| Health System Reform |
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On March 23, President Obama signed the Patient Protection and Affordable Care Act into law. The following points out the key provisions of the legislation that impacts provider practices and patients, respectively. |
| Impact on Providers |
Medicare Payment Changes
- 10% incentive payments for primary care physicians - family medicine, general internal medicine, geriatrics and pediatrics. Timeline: 2011-2016.
- 10% incentive payments for general surgeons performing major surgery in health professional shortage areas. Timeline: 2011-2016.
5% incentive payment for mental health services. Timeline: 2010.
Medicaid Payment Changes
- Raise Medicaid payments to family medicine physicians, general internists and pediatricians for evaluation and management services and immunizations to at least Medicare rates. Timeline: 2013 & 2014.
- Employers with more than 50 employees are required to offer health insurance coverage to their employees or be assessed a range in fees. Employers with 50 employees or less are exempt from this requirement. Timeline: 2014.
Preventive & Screening Benefit Expansions
- Medicaid will be required to cover tobacco cessation services for pregnant women. Medicare payments for certain preventive services will be increased to 100% with no cost-sharing (i.e., co-payments will be eliminated). Timeline: 2010.
General Changes
- Health plans will be required to provide a minimum level of coverage without cost-sharing for preventive services such as immunizations, preventive care of infants, children and adolescents, and additional preventive care and screenings for women. Timeline: 2010.
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