Embed Size (px)
DESCRIPTION
synopsis of HCR and nursing
Citation preview
HEALTH CARE REFORM
What Every Nurse Should KnowAmerican
Martina Travis, BSRN, MPH
July13, 2011
OBJECTIVES
• Know major components and proposed timeframes for the HCR Bill.
• Know how the HCR Bill may impact nursing care and sh
• Know the status of attempts to impede the implementation of the bill.
BY THE END OF THIS PRESENTATION, PARTICIPANTS WILL:
EARLY HEALTH CARE REFORM
findingdulcinea.com
CONTEMPORARY HEALTH CARE REFORM
zimbio.com
Frontline, Sick Around the World
How Do We CompareTo Other Developed Nations
United Kingdom
Japan
Taiwan
GermanySwitzerland
Canada
COMPARISON TO OTHER COUNTRIES
Organization for Economic Co-operation and Development, 2007 report
COMPARISON TO OTHER COUNTRIES
Organization for Economic Co-operation and Development, 2007 report
COMPARISON TO OTHER COUNTRIES
Organization for Economic Co-operation and Development, 2007 report
Frontline, Sick Around the World
How Do We CompareTo Other Developed Nations
United Kingdom
Japan
Taiwan
GermanySwitzerland
Canada
APPROACH
worldnewsheardnow.com
Insurances
• Requirement to have insurance 2014• Health Care Exchanges• Multi-State Plan• Health Care Choice
Compact• Co-op Insurance
Children
•2010- Pre-existing Conditions•2010-Young adults remain on parent’s plan•2015-Extension of CHIP
LONG TERM CARE
• Long Term Care Service 2010
• CLASS -2011
MEDICAID and MEDICARECHANGES
Drug Reform
thecontrolcenter.org
DONUT HOLEDefinitions Total drug
spend TrOOP Out-of-pocket cost
Portion covered by Medicare
Deductable $0–$295 $0–$295 Deductible is out-of-pocket
No Medicare coverage of costs
CMS coverage
$295–$2,700
$295–$896.25 25% out-of-pocket 75% covered by
Medicare
Donut hole $2,700-$6,154
$896.25-$4,350.25
All costs are out-of-pocket
No Medicare coverage of costs
Catastrophic over $6,154 over $4,350.25 5% out-of-pocket 95% covered by
Medicare
2009 Medicare Part D payments
Prevention and Wellness
thekathleenshow.typepad.com
Monitoring HCRBuilt in protections
Financing through tax and fines
olaaasprang.wordpress.com
Administrative savings associated with CATEGORY
$196$ BILLIONS
Administrative savings associated with technology and payment reform
$196
Savings from pooling small firms into larger groups
$64
Impact of fewer and less expensive acute care episodes
$299
TOTAL $559
Impact of health care modernization on the Federal Budget, 2010–2019
Center for American Progress | Financing Health Care Reform, 2009
– Tanning Tax of 2010– Changes Tax Free Savings
Accounts 2011– Pharmacy Co. Fee– Medicare Tax Increase 2013 – Medical Devices -2013– High cost (value) insurance
employee provided insurance 2018
TAXES
Research
HCR-IMPLICATIONS FOR NURSING
Copyright © National Academy of Sciences. All rights reserved.The Future of Nursing: Leading Change, Advancing Healthhttp://www.nap.edu/catalog/12956.html
famu.edu
• Competent, efficient care• Affordable• Allows for choice and
accountability
Robert Wood JohnsonFuture of Nursing
• rwjf.org
INDICATORS OF NURSING SHORTAGE
• phawker.com
NURSING SHORTAGE
Aging nursing populationA shortage of nursing school faculty
Aging population
Insufficient staffing
High nurse turnover and vacancy rate
TRANSFORMING THE NURSING
PROFESSION:• Practice extent of education /
training.
• Achieve higher education in better education system
• Full partners, with doctors and other professionals, in HC redesign
• Workforce planning / policy making require better data and information infrastructure.
EDUCATION
udel.edu
CURRENT RESTRICTIONS
rwjf.org
CLINICAL EXPANSION
whsc.emory.edu
RESEARCH/ASSESSMENTS
COURT CASES
In 2009, Sarah Paelin had the distinction of being awarded the “LIE OF THE YEAR” by Politifact — the Pulitzer-Prize winning project of the St. Petersburg Times . What was it?
Opposition
RYAN BILL
• 55 year old and younger• Bears similarities to current proposal
“• Stay committed to
your decisions, but stay flexible in your approach.”
Tom Robbins
• http://www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_508315.html#s75260&title=Encouraging%20Investment%20in%20New%20Therapies
• http://www.kaiserhealthnews.org/Daily-Reports/2011/January/27/states-and-health-reform.aspx
REFERENCES• http://www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_5083
15.html#s75260&title=Encouraging%20Investment%20in%20New%20Therapies• http://www.kaiserhealthnews.org/Daily-Reports/2011/January/27/states-and-heal
th-reform.aspx• National Academies Press.ISBN: 0-309-15824-9, 620 pages, 6 x 9, (2010)• http://www.nap.edu/catalog/12956.html• The Future of Nursing: Leading Change, Advancing• Health, Committee on the Robert Wood Johnson Foundation• Copyright © National Academy of Sciences. All rights reserved.• The Future of Nursing: Leading Change, Advancing Health• http://www.nap.edu/catalog/12956.html
REFERENCES
• http://www.kaiserhealthnews.org/Stories/2011/March/02/health-reform-law-court-case-status.aspx#dismissedconst
• http://www.q1medicare.com/PartD-MedicareAdvantagePlans-Explained.php
• http://www.therepublic.com/view/story/PFP-MEDICARE_4569562/PFP-MEDICARE_4569562/
• http://www.americanprogress.org/issues/2009/06/pdf/financing_health_reform.pdf
REFERENCES
• http://en.wikipedia.org/wiki/Medicare_Part_D_coverage_gap
• http://healthreform.kff.org/timeline.aspx• http://abcnews.go.com/Politics/paul-ryans-2012-bud
get-medicare-plan-similar-obamacare/story?id=13431119&singlePage=true
• From Medscape Medical News • Healthcare Reform Legislation Effects on Nursing: An Expert
Interview With Rebecca M. Patton, MSN, RN, CNOR• Laurie Barclay, MD
REFERENCES
• Fact Check: Pat Boone On The Ryan Plan MARILYN WERBER SERAFINI , KHN Staff Writer MAY 27, 2011
• Healthcare Reform and Nurses: Challenges and Opportunities
• Laura A. Stokowski, RN, MS http://www.medscape.com/viewarticle/721049
• http://www.naic.org/documents/committees_b_Exchanges.pdf
• http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html
