Healthcare Reform: The Road Ahead
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Sharon R Williams,
Williams Jaxon Consulting, LLC
March 15, 2017
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Unknowns > Knowns
Regulatory/legislative resolution by new federal fiscal year
Healthcare industry reaction
State markets response
Implications for aging, disabilities and other HCBS
Medicare/Medicaid integrated care initiatives
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Affordable Care Act modifications
Medicaid
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Block grants
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Federal funding reduced
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State funding implications
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2016 Medicaid Mega Rules
Medicare
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Alternative payment models
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Dual Demonstrations
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Medicare Advantage
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Triple Aim
Improved quality outcomes
Better consumer experience with healthcare system
Reduction of healthcare costs
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Individual Mandate or Surcharge
Cost containment remains a key priority
Continuous Quality Improvement
More flexible benefit packages
Stabilization in Exchange markets
Medicare/Medicaid policy/funding
Taxes decreased
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Dual demonstrations
ACO performance
Medicaid managed care expansion, including MLTSS
Growth in Medicare Advantage enrollment
Payment reform
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Utilize regional/state healthcare market trends to re set
marketing plans
Increase in pressure to contain costs − opportunity for more
preventative services
Advocacy/Education is critically important
Potential Medicaid funding reductions
Eligibility limitations
Benefit reductions
Dollars redirected to other state services
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Stay informed about issues
NRCNA is a great resource
Advocate for person-centered policies local/federal
Tell compelling stories backed up with solid data
Identify/fortify with stakeholders
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Sharon R. Williams
Chief Executive Officer
Williams Jaxon Consulting, LLC
sharonr.williams@comcast.net
313-516-3326
The healthcare industry is navigating through uncertainties towards known regulatory changes, emphasizing quality outcomes, cost containment, and key industry initiatives like integrated care and payment reform. Stakeholders are advised to adapt to market trends, advocate for policy changes, and stay informed about emerging issues.
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Presentation Transcript
Healthcare Reform Are We There Yet?!! Sharon R Williams, Williams Jaxon Consulting, LLC March 15, 2017 1
The long and winding road Unknowns > Knowns Regulatory/legislative resolution by new federal fiscal year Healthcare industry reaction State markets response Implications for aging, disabilities and other HCBS Medicare/Medicaid integrated care initiatives 2
Healthcare Reform 2.0 Affordable Care Act modifications Medicaid o Block grants o Federal funding reduced o State funding implications o 2016 Medicaid Mega Rules Medicare o Alternative payment models o Dual Demonstrations o Medicare Advantage o ??? 3
Continued Emphasis on Quality/Performance Outcomes Triple Aim Improved quality outcomes Better consumer experience with healthcare system Reduction of healthcare costs 4
Implications for Healthcare Industry Individual Mandate or Surcharge Cost containment remains a key priority Continuous Quality Improvement More flexible benefit packages Stabilization in Exchange markets Medicare/Medicaid policy/funding Taxes decreased 5
Key Industry Initiatives Integrated Care Dual demonstrations ACO performance Medicaid managed care expansion, including MLTSS Growth in Medicare Advantage enrollment Payment reform More industry recognition of the value of Social Determinants of Health (SDOH) 6
Implications for YOU! Utilize regional/state healthcare market trends to re set marketing plans Increase in pressure to contain costs opportunity for more preventative services Advocacy/Education is critically important Potential Medicaid funding reductions Eligibility limitations Benefit reductions Dollars redirected to other state services 7
Keep Hope Alive!! Stay informed about issues NRCNA is a great resource Advocate for person-centered policies local/federal Tell compelling stories backed up with solid data Identify/fortify with stakeholders 8
THANK YOU!!! Sharon R. Williams Chief Executive Officer Williams Jaxon Consulting, LLC sharonr.williams@comcast.net 313-516-3326 9
