Hosam Mohamed-
HITECH Act
-provides incentives to encourage meaningful use of electronic health records
- widespread use of EHRs can help improve record keeping, interdisciplinary care, and minimize errors
-was sunset by CMS and replaced with quality improvement program
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PPACA
-individual mandate, medicaid expansion, health insurance marketplace, dependent coverage up to age 26
- offered premium subsidies, cost sharing subsidies, made insurance plans cover 10 essential categories of benefits.
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illegal to reject applicants with preexisting conditions, closed donut hole, required insurances to have MLR of 85%
What were some major changes of PPACA?
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Medical loss ration (MLR)
-the proportion of total revenue spent on reimbursing health insurance claims
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MACRA
-reinvented physician payment mechanisms in medicare part B and streamlined quality incentives through the quality payment program
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MIPS & APM
-voluntary programs for individual providers or groups where they're performance is measured
- depending on performance; they either qualify for an incentive or penalty
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Patient centered medical home (PCMH)
-an effort to bring interdisciplinary collaborative practice to ambulatory care and primary care
-includes doctors, nurses, pharmacists, and other health professionals
-provides incentives for providers to register as PCMH through APM programs
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central clearing house
The PCMH model aims to serve as a _________ for all patient medical records to help share information and improve continuity of care.
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ACOs
- groups of providers that choose to bill together, report quality performance and assume risk for patient care through incentives and penalties
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21st century cures act
-streamline drug and device approval and encourage innovations in medical technology
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Inflation reduction act
-lower the cost of insulin to $35 a month
-no 5% coinsurance
-medicare required to negotiate prices for select drugs
-removed cost-sharing for all vaccines in medicare, medicaid, and chip
