Everything new independent practices need to know in terms of health policy
Healthcare delivery, reimbursement, and regulations are constantly evolving to enable providers to provide higher quality care in a safe and effective environment. In the past few years alone, many policies have been adjusted and updated. New practices need to know about these main considerations in terms of health policy.
Cures Act 2021
Patients and providers need secure access to their health information. The 21st Century Cures Act ensures that that data is available through tools such as patient portals and that all patients have access to their portal. The rule includes a provision that patients are able to access their electronic health information at no cost to them.
Taking effect on April 5, 2021, the Information Blocking rule states that healthcare providers are required to make a core set of clinical data available to patients in a timely fashion to encourage interoperability and portability of health data.
Telehealth
At the onset of the COVID-19 pandemic, many healthcare providers turned to the use of telehealth to ensure their patients were able to access care securely and safely. As a result of the necessity and the success of this shift to virtual care, the Centers for Medicare & Medicaid Services (CMS) expanded its coverage for telehealth services.
Many of those services are now permanently included on the list of reimbursable services that will continue to be covered beyond the public health emergency. Third-party payers are increasingly supporting the transition to telehealth services, following the lead of CMS.
As the CDC explains, telehealth services help provide the necessary care to patients while minimizing the risks of transmitting the virus to physicians, their staff, and their other patients. These recent policy changes have reduced barriers to telehealth access, promoting the technology as a way to deliver care for patients who need acute, chronic, primary, and specialty care. Telehealth has been shown to improve patient health outcomes as well.
Elation Health helps new practices understand the telehealth options available to them as they prepare for the new normal in healthcare delivery.
ACA Changes
The Affordable Care Act (ACA) of 2010 has also undergone some changes recently, primarily in response to the increased need for healthcare coverage during the COVID-19 pandemic. More people are now eligible for subsidies as a result of the American Rescue Plan Act of 2021. Under the new law regarding costs for Marketplace health insurance coverage:
- More people qualify for help with paying for their health coverage, including those who weren’t eligible in the past based on their income.
- Most people currently enrolled in a Marketplace plan may qualify for more tax credits.
- Health insurance premiums will decrease as a result of the new savings guidelines.
Value-Based Care
The move toward value-based care continues in 2021 and beyond. Quality healthcare outcomes for patients are trending toward being a priority over fee-for-service delivery models. New independent physicians will need to ensure they are tracking those outcomes and reporting them in a timely manner to realize the benefits themselves.
To aid in these efforts, electronic health record (EHR) capabilities have expanded and will continue to evolve with enhanced processing features. Wearable technology can also aid patients in making real-time health decisions based on data that is immediately available to them and their providers.
