Already the Affordable Care Act (ACA) has brought in millions of dollars to Illinois and to community based organizations (CBOs) in our state. Those already funded, along with the many who will receive funding over the next years of ACA implementation have the potential to make an enormous impact on the health of our communities. Some of the most significant elements of the ACA that will impact CBOs include:
Community Health Centers: Over the next 5 years of implementation of the ACA, we can expect Illinois to receive between $285 and $437 million for operational capacity expansion and $45-$69 million for physical expansion and construction. The legislation requires that private insurers contract with Federally Qualified Health Centers (FQHCs) and reimburse at no less than the Medicaid rate. $1.5 Billion has been allocated nationally to expand the National Health Service Corps by placing primary care providers in provider-shortage community areas. Illinois can expect several hundred newly funded physicians, nurses and dentists through this program.
Safety Net Hospitals: Medicaid will now cover all people up to 133% of the poverty level, meaning that hundreds of thousands of people heretofore uninsured will be insured after 2014 helping to provide support for safety net institutions and community health center providers. Safety net hospitals will have the opportunity to collaborate with other community based providers to develop innovative programs and apply for any of the many grant opportunities under the CMS Innovations Center.
Health Care Workforce: The legislation provides primary care providers with a 10% Medicare payment increase for primary care services for 5 years. This increased reimbursement should help ensure greater availability of primary care physicians. In addition, the legislation requires that primary care services through Medicaid cannot be paid less than the Medicare payment rates in 2013 and 2014. This too should expand the pool of primary care providers willing to see Medicaid eligible people.
The legislation authorizes $10.8 Million for geriatric education centers to provide training focused on geriatrics, chronic care management and long term care. The legislation authorizes $10 million for career incentives to foster interest in the fields of geriatrics, long-term care and chronic care management. Furthermore, $10 million is authorized for grants to provide advanced training opportunities for direct care workers employed in long-term care settings. ACA also authorizes demonstration projects for patient navigator programs within community settings. Beginning in 2011, the legislation increases the reimbursement rate for nurse-midwife services from 65% of the rate of a physician to the full amount.
Health & Medicine Policy Research Group is a Chicago based health policy research and advocacy center focused on improving health and health systems throughout Illinois. HMPRG will continue to provide analysis of the ACA, conduct policy forums on the ACA and work with state and local partners to maximize the potential of the Act in Illinois. For more information on HMPRG or to access our analysis of the ACA and upcoming forums, visit us at www.hmprg.org, or call 312-372-4292.
Health & Medicine Policy Research Group