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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Coverage and Delivery Expansion

Coverage Expansion | Demonstrations and CMMI | HIT | Patient Care Quality

The Affordable Care Act (ACA) calls for new programs and initiatives that will transform how healthcare is delivered. Innovative pilot programs specified in the legislation, such as accountable care organizations (ACOs), are currently being implemented. The ACA also created the Centers for Medicare and Medicaid Innovation (CMMI), which is tasked with developing and funding demonstration projects to improve the quality of care for patients. CMMI launched programs such as the Pioneer ACO, Bundled Payments for Care Improvement, and the Health Care Innovation Challenge.

The ACA also establishes new requirements for health insurance coverage. Starting in 2014, consumers and small businesses will be able to purchase coverage through state-level exchanges. These exchanges will offer insurance options, aid consumers in selecting plans, and coordinate eligibility for premium tax credits. Also in 2014, Medicaid will expand to cover those at or below 133 percent of the federal poverty level.

Related: Geographic Variation | Inpatient Prospective Payment System

News and Updates

AAMC Opposes Senate Health Care Reform Bill

June 23, 2017

The Senate June 22 released a discussion draft of its health care reform bill, the Better Care Reconciliation Act of 2017 (BCRA). The bill would dramatically restructure Medicaid financing, modify the premium tax credits, and loosen 1332 waiver requirements, among other provisions.

HHS OIG Releases Updated Work Plan

June 16, 2017

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) June 15 released its updated work plan, which sets forth several different projects – including OIG audits and evaluations that are underway or planned – to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of Evaluation and Inspections. The work plan was last published November 2016.

AAMC Submits Comment Letter to CMS to Delay Episode Payment Models

April 21, 2017

The AAMC April 19 submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the delay of Episode Payment Models (EPMs) under the interim final rule with comment period.

House Republican Leadership Introduces and Advances American Health Care Act

March 10, 2017

The House Ways and Means and Energy and Commerce Committees March 6 introduced the American Health Care Act, which repeals significant portions of the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) and changes the Medicaid financing structure.

CMS Releases Affordable Care Act Market Stabilization Proposed Rule

February 17, 2017

The Centers for Medicare and Medicaid Services (CMS) Feb. 15 released the Patient Protection and Affordable Care Act Market Stabilization proposed rule, which proposes reforms to stabilize the individual and small group health insurance markets. Most of the policies will be effective for the 2018 plan year, but some could be implemented in 2017. 

On Government Affairs

Testimony and Correspondence

External Resources