Healthcare Reform Timeline

The Affordable Care Act, signed into law in 2010, is the roadmap for healthcare reform for the next decade. The legislation includes several initiatives that will impact the way physicians operate and change their everyday business practices. Here is a year-by-year outline of the biggest benchmarks that will affect physician practices.

2011  /  2012  /  2013  /  2014  /  2015

2011

Closing the doughnut hole
Pharma companies to provide a 50 percent discount on brand-name prescriptions for those enrolled in Medicare Part D who reach the coverage gap; seniors see additional savings on brand-name and generics until gap closed in 2020.
Effective Jan. 1, 2011

EHR incentives begin
Registration for the Medicare EHR Incentive Program begin; eligible professionals meeting “meaningful use” requirements can register online through CMS; states can also launch their Medicaid programs as well; eligible hospitals and critical access hospitals have until Nov. 30 to register and attest for incentive payments.
Registration for Medicare program effective Jan. 3, 2011; attestation begins April 2011 with payments expected between April and May 2011

Improved Medicare payments for primary care
Providers of primary-care services see 10 percent Medicare bonus payment; same bonus for general surgeons practicing in areas of practitioners shortages.
Effective for services between Jan. 1, 2011 and Dec. 31, 2015

No-cost preventative care for seniors, others
Seniors enrolled in Medicare receive free preventative services, including annual wellness visits, personalized prevention plans; all health plans must cover select services such as mammograms and colonoscopies without charging a deductible, co-payment, or coinsurance.
Senior care effective Jan. 1, 2011; health plan rule effective as of Sept. 2010

CMS explores ‘Innovation’
Center for Medicare and Medicaid Services goes live with new Innovation Center to test new payment and delivery system models to reduce cost while maintaining quality; will seek input from healthcare stakeholders.
Effective Jan. 1, 2011

Focus on community care
Community Care Transitions Program established to aid high-risk Medicare beneficiaries leaving hospital to avoid readmission; coordination of care, connecting patients to community services other key elements.
Effective Jan. 1, 2011

Doctor directory
CMS launches “Physician Compare,” a new website allowing consumers to access more information about physicians enrolled in the Medicare program, including data regarding “quality of care.”
Effective Jan. 1, 2011

PQRI now PQRS
Medicare’s Physician Quality Reporting Initiative renamed Physician Quality Reporting System; incentive payments increased 1 percent for 2011 reporting and by 0.5 percent from 2012-2014; additional 0.5 percent made to those who participate in a qualified Maintenance of Certification Program.
Effective Jan. 1, 2011

5010 testing recommendation
CMS encourages payers, providers to test 5010 for electronic claims as it begins accepting 5010 claims and continues to accept 4010 claims.
Suggested start – Jan. 1, 2011; suggested completion – Dec. 1, 2011

Infection interference
Federal payments to states for Medicaid services related to certain hospital-acquired infections are prohibited.
Effective July 1, 2011

Boosting primary care workforce
Scholarships, loan repayments for primary-care physicians and nurses employed in underserved areas; state-based loan repayment/forgiveness program to increase providers in these areas without having to pay taxes on payments; establishes graduate medical education policy opening unused training slots to be re-distributed to increase primary care training.
Funding to begin October 1, 2011; training slots effective July 1, 2011

Improved access to home care
States will be able to offer home, as well as community-based services, to individuals with disabilities through Medicaid’s Community First Choice Option versus care in nursing homes.
Effective Oct. 1, 2011

Saving Medicare
Fifteen-member Independent Payment Advisory Board, composed of medical experts, established to make recommendations to White House and Congress on extending life of Medicare program, future plans to lower costs, improve health outcomes, and expand access to care.
Funding available Oct. 1, 2011; report due Jan. 15, 2014