In the ever-changing landscape of healthcare, SMAs (State Medicaid Agencies) are tasked w/the ever-growing demands of maintaining legacy systems while keeping up to date w/current operational demands that require more agility than aging computer systems and architecture currently allow. As with any governmental entity, the question of funding inevitably comes up. Who the heck is going to pay for all of this? This blog article from the 3M Health Information blog brings up some good points that were gleaned from a conference back in March.
One of the key tenets of the Affordable Care Act was for each individual state to run their own health insurance exchange. However, we know either politics, poor implementation activities and deployment, or a combination of all the above had several states doing enrollment through healthcare.gov instead. The federal government had been providing states with funds to create and maintain the exchanges. This funding ended on 1/1/15. Here is a look at the numbers by state.
It’s been a bit of a rollercoaster since the rocky start of healthcare.gov and many state-run exchanges back in October of 2013. The numbers since then are pretty staggering: 11.4 million enrollees total with the vast majority through the federal exchange.
Here’s an interesting article about some key observations and lessons learned during this time from an enrollment perspective.
I’ve already written previous blog posts regarding alternative payment models including ACOs. Here is a nice article that dives a little more into some recent ACO activities and some positive outcomes from some ACOs around the country including impacts to population health.