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EMPLOYER'S ROLE IN 'POST-EXCHANGE' WORLD

Bruce Sherman, medical director of Employers Health, explains the employer's role in managing employee health in the health care reform environment built upon private and public insurance exchanges. Watch the video here.

NBCH SUBMITS COMMENT LETTER ON EMPLOYER REPORTING REQUIREMENTS UNDER THE ACA

NBCH, on behalf of its members, has submitted a comment letter to the Internal Revenue Service (IRS) on two proposed rules regarding required reporting employers must provide both to the IRS and to employees.  The two rules describe the proposed process for employers to report to the IRS regarding their compliance with the employer shared responsibility provision ("pay or play") and the minimum value of the coverage provided.  The full letter can be found here.

NBCH SUBMITS COMMENT LETTER ON MINIMUM VALUE PROPOSED RULE

NBCH, on behalf of its members, has submitted a comment letter to the Internal Revenue Service (IRS) on the proposed rule regarding minimum value of eligible employer-sponsored plans. The full letter can be found here.

NBCH AND THE COMMONWEALTH FUND RELEASE FIRST BRIEF IN NEW "HEALTH REFORM & YOU" SERIES

NBCH is pleased to partner with the Commonwealth Fund to produce a series of briefs titled "Health Reform & You". Click here to see the first brief on the importance of primary care.

NBCH SUBMITS COMMENT LETTER ON "PAY OR PLAY" PROPOSED RULE

NBCH, on behalf of its members, has submitted a comment letter to the Internal Revenue Service (IRS) on the proposed rule regarding the employer shared responsibility provisions set forth in Section 1513 of the ACA. The so-called “pay or play” provisions impose new shared responsibility requirements on employers regarding the offering of health coverage by employers to their full-time employees. NBCH’s letter highlights the leadership role employers have always played in offering affordable health insurance to their employees and families. It goes on to express concern that these new ACA requirements will be overly burdensome and complex for employers, causing them to consider alternatives to offering traditional employer-sponsored health insurance. The full letter can be found here.  

NBCH SUBMITS COMMENT LETTER ON WELLNESS PROGRAM INCENTIVE CHANGES

The ACA adds new section 2705 to the Public Health Service Act, which makes changes to existing HIPAA regulations on employee incentives in employer-sponsored wellness programs.  The new section allows employers to increase from 20 percent to 30 percent the maximum premium differential for employees who satisfy a specified goal under a health-contingent wellness program.  NBCH submitted a comment letter to the Departments of Labor, Treasury, and HHS, which are jointly responsible for implementation of this provision.  The letter applauds the Departments for applying the new provision to all plans, regardless of grandfather status, while cautioning that the application of "reasonable alternative standards" employers must put in place to ensure health-contingent wellness programs are fairly administered not be allowed to become so burdensome for employers that they are discouraged from offering health-contingent wellness programs.  The full letter can be found here.  

NBCH SUBMITS COMMENT LETTER TO OPM ON MULTI-STATE PLAN PROGRAM

The ACA gives the Office of Personnel Management (OPM) the authority to "stand in the shoes" of individual state health insurance exchanges (both state-run and federally-run) to determine Qualified Health Plan status for issuers selling on the exchanges.  For large, nation-wide issuers, OPM's Multi-State Plan Program (MSPP) will greatly reduce administrative burden and allow for easier streamlining of efforts, both for exchanges and for issuers.  OPM recently published a proposed rule describing the parameters of the MSPP, and NBCH submitted a comment letter advocating for the use of eValue8 as a valuable plan management tool to ensure these large, nation-wide issuers are held to high standards of accountability for providing high-value care to exchange customers.  See the full letter here.

NBCH RESPONDS TO CMS RFI: HEALTH CARE QUALITY FOR EXCHANGES

NBCH has responded to a CMS request for information on what kind of quality data should be gathered and used in health insurance exchanges. See the full letter here.

NBCH SUBMITS COMMENT LETTER TO HHS ON TRANSITIONAL REINSURANCE PROGRAM

NBCH, on behalf of its members, has submitted a comment letter to HHS on the proposed rule for the Transitional Reinsurance Program (TRP).  The TRP is a program under which per capita fees will be collected from employers to provide reinsurance to issuers in the new health insurance exchanges to help mitigate the uncertainty of the risk in that market.  NBCH's letter commends HHS for proposing flexible standards and options for counting plan enrollees, but expresses concern about the unanswered questions still remaining regarding issues such as treatment of disease management and wellness programs, and the interaction between the federal TRP and state high-risk pools. 

CATALYST FOR PAYMENT REFORM PUBLISHES NEW PRICE TRANSPARENCY MATERIALS

The Catalyst for Payment Reform (CPR), an organization with which NBCH works very closely and is familiar to many of our members, has published three new resources on health plan price transparency:


As we move toward more implementation of value-based purchasing strategies, more information is needed to help employers and employees and their families make decisions about health care.  Transparency of price information is essential if employees are going to be able to make wise value-based decisions.  The work CPR is doing on this front is essential.  NBCH staff will be keeping our members informed as CPR's work progresses.  


BUYING VALUE WEBSITE LAUNCHES

In July of 2012, the Buying Value website launched.  Buying Value is an initiative of private health care purchasers—employers, leading business health organizations, and union health funds. The initiative seeks to achieve better care and lower health costs employers and their employees by replacing the current volume-based purchasing model in health care with one based on quality, patient safety, and increased care coordination and communication. 


The initiative works closely with consumer organizations and is dedicated to supporting the Partnership for Patients and other quality/safety initiatives.
Buying Value builds on pioneering work in value purchasing by leading private purchasers and employer-led health groups and takes advantage of major reforms in Medicare that are moving the largest purchaser in the nation towards value purchasing in its programs. This is a trail that was blazed by many of Buying Value’s partners and through a variety of experiments funded by national foundation and private sector health care initiatives. By 2017, the Centers for Medicare and Medicaid Services will attach nine percent of Medicare payments to purchasing based on quality. The importance of mirroring these changes in order to avoid the cost-shifting that will take place will drive the Buying Value initiative’s focus on aligning private purchasing practices with the Medicare payment reforms as well as working with State Health Exchanges and Medicaid programs to do the same.  

The initiative is made up of 19 organizations, including NBCH, that either represent, or are themselves, large health care purchasers—including Fortune 500 corporations, union health funds, and national and regional business coalitions. National consumer organizations are also involved.

The initiative is designed to encourage and assist private purchasers changing from the traditional volume-based purchasing model of paying for care based on the number of individual tests or procedures performed to a model that emphasizes coordination, patient safety, and care that is proven to work.

The website contains valuable information, such as a value-based purchasing primer, and anti-trust guidelines written by former FTC and DOJ attorneys.


Health Reform Hits Main Street

Health care reform explained in "Health Reform Hits Main Street."Confused about how the new health care reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Written and produced by the Kaiser Family Foundation. Narrated by Cokie Roberts, a news commentator for ABC News and NPR and a member of Kaiser's Board of Trustees. Creative production and animation by Free Range Studios.


 



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