Deloitte's take on US healthcare reform

 

The Deloitte Center for Health Solutions has teams of people studying US healthcare reform. Deloitte has yet to provide a view on how the reforms will affect medical tourism, but has offered an independent and balanced view of the overall impact of healthcare reform in the USA.

Paul Keckley of Deloitte’s Center for Health Solutions comments;
” Health reform—HR3590 and HR4872—is now the law of the land. It features expansion of coverage to 32 million currently uninsured, regulatory changes to control premiums and competition for insurance plans, delivery system reforms to coordinate care and reward value instead of volume, and mechanisms to bridge gaps between human services programs and health care especially for underserved populations.”

“ The impact of insurance reforms combined with new industry taxes will likely increase premiums above the underlying cost of health for most Americans. And the physician fix is not fixed even as economic recovery is slower than hoped. Curve-bending resulting from delivery system reforms—integrated health systems, evidence-based medicine, the medical homes, pay for performance, primary and preventive health—combined with a dose of personal accountability for healthier living and adherence to recommended treatments—are delayed in the bill so we’ll likely not know until after the decade is past. Though promising and logical, unknowns prevail.”

“ Will quality of care improve? Conceivably the deployment of health care information technology, implementation of comparative effectiveness, transparency of outcomes and satisfaction will increase its likelihood. And the promise of widespread use of electronic health records with personal health records is worth serious pursuit.”

“ Health reform requires finding middle ground on complex issues for which trade-offs are necessary. It means changes for everyone including regulators, industry leaders, and consumers.’

“The events of the past year hopefully will lead us on a path to fundamental improvements in the U.S. health system that improve quality, rein in unsustainable costs, and eliminate disparities in access. The health care industry will thrive because it’s too important to fail.”

The 2010-2011 changes most noticeable to consumers include:
• Medicaid expansion: States may increase eligibility threshold to 133 percent of the federal poverty level (mandated by 2014)
• Tax credits for small businesses: Businesses with 25 or fewer employees and average wages of less than $50,000 can qualify for a tax credit of up to 35 percent of the cost of their premiums
• Dependent coverage: Parents are allowed to keep children on their health insurance until age 26 if the child is ineligible for coverage through an employer
• High-risk pools: In the next 90 days, individuals with pre-existing conditions that left them uninsurable for the last six months may enroll in a new high-risk insurance program subsidized by the federal government and administered by the states
• Risk assessments and preventive health plans for seniors: Effective 2011, Medicare enrollees will be provided a comprehensive risk assessments and personalized prevention plans as part of the program
• Insurance industry regulatory changes: Lifetime caps eliminated, rescission of coverage for other than fraud eliminated, mandatory reporting of medical loss ratios, and elimination of pre-existing condition as a basis for coverage for children under two years of age (begins for adults in 2014)

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