What a difference a day—or 365 of them—can make. From October 2013 to today, healthcare has undergone more changes than at nearly any other time in recent history. The private insurance market was overhauled, technology changes were foisted upon providers, and hospitals have scrambled to find inventive ways to cut costs and improve quality. Here are a few highlights from the past year in healthcare.
Healthcare.gov
Then: A catastrophic meltdown welcomed the launch of one of the most critical provisions of the Affordable Care Act. A spectacular technological crash occurred when state exchanges run by the federal government saw unexpectedly large numbers of people trying to enroll in the plans. Even the telephone hotlines set up to help people were unsuccessful at addressing the problems.
Now: The Obama administration is hoping to stave off the mayhem from last October by preparing in advance. Insurers began end-to-end testing on the site early this month. Time will tell if turnover among the administration’s top IT staff and lessons from last year will create a smoother enrollment period in November.
Employer-sponsored insurance
Then: Due to the creation of the state exchanges, many predicted that businesses would drop employer-sponsored insurance like a bad habit. Some large, national employers, including Trader Joe’s and Home Depot, did drop coverage for many of their part-time workers in the fall of 2013.
Now: Just this month, Wal-Mart announced that all remaining part-time employees working fewer than 30 hours a week would be losing their health insurance benefits. This may seem like another blow to employer-sponsored coverage, but studies showed that over the year, most workers retained their plans. According to an annual survey by the Kaiser Family Foundation, 55% of firms offered health insurance to at least some of their workforce and 62% of workers at those firms were covered in 2014 – percentages equal to findings in the 2013 survey.
ICD-10
Then: The drop-dead date for switching over to ICD-10 was slated for Oct. 1, 2013, but (much to the relief of providers everywhere) the Department of Health and Human Services delayed it to October 1 of this year.
Now: President Obama signed legislation this spring that pushed the compliance date back, yet again, to October 1, 2015. Providers now have another year to prepare for, and worry about, the switch.
Meaningful use
Then: October 2013 marked the month that providers were required to begin the process of attestation for that year and qualify for incentive payments of $15,000 for Medicare and $21,250 for Medicaid.
Now: This year was a troubling one for Meaningful Use, with only 143 hospitals reportedly attesting and 44,000 providers applying for hardship exemptions.
Providers attesting for the first time this year were supposed to do so by October 1, but the Centers for Medicare & Medicaid Services allowed a hardship exemption for providers that were unable to attest to 2014 standards because of vendor delays. The deadline was also extended to November 30. This slight reprieve will allow providers an opportunity to avoid 1% Medicare reimbursement cuts in 2015. Some provider organizations have recently argued that the entire program is in jeopardy because of a one-year reporting requirement for Stage 2.