By Linda L. Fleming and T.J. Ferrante

Health care reform remains a hot topic as the Patient Protection and Affordable Care Act,[1] commonly referred to as the Affordable Care Act, continues to reshape America's health care landscape. The upcoming U. S. Supreme Court hearing on the constitutionality of the Affordable Care Act will again focus attention on health care, as federal and state governments implement new provisions of the law that seek to improve the efficiency and quality of the health care system. Below is a timeline of what lies ahead for health care reform in 2012. 

JANUARY 2012

Accountable Care Organizations in Medicare:

• On January 1, the Affordable Care Act started providing a financial incentive for physicians, hospitals and health care providers that voluntarily join together to form Accountable Care Organizations, or ACOs, and coordinate care for patients with original Medicare. Under the law, those that demonstrate improved quality and outcomes in care, lower costs and patient priority will share the savings with the Medicare system. If ACOs provide high quality care and reduce costs to the health care system, they can share in some of the savings.
• On December 19, 2011, the Department of Health and Human Services announced 32 health care organizations that will participate in the new Pioneer Accountable Care Organization initiative under the Affordable Care Act.
• Effective January 1, 2012

MARCH 2012

Understanding and Fighting Health Disparities[2]:

• The ACA contains several provisions aimed at improving data collection and reporting procedures, explicitly to track and reduce health disparities. Perhaps most significantly, by March 2012, all federally-funded health programs and population surveys will be required to collect and report data on every patient’s race, ethnicity and language (REL) and other demographic characteristics using standards identified by the Department of Health and Human Services (HHS) as most appropriate for reducing disparities.
• Effective March 23, 2012

OCTOBER 2012

Value-Based Purchasing[3]:

• The Affordable Care Act establishes a hospital Value-Based Purchasing program (VBP) in Original Medicare. This program offers financial incentives to hospitals to improve the quality of care. Under VBP, hospitals will be evaluated and be required to publicly report on 17 process-of-care measures, claims-based measures, structural measures and patient experience measures as indicated by the Hospital Consumer Assessment of Healthcare Providers and Systems survey.[4]
• Effective for payments for discharges occurring on or after October 1, 2012

Reducing Paperwork and Administrative Costs:

• New regulations go into effect in 2012 that will increase the use of electronic health records (EHR). These will “institute a series of changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care.”[5]
• First regulation effective October 1, 2012

Long-Term Care Insurance (CLASS):

• CLASS - a voluntary long-term care insurance program created by the reform law – was slated to launch in October 2012. However, the Obama administration recently announced the CLASS program would not launch on time as it remains fiscally unsustainable.

[1] Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010)

[2] PPACA §4302(a)

[3] PPACA § 3001. Hospital Value-Based Purchasing Program

[4] The Secretary of HHS is required to ensure that the measures are related to the Hospital Consumer Assessment of Healthcare Providers and Systems survey and cover at least the following 5 specific conditions or procedures: Acute myocardial infarction; Heart failure; Pneumonia; Surgeries, as measured by the Surgical Care Improvement Project; Healthcare-associated infections, as measured by the prevention metrics and targets established in the HHS Action Plan to Prevent Healthcare-Associated Infections (or any successor plan) of the Department of Health and Human Services.

[5] “The Affordable Care Act – Implementation Timeline,” http://www.whitehouse.gov/healthreform/timeline