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Coverage and Delivery Reform

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.

Court Update: What You Should Know About the Recent Circuit Court Rulings on the ACA, the IRS, and Tax Subsidies 

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 | Requirements for 501(c)(3) Hospitals

New Coverage and Delivery Reform Resources

What You Should Know About the Recent Circuit Court Rulings on the ACA, the IRS, and Tax Subsidies

July 25, 2014

An update on the Affordable Care Act (ACA) court cases that challenged the Internal Revenue Service (IRS) rules allowing tax credits for individuals in both state-established and federally-established exchanges

News and Updates

AAMC Joins Community Letter Opposing ‘Right to Try’ Legislation

March 16, 2018

The AAMC March 12 joined 85 organizations in a community letter opposing the latest version of the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act, legislation that would create a secondary pathway for accessing investigational therapies outside of clinical trials that would remove Food and Drug Administration (FDA) approval and consultation.

AAMC Comments on Association Health Plan Proposed Rule

March 9, 2018

The AAMC March 5 submitted comments on the Department of Labor’s (DOL) proposed rule on association health plans (AHPs).

AAMC Signs Community Letter Questioning Anthem Payment Policies

March 9, 2018

The AAMC March 5 signed a hospital community letter to Anthem asking the insurer to abandon coverage policies for outpatient imaging and emergency care services that could diminish access to care.

On Patient Care

Testimony and Correspondence