparednessandResponsetoawardgrantstopilot projectsthatdesign,implement,andevaluatenew modelsforemergencycare.Fundsemergency medicineresearch,pediatricemergencymedicine researchtoimprovetraumacentercapacity.
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ACAPROVISIONRELATINGTOCARE
ConsumerPortalWebsite
Createsawebsite,HealthCare.gov,toeducate consumersabouttheAffordableCareAct includinginsurancecoverageoptionsand informationonhealthcarequalityandpreventive care.
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ACAPROVISIONRELATINGTOCARE
ExtendsPhysicianQualityIncentives
ExtendsthePhysicianQualityReportingInitiative, aprogramthatmakesincentivepaymentsto physicianswhoreportqualitymeasuresdatato Medicare.
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ACAPROVISIONRELATINGTOCARE
CreatesClinicalEffectivenessInstitute
EstablishesthePatientCenteredOutcomes ResearchInstitute thatwillconductresearch comparingclinicaleffectiveness,appropriateness, andprocesses usedformedicaltreatmentsand procedures.TheInstitutesresearchwillassist patients,providers,purchasers,andpolicymakers inmakinginformedhealthdecisionsbasedon continuouslyimprovingthedeliveryofhealthcare, fullyinformedbydataabouttheeffectivenessof variousapproachestocare.
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ACAPROVISIONRELATINGTOCARE
UsesMedicareDatabaseForQuality Measurements
DirectstheHHSSecretarytomakestandardized extractsofMedicareclaimsdataavailable to qualifiedentitiesforanalysisofproviderand supplierperformanceonquality,efficiency,and effectiveness.
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ACAPROVISIONRELATINGTOCARE
ImprovesHomeBasedCarefor PatientswithMultipleConditions
EstablishestheCommunityBasedCare TransitionsProgram toimprovehomebased chroniccaremanagementforMedicare beneficiarieswithmultiplechronicconditions.
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ACAPROVISIONRELATINGTOCARE
CreatesHomeCareServicesforCertain MedicaidPatients
CreatestheCommunityFirstChoiceOption,which givesstatestheabilitytoofferhomeand communitybasedattendantservices tocertain Medicaidbeneficiaries.
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ACAPROVISIONRELATINGTOCARE
CreatesCollaborativeCareNetwork
EstablishestheCommunityBasedCollaborative CareNetwork Programtosupportproviders thatworkcollaborativelytocoordinatecarefor lowincomeandunderinsuredpopulations.
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ACAPROVISIONRELATINGTOCARE
CreatesInterdisciplinaryCareTeams
Establishesinterdisciplinarycommunityhealth teams,createdbygrantsandcontractstoeligible organizationsfromtheHHSSecretary,tofacilitate collaborationbetweenprimarycareprovidersand communitybasedprevention,patienteducation, andotherresources.
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ACAPROVISIONRELATINGTOCARE
CoordinatesCareforDualEligibles
CreatestheFederalCoordinatedHealthCare Office,anewofficewithintheCentersfor MedicareandMedicaidServicestoimprove coordinationofcarefordualeligibles individualswhoqualifyforbothMedicareand Medicaidcoverage.
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ACAPROVISIONRELATINGTOCARE
CreatesNationalCongenitalHeartCare TrackingProgram
CreatesaNationalCongenitalHeartDisease SurveillanceSystem totrackepidemiological dataonheartdiseaseandidentifyareasfor preventionandoutreach.
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ACAPROVISIONRELATINGTOCARE
EstablishesCentersofExcellenceFor Depression
EstablishesCentersofExcellenceforDepression anetworkoforganizationsdevelopingand implementingevidencebasedtreatmentand preventionstandards;fosteringcommunication withstakeholders;leveragingcommunity resources;andpromotinguseofelectronichealth recordstocoordinateandmanagetreatmentof depressivedisorders.
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ACAPROVISIONRELATINGTOCARE
CreatesNationalDiabetesReportCard
CreatesaNationalDiabetesReportCard: biennial,publiclyavailablereportofaggregate prevention,qualityofcare,riskfactors,and outcomesdatafordiabeticpatients.
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ACAPROVISIONRELATINGTOCARE
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ACAPROVISIONRELATINGTOCARE
FocusesonImprovingHospital UtilizationforMedicare
ExtendstheMedicareHospitalGainsharing Demonstration,whichevaluatesarrangements betweenhospitalsandprovidersaimedat improvingutilizationofinpatienthospital resources.
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ACAPROVISIONRELATINGTOCARE
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ACAPROVISIONRELATINGTOCARE
EstablishesPediatricAccountableCare Organizations
Establishesademonstrationprojectforpediatric ACOs.
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ACAPROVISIONRELATINGTOCARE
ProvidesInHomeCareforHighNeed MedicarePatients
CreatesanIndependenceatHomedemonstration program toprovideinhomeprimarycare servicesforhighneedMedicarepatients.Allows providerstoshareincostsavings.
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ACAPROVISIONRELATINGTOCARE
ACAPROVISIONRELATINGTOCARE
CreatesOfficeofWomensHealth
EstablishesanOfficeofWomensHealthwitha mandateforhelpingimprovehealthcarein Americaforwomen.
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ACAPROVISIONRELATINGTOCARE
CreatesOfficeofMinorityHealth
Establishesprogramstoimprovehealthand careforminoritypopulations.
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ACAPROVISIONRELATINGTOCARE
CreatesNationalEmergencyCareCorps
EstablishesaRegularCorpsandaReady ReserveCorpsoftrainedcaregiversavailable andreadytoserveinnationalemergencies.
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ACAPROVISIONRELATINGTOCARE
CreatesFundToInvestInPublicHealth ImprovementPrograms
EstablishesaPreventionandPublicHealthFund(PPHF) toinvestinpreventionandpublichealthprograms with thegoalofimprovinghealthandslowingtherateof growthinhealthcarecosts.
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ACAPROVISIONRELATINGTOCARE
EliminatesCostSharingforPreventive Services
Eliminatescostsharingforadefinedlistof medicallyappropriatepreventiveservices.
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ACAPROVISIONRELATINGTOCARE
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ACAPROVISIONRELATINGTOCARE
ProvidesGrantsforTobaccoCessation, WeightControl,HealthParticipation
Awardsgrantstostatesforprogramsthat incentivizeMedicaidbeneficiaryparticipationin tobaccocessation,weightcontrol,andother healthpromotionprograms tohelppreventor managechronicdisease.
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ACAPROVISIONRELATINGTOCARE
CreatesaProgramtoStabilizePatients withEmergencyPsychiatricConditions
CreatesaMedicaiddemonstrationprogram requiringstatestoreimbursequalifiedmental healthcareinstitutionsforservicestostabilize Medicaidbeneficiariesexperiencingan emergencypsychiatriccondition.
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ACAPROVISIONRELATINGTOCARE
RequiresHospitalCommunityNeeds Assessments
Requiresnonprofithospitalstoconduct communityneedsassessments,takinginto accountinputfromthecommunityservedbythe hospital,andadoptimplementationstrategiesto meetidentifiedneeds.
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ACAPROVISIONRELATINGTOCARE
PromotesEmployerBasedWellness Programs
Promotesemployerbasedwellness programs byprovidingtechnicalassistance, implementationsupport,andgrantstosmall employers.
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ACAPROVISIONRELATINGTOCARE
IncreasesFundingforCommunity HealthCenters,SchoolHealthCosts
Increasesfundingandprovidesdirectionto theNationalHealthServiceCorps,community healthcenters,schoolbasedhealthcenters, andnursemanagedclinics.
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ACAPROVISIONRELATINGTOCARE
StreamlinesAccesstoLongTermCarefor ElderlywithDisabilities
SupportsAgingandDisabilityResourceCenters aimedatstreamliningaccesstolongtermcare fortheelderlyandpeoplewithphysical,mental, ordevelopmentaldisabilities.
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ACAPROVISIONRELATINGTOCARE
EvidenceBasedCancerProgram
Createsanevidencebasednationaleducation campaigntoincreaseawarenessaboutbreast cancerpreventionandtreatment.
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ACAPROVISIONRELATINGTOCARE
CreatesDeliveryModelInnovations
CreatesanewCenterforMedicareandMedicaid Innovation(CMMI)withinCMStotestand evaluatepaymentandservicedeliverymodels that reducecostsandmaintainorimprovequalityof care.
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ACAPROVISIONRELATINGTOCARE
PromotesandEvaluatesMedicalHomes
Patientcenteredmedicalhomes willbeevaluatedin primarycaresettingswiththegoalofproviding coordinatedteamcaretopatientswithmultiple healthconditions.
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ACAPROVISIONRELATINGTOCARE
CreatesDirectContractingPilots
Createspilotprogramstotestdirectcontracting modelswithproviders,services andsuppliers to reducethecostsofcareandmaketheunitcosts ofcaremoreaffordable.
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ACAPROVISIONRELATINGTOCARE
TestsComprehensiveCarePlansand GeriatricAssessmentTools
Createspilotprogramstotesttheeffectiveness ofutilizinggeriatricassessmentsand comprehensivecareplanstocoordinatecarefor patientswithmultiplechronicconditions.
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ACAPROVISIONRELATINGTOCARE
SalaryBasedCareGiverPilotPrograms
Promotingcarecoordinationbetweenproviders andsupplierstofacilitatethetransitionaway frompurefeeforservicereimbursementand towardsalarybasedpaymentapproachesfor keycaregivers.
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ACAPROVISIONRELATINGTOCARE
CreatesCareSupportToolsBuiltOn HealthCareITCapabilities
Pilotwilltestsupportingcarecoordinationfor chronicallyillpatientsthroughtheuseofhealth ITenabledprovidernetworks,includingcare coordinators,achronicdiseaseregistry,layersof caregiver/patientconnectivityandhome telehealthtechnology.
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ACAPROVISIONRELATINGTOCARE
TestsPaymentModelsBasedon AppropriatenessofService
Adjustspaymentmethodologiesto physiciansorderingdiagnosticimaging servicesbasedonthemedical appropriatenessoftheserviceordered.
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ACAPROVISIONRELATINGTOCARE
EvaluatesTherapyManagementApproaches
Establishesprogramstoevaluate medicationtherapy managementservicesintended toimprovepatient useofmedication.
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ACAPROVISIONRELATINGTOCARE
AssistingPrimaryCareDoctorswith ChronicCareManagement
Establishingcommunitybasedhealthteams that functiontoassistprimarycareprovidersin chroniccaremanagementforpatientswhose medicalconditionsrequireteamcare.
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ACAPROVISIONRELATINGTOCARE
FacilitatesBetterInformedPatient Choices
Establishespilotprogramstoassistpatientsin makinginformedhealthcarechoices bypaying providersforusingpatientdecisionsupporttools.
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ACAPROVISIONRELATINGTOCARE
AllowsStateInnovationforDual EligiblePrograms
Allowsstatestotestandevaluatemodelsforthe integrationofcare fordualeligibles.
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ACAPROVISIONRELATINGTOCARE
TestsAllPayerFeeApproaches
ACAallowingstatestotestandevaluatesystems ofallpayerpaymentreform.
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ACAPROVISIONRELATINGTOCARE
PromotesEvidenceBasedCancerCare Approaches
Promotesthealignmentofevidencebased guidelinesofcancercare withpaymentincentives forprofessionaltreatmentplanningandoptimal followupcare.
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ACAPROVISIONRELATINGTOCARE
CoordinatesPostAcuteCare
Establishespilotstoimprovepostacutecare throughcontinuingcarehospitals,longterm carehospitals,homehealth,andskillednursing care toimprovepatienthealthstatusaftera hospitaldischarge.
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ACAPROVISIONRELATINGTOCARE
HomeHealthforChronicCare
Setsuppilotstofundhomehealthprovidersof chroniccaremanagementservicestohelp improveteamcareforchroniccarepatients.
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ACAPROVISIONRELATINGTOCARE
SupportsElectronicMonitoringby Specialists
Supportsimprovementsin inpatientcare through theuseofmodern,patientfocusedelectronic monitoringbyspecialists.
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ACAPROVISIONRELATINGTOCARE
SupportsDirectReferralsforOutpatient Services
Pilotwilltestefficiencyandaccesstooutpatient servicesthoughmodelsthatdonotrequirea providersreferralfortheservice.
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ACAPROVISIONRELATINGTOCARE
TestsHealthcareInnovationZone PaymentApproaches
EstablishesHealthcareInnovationZonepayment pilots teachinghospitals,groupsofproviders,and otherclinicalentitiesthat,throughtheirstructure, deliverintegratedandcomprehensivehealth services whileincorporatinginnovativemethodsfor theclinicaltrainingoffuturehealthcare professionals.
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ACAPROVISIONRELATINGTOCARE
EstablishesNewTherapiesTaxCredit
ProvidesanEncouragingInvestmentinNew Therapiestaxcredit toencourageinvestmentsin newtherapiestopreventanddiagnoseacute andchronicdiseases.
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ACAPROVISIONRELATINGTOCARE
CreatesCuresAccelerationNetwork
EstablishestheCuresAccelerationNetworkin theOfficeoftheDirectorofNIHthatwillaward grantsandcontractstoacceleratethe developmentofproductsandtherapiestocure certainhighneedconditions.
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ACAPROVISIONRELATINGTOCARE
FostersTeamManagementofMedications
Awardgrantsandcontractstoimplement collaborativemedicationmanagementservices, wherepharmacistsandotherproviderswould formulatetreatmentplans,preventadversedrug interactions,andeducatepatientsandcaregivers onthemanagementofchronicdiseases.
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ACAPROVISIONRELATINGTOCARE
CreatesBiosimilarLicensing
Establishesaformallicensingprocessfor approvingbiosimilartherapeutics,withdata exclusivityperiods.
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ACAPROVISIONRELATINGTOCARE
EncouragesMalpracticeLitigation Alternatives
Awardsfiveyeardemonstrationgrantstostates todevelop,evaluate,andimplementalternatives tocurrentmedicalmalpracticelitigation.
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ACAPROVISIONRELATINGTOCARE
CreatesComparativeDatabasefor PhysicianPerformance
CreatesPhysicianCompare,awebaccessible databaseofperformance,effectiveness,safetyand otherassessmentsofproviders whoparticipatein MedicarePhysicianQualityReportingInitiative.
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ACAPROVISIONRELATINGTOCARE
RequiresFinancialDisclosureswith ProvidersandSuppliers
Requiresopendisclosureoffinancial relationshipsbetweenhospitals,providers,and manufacturersanddistributorsofdrugsand medicaldevices.
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ACAPROVISIONRELATINGTOCARE
CreatesOwnershipTransparency Requirements
RequiresMedicareandMedicaidnursing facilitiestodiscloseownership,expenditureand certificationinformation.
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ACAPROVISIONRELATINGTOCARE
CreatesEnhancedDatabaseonPatient Populations
Requiresenhancedcollectionandreportingof patientpopulationdataonrace,ethnicity,sex, primarylanguageanddisabilitystatus inall federallyconductedorsupportedhealthcareor publichealthprograms.
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ACAPROVISIONRELATINGTOCARE
CreatesNationalOfficeofHealth InformationTechnology
FormallyestablishestheOfficeoftheNational CoordinatorforHealthInformationTechnology tooverseedevelopmentandsupportfora nationalhealthinformationnetwork.
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ACAPROVISIONRELATINGTOCARE
StrengthensDataPrivacy
Strengthenshealthinformationprivacyand securitystandards.
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ProvidesFinancialSupportforHealth CareITAdoption
Authorizesgrantstoassiststateandlocal governmentsandhealthcareprovidersin adoptingandusinghealthIT.
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CreatesHealthCareWorkforceCommission
EstablishesanationalHealthCareWorkforce Commissionof15members,appointedbytheU.S. GovernmentAccountabilityOffice,todevelopa nationalhealthcareworkforcestrategy.
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ACAPROVISIONRELATINGTOCARE
IncreasestheNumberofNurses
Increasesthenurseworkforcethoughtraining programs,loanrepaymentandretentiongrants.
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ACAPROVISIONRELATINGTOCARE
RefocusesGraduateMedicalEducation Priorities
RedistributesunusedGraduateMedical Educationtrainingpositionstowardprimary care,generalsurgery,andmedically underservedgeographicareas.
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ACAPROVISIONRELATINGTOCARE
SupportsRecruitmentofProvidersto RuralAreas
Providesbonuspaymentsandgrantsfor recruitmentandtrainingofproviders toservein ruralandunderservedareas.
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ACAPROVISIONRELATINGTOCARE
SupportsDeliveryReformInitiatives
Supportsdevelopmentoftrainingprograms focusedonprevention,publichealth,primary care,medicalhomes,teammanagementof disease,andintegrationofmentalandphysical healthservices.
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StageOneGuaranteedIssue
BillCreatesImmediateAccessto GuaranteedCoverageforHighRiskPatients inEveryState
Guaranteedcoveragecanbeaqualityofcare issue.EverystatenowhasinplaceaPCIP(pre existingconditioninsuranceprogram)runbythe stateorthefederalgovernment.Noonein Americaisuninsurablerightnow.Highrisk patientscannowgetcoverage thereby improvingthelikelihoodthathighriskpatients willreceivebettercare.
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