Healthcare reform
Premier healthcare alliance members are setting the standard for performance improvement through industry-leading collaboratives:
QUEST® is a hospital's insurance policy for healthcare reform. Over two years, QUEST member hospitals have saved 22,164 lives and $2.13 billion in costs.
Premier's Accountable Care Implementation and Accountable Care Readiness Collaboratives give participating members the forum and the resources to define patient population care for their respective communities while driving top performance goals for improved patient outcomes and cost effectiveness.
In the reform decade, clinical quality, operational efficiency, and financial performance are inseparable. Pay for performance and penalties for preventable events will further accelerate existing financial pressures.
Change must start now.
Health reform resource center
These are historic times in Washington and among our country's healthcare providers and consumers. After a century of discussion and debate, reform has passed. Our future will be impacted personally and professionally for years to come. We are entering what is likely to be a decade of transformational change. To help you prepare for the strategic implications of reform provisions, Premier offers a wealth of resources, listed below, including recordings and material from our Advisor Live® sessions on reform, material from our health reform executive briefing sessions held throughout the spring and summer of 2010, as well as a wide variety of other resources.
Listed below:
- Advisor Live sessions
- Summaries and side-by-side comparisons
- Major reform provisions impacting hospitals
- Reform timelines
- Legislative resources
- Fact sheets
- Regulations implementing the Patient Protection and Affordable Care Act
- Other resources
Advisor Live sessions
Premier's Advisor Live is a webinar series that provides discussion on timely topics and best practices in healthcare. Everyone is invited to attend. There is no charge to participate. Reform topics include legislation overviews, accountable care organizations (ACOs), electronic medical records, hospital-acquired conditions, readmissions and value-based purchasing. Visit www.premierinc.com/advisorlive to register for upcoming programs and to download archived presentations and recordings.
Resources
Summaries and side-by-side comparisons:
- Premier Accountable Care Collaborative (5/31/11)
- Premier comprehensive summary of healthcare reform legislation (Updated 4/26/10)
- Premier summary of rural health provisions in reform bill (04/08/10)
- Premier summary of quality provisions in reform bill (4/2/10)
- Premier side-by-side summary of disparity provisions in healthcare reform legislation (5/10/10)
- Premier summary of pilot programs, demonstration projects and grants in reform bill
- Alston & Bird side-by-side summary of healthcare reform legislation (3/26/10)
- Kaiser Family Foundation side-by-side comparison of healthcare reform bills
Major healthcare reform provisions impacting hospitals - PowerPoint
- Premier healthcare reform implementation tracking charts (Updated 2/1/12) (password protected)
- Premier timeline on major healthcare reform provisions impacting hospitals (3/26/10)
- Premier healthcare reform timeline (PPT slide) (1/19/11)
- Premier healthcare reform timeline on disparities provisions (PPT slide) (5/10/10)
- Kaiser Family Foundation healthcare reform timeline
- Commonwealth Fund timeline
- Alston & Bird healthcare reform timeline
- Consolidated Patient Protection and Affordable Care Act -- final consolidated bill with changes made by the amended Budget Reconciliation bill
- The Patient Protection and Affordable Care Act (H.R. 3590) (Senate- & House-passed healthcare reform bill)
- Budget Reconciliation bill (H.R. 4872)
- House Speakers’ page
- Congressional Budget Office score
Regulations implementing the Patient Protection and Affordable Care Act
- Accountable care organizations/Medicare Shared Savings Program
Final rule
- Final regulations for the ACO/Medicare Shared Savings Program (10/20/11)
- CMS/OIG interim final rule on waivers in connection with MSSP (10/20/11)
- Final Antitrust Policy Statement from Federal Trade Commission and Department of Justice (10/20/11)
- IRS Fact Sheet on Tax-Exempt Organizations Participating in the MSSP (10/20/11)
- Premier's media statement in response to the final rule (10/20/11)
Proposed rule
- Premier comments on proposed rule for Medicare Shared Savings Program (6/2/11)
- Premier comments on proposed CMS/OIG waivers for ACOs (6/2/11)
- Premier comments on Federal Trade Commission and the Department of Justice proposed Antitrust Policy Statement (5/31/11)
- Premier comments on IRS notice regarding the need for additional tax guidance for tax-exempt organizations (5/31/11)
- Premier detailed summary of proposed rule (Premier members only)
- CMS and OIG proposed rule for the Medicare Shared Savings Program (April 7 Federal Register)
- Joint CMS and OIG proposed rule on waiver designs (April 7 Federal Register)
- Proposed Antitrust Policy Statement issued by FTC/DOJ (April 19 Federal Register)
- IRS notice regarding the need for additional tax guidance for tax-exempt organizations
- Medicare hospital value-based purchasing
- Final rule (5/6/11 Federal Register)
- Premier summary of final rule (Premier members only)
- Proposed rule (1/13/11 Federal Register)
- Premier summary of proposed rule (1/19/11)
- Premier comments on proposed rule (3/2/11)
- Health insurance exchanges
- Health insurance issuers implementing medical loss ratio (MLR)
requirements under the Affordable Care Act
- MLR interim final rule with comment (12/1/10)
- Premier summary of MLR interim final rule with comment (Premier members only)
- Provisions affecting physicians and other clinicians, ambulance providers, clinical labs, dialysis facilities, DME providers, and biosimilar products: Final rule for CY 2011 Medicare physician fee schedule (11/29/10 Federal Register)
- Pre-Existing Condition Insurance Plan Program: Interim final rule (published in Federal Register 6/30/10)
- Group health plans and health insurance issuers relating to internal claims and appeals and external review processes: Interim final rule (7/23/10)
- Group health plans and health insurance issuers relating to coverage of preventive services: Interim final rule (7/19/10)
- Preexisting condition exclusions, lifetime and annual limits, rescissions, and patient protection: Interim final rule (Put on public display on 6/22/110)
- Group health plans and health insurance coverage relating to status as a grandfathered health plan: Interim final rule (6/17/10)
- Inpatient prospective payment system (IPPS) changes implementing
PPACA provisions:
Supplemental proposed rule (6/2/10)
- Correction notice for IPPS proposed rule (6/17/10)
- IPPS final FY 2010 wage indices and payment rates implementing PPACA provisions: Rate notice (6/2/10)
- Adult child coverage: Interim final rule (5/5/10)
- Early retiree insurance program (5/5/10)
- Insurance web portal requirements: Interim final rule (5/5/10)
- Fraud and abuse: Interim final rule (5/5/10)