HHS releases clearer guidelines for exchanges

With January 2013 quickly approaching, the government released clearer guidelines that will help many consumers and patients participate in Healthcare Insurance Exchange models by way of promising tax credits and funding grants.

The government view this program as what should be a one stop shop for consumers to see what policies they are eligible for and tax credits they will receive upon enrolling in that specific program.  Small businesses and individuals will be able to work together in order to secure better rates along with the tax breaks they are eligible to receive.

The government also announced that 16 states and Washington, DC are receiving $185 million help build the exchanges.  Another desire of HHS is that all exchanges are required to have smooth connections between the state run and federal systems.  The New York Times reports that states have already received $50 million last year, and seven states received extra incentive as early innovators on the project.

The Healthcare Insurance Exchange Congress, taking place this November 9-11, 2011; will host an IT workshop entitled Examine the IT Infrastructure Requirements of Health Insurance Exchanges to examine how to identify how to create a user-friendly experience with the online health exchanges.  For more information on this program and the rest of the HIX Congress, download the brochure.

What are the other guidance do states need from HHS to move forward in establishing exchanges?

Government to start "Secret Shopper" Calls to Primary Physicians

With the new Affordable Care Act, Obama has promised more Americans access to primary care.  This puts a strain on the already stretched system where there aren't enough primary care physicians to treat the patients they are already seeing.  A problem has arisen where doctors are currently refusing to accept new patients from the government due to continual threats to reduce or stop payments for the Government patients.

In order to get a grasp on how many physicians are doing this, the government has announced a "Secret Shopper" program where they will be calling primary physicians to see if they can visit the doctor, confirming whether doctors will or will not take new patients from the government.  States with doctors scheduled to receive call according to the New York Times are Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas and West Virginia.

How do you ensure your provider network is strong enough to handle a huge newly eligible population? Attend the Health Insurance Exchange Congress to learn strategies to ensure a sufficient choice of providers to consumers and include essential community providers that serve predominately underserved individuals.

Do you think doctors will receive this well?  What are some of the arguments that could be used to support both the US Government and the primary care physicians?