Affordable Care Act Posts

Transformative Behavioral Health Consultation Services – Why Now?

Tuesday, April 28th, 2015

Doctor_women_in_pinkHealthcare is at its most disruptive point since the 1980s when DRGs were implemented. At the center of the disruption is the ACA, which has turned our healthcare payment systems upside down. Healthcare leaders are now charged with developing systems to right-size reduced reimbursement with new care-delivery models.

At the center of the ACA is the mandated connection with mind and body, which has led to population management models requiring accountability for the whole person. There has never been a time when healthcare leaders have sought so much from the behavioral health field. In a recent CHA survey asking what keeps hospital CEOs up at night, the problem of psychiatric patients in their units and EDs was in the top three responses. The issue of having too many psychiatric patients has been ignored for too long. Innovative strategies are needed to develop new and different ways to treat these patients better and to turn the problem into an opportunity.


Healthcare Organizations Can Expect Financial Pinch in 2014

Wednesday, January 15th, 2014

The Patient Protection and Affordable Care Act (PPACA) is a game changer for hospital and health system revenues, costs, and operations. In addition, legislative and regulatory actions, as well as industry trends, will produce a challenging economic landscape for providers in 2014. HFS executives provide insight on the significant changes and trends that healthcare organization executives can expect in 2014.

CEO Insight on the Affordable Care Act
Trahan WhittenThe largest issue facing healthcare organizations is the multi-faceted impact of the PPACA on both revenues and expenses. Revenues are decreasing dramatically from both Medicare and Medicaid (Medi-Cal), which do not even cover the cost of care to their beneficiaries. At the same time, insurance companies are demanding lower rates and eliminating providers from their networks, which cannot compete on costs. This will place a premium on healthcare organizations’ ability to manage cost reduction, both labor and non-labor and to achieve revenue recovery in 2014. HFS is perfectly positioned to help accomplish these difficult competing priorities.

Trahan Whitten


What is the Patient Centered Medical Home?

Monday, October 14th, 2013

“Patient Care Medical Home” is a term that coincides with the Patient Protection and Affordable Care Act’s (ACA) emphasis on enhancing the role of primary care.

Medical-home-231x300Clinics such as Federally Qualified Health Centers (FQHC), rural health clinics (RHC), and some hospital outpatient departments (such as 1206-d clinics), frequently function as safety net providers and the medical access point for their communities. As a result, they evolve into the base “medical home” for local residents. This initial access point of care makes them an ideal starting point for developing a patient relationship that can be expanded to other areas of care.

By obtaining more information about each patient at the initial point of contact, asking the right questions, and entering the information into a now required electronic medical records system, clinics have opportunities for improving how they coordinate patient care. This data becomes a key component in understanding the needs of each patient, assisting in better care planning and allows for future sharing of information with other providers as needed.


Healthcare Reform Impacts FQHCs and RHCs in California

Tuesday, May 14th, 2013

PatientSignInAmong the changes mandated in the Affordable Care Act is the expansion in the next few years of Medi-Cal eligible patients. As part of the implementation of California’s Medi-Cal program, Medi-Cal managed care will be arriving in the 25 counties not currently using the plan. This now goes into effect on September 1, 2013. For those already enrolled in managed care plans, there are significant changes in the annual reporting.


Affordable Care Act Brings New Medi-Cal Programs

Friday, March 22nd, 2013

waitingRoomAs California begins to implement the Affordable Care Act (ACA), Medi-Cal is experiencing a re-design of its programs and delivery system.
The Department of Health Care Services (DHCS), in partnership with the Centers for Medicare and Medicaid Services (CMS), has initiated special waiver and demonstration programs designed to bring the state in line with the goals of federal healthcare reform.

The state is proactively moving toward healthcare reform using the Medi-Cal managed care network as a key element, and re-configuring many programs with the Medi-Cal managed care delivery system at the core.

Re-designed Medi-Cal programs in 2013 include:

Medi-Cal Managed Care Rural Expansion


Community Health Needs Assessments (CHNA) Requirements

Monday, March 11th, 2013

paperworkThe Community Health Needs Assessment is a provision of the Affordable Care Act. It is a requirement for all non-profit, non-governmental hospitals that file IRS Form 990; it is a public document that must be posted on a hospital’s website.

The CHNA requirements become effective starting with the first tax year beginning after March 23, 2012, and must be filed every three years.

Specific community healthcare needs and how the hospital is meeting them must be identified by the CHNA. The hospital must also develop action plans to meet the needs of the community, monitor them and report progress on their implementation.

Specific CHNA requirements: (more…)

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