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Coverage and Delivery Reform

Coverage Expansion | Demonstrations and CMMI | 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

Final Rules Released on Religious and Moral Exemptions and Accommodation for Coverage of Contraceptive Services Under ACA

November 9, 2018

The Departments of Health and Human Services, Treasury, and Labor Nov. 7 issued two final rules to provide broader conscience protections for entities and individuals who have religious or nonreligious moral objections to health insurance that covers contraceptive methods and/or sterilization procedures, and whose health plans are subject to the mandate of contraceptive coverage as preventative health services through guidance issued under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152).

AAMC Submits Comments on CMS’s Medicare Shared Saving Program ACO Proposed Rule

October 18, 2018

The AAMC Oct. 16 submitted comments on the Centers for Medicare and Medicaid Services’ (CMS) “Accountable Care Organizations – Pathways to Success” proposed rule, which would make significant changes to the Medicare Shared Savings Program (MSSP).

AAMC Comments on the MSSP Proposed Rule

October 16, 2018

The AAMC submits comments to the Centers for Medicare & Medicaid Services (CMS) in response to the Agency’s proposed rule entitled “Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations – Pathways to Success,” 83 Fed. Reg. 41786 regarding significant proposed changes to the MSSP.

On Patient Care

Testimony and Correspondence