Today’s Talk 2 Expanding opportunities due to the Affordable Care Act (ACA) Examples in L.A. Care Health Plan tasks Questions.

Slides:



Advertisements
Similar presentations
Milliman USA Texas State Planning Grant Conference January 31 – February 1, 2002 Options for Expanding Health Insurance in Texas – CHIP Full Cost Buy-In.
Advertisements

The Affordable Care Act: An Early Progress Report David Grande, MD, MPA Senior Fellow, Leonard Davis Institute of Health Economics Assistant Professor.
Integrating Care for Medicare- Medicaid Enrollees Medicare-Medicaid Coordination Office Centers for Medicare & Medicaid Services November 2011.
Expanding Coverage Under the ACA: Status Update and Why It Matters to Hospitals Brian Tabor, VP January 21, 2014.
“Medicaid Made Simple” in West Virginia House Government Organization Committee February 2, 2012 Renate Pore, Health Policy Director WV Center on Budget.
Nancy Atkins, R.N., M.S.N., N.P.-B.C. Commissioner West Virginia Bureau for Medical Services Enroll WV: The Changing Face of Medicaid.
We are funded by generous grants from the California Wellness Foundation, the California Endowment, Blue Shield of California Foundation, California Community.
The Patient Protection & Affordable Care Act (ACA) implements broad, historic changes to U.S. health care Expanded access to health insurance and care.
Affordable Care Act Lowered Medicare Beneficiary Costs Based on an HHS report, “the 2010 health care law will save Medicare beneficiaries $59 billion through.
DRAFT 0 Medical Malpractice: Is the Crisis Over? CAS Spring Meeting 2006 Puerto Rico Carl Ashenbrenner, F.C.A.S., M.A.A.A. Principal and Consulting Actuary.
ANGELICA RAMIREZ, MPH CAHPSA COORDINATOR I’m Covered, You’re Covered, We’re ALL Covered….Not.
The Affordable Care Act: Impact and Opportunities for Case Managers Lisa Kraus, RN,BSN, CCM Vice President Care Management CareFirst.
Program of All-Inclusive Care for the Elderly PACE Financing Chris van Reenen, NPA MN PACE Summit July 2004.
 You pay a premium into an insurance pool. In the event that you are sick or injured, the insurance policy pays all or part of your medical expenses.
A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado (Twitter)
Section 5: Public Health Insurance Programs Medicare Medical Assistance (Medicaid) MinnesotaCare General Assistance Medical Care (GAMC) Minnesota Comprehensive.
Introduction to Health Insurance Exchanges. Affordable Care Act (ACA) Insurance Reforms – No lifetime limits, annual limits – Pre-existing conditions.
Health Care Reform and West Virginia Medicaid Nancy V. Atkins, R.N., M.S.N., N.P.-B.C.
Health Insurance Coverage of the Nonelderly, 2010 * Medicaid also includes other public programs: CHIP, other state programs, Medicare and military-related.
This presentation is a high-level summary and for general informational purposes only. The information in this presentation is not comprehensive and does.
Presented by: Jerry Leemkuil Field Manager Association Risk Management Services Federated Insurance Presented by: Jerry Leemkuil Field Manager Association.
The Affordable Care Act’s Credits, Subsidies, Penalties and Fees This presentation is a high-level summary and for general informational purposes only.
TAX-AIDE Patient Protection and Affordable Care Act (PPACA) Better known as ACA The Basics.
Taiwan’s National Health Insurance: The Experience and Reform of a Single-payer System 1 Yi-Ren Wang, MS, ML Director, Planning Division Bureau of National.
Impact of ACA, CMS and Exchanges to Cigna Clarifying the Government Sector.
INTEGRITY | TEAMWORK | COMMITMENT | RESPECT | EXCELLENCE Chuck Seviour, VP – Revenue Cycle Consulting Three Phases of Modern Day Revenue Cycle Staff Training.
Page 1 The Health Benefit Exchange and the Commercial Insurance Market Delaware Department of Health and Social Services.
ACA Risk Mitigation Programs (3Rs) Update Kevin M. Dyke, FCAS, MAAA Chief Actuary 30 th Annual MAHP Summer Conference July 17,
The Affordable Care Act Early Impacts. The main provisions of the law do not launch until However, a lot of change has taken place. Dependent Coverage:
Overview of CMS CMS Headquarters DHHS Secretary Kathleen Sebelius.
Health Policy Challenges Ahead Ryan Sullivan Michigan Consumers for Healthcare.
HEALTH CARE REFORM UPDATE FOR AVOYELLES PARISH SCHOOL BOARD EMPLOYEES Prepared by: APSB Finance Department.
Medicare, Medicaid, and Health Care Reform Todd Gilmer, PhD Professor of Health Policy and Economics Department of Family and Preventive Medicine 1.
Under the data-hood of the “Patient Protection and Affordable Care Act, 2010” (this presentation based solely on publicly-available data and reports)
1 Healthcare Group of Arizona Director Anthony D. Rodgers State Coverage Initiatives - Summer Workshop ‘Pressing Forward: Cuts, Coverage, and Creativity’
Healthy NY NYS Insurance Department Health Bureau.
Problems and Improvements for the Financing of the Massachusetts Duals Demonstration A Presentation to the Implementation Council March 15, 2013 BD Group.
Commonwealth of Massachusetts Executive Office of Health and Human Services Implementing the Affordable Care Act in Massachusetts 2012 Legislative Changes.
Patient Protection and Affordable Care Act (PPACA) AKA Obamacare Stability Security.
Washington Health Benefit Exchange State of Reform Spokane, WA September 2015 Phil Dyer Board Member.
1 Safety Net Health Plans and Health Insurance Exchanges National Association of Public Hospitals Annual Conference September 20, 2011 Jennifer Babcock.
Update on Level 1 Establishment Grant Kaitlyn Kenney Director of Policy and National Health Care Reform Coordinator March 12, 2012.
Medicare Part B Premium and Deductible: What’s in Store for 2016? October 14, 2015 National Coalition on Health Care Tricia Neuman, Sc. D. Director, Program.
1. ACA Progress to Date - Summary Coverage 10.2 million enrolled on Marketplaces as of March 31, million additional Medicaid enrollees since.
Follow the MHA on social media. Follow the MHA on social media How Michigan Hospitals Contribute to the State’s Healthcare Budget.
Health Plan Accountability Under the ACA FamiliesUSA Health Action 2016 February 5, 2016 Karen Pollitz, Senior Fellow Kaiser Family Foundation.
Direct Physician Access. Dan Hawkins’ Background 19 Years in the Insurance Industry 10 Years Employee Benefits 2 Years Kansas House of Representatives.
Exhibit 1 Projected ACA-Compliant Membership On and Off of the Health Insurance Exchanges, 2014 to 2016 Data: Authors’ analysis of Uniform Rate Review.
Chapter 5 Healthcare Reform. Objectives After studying this chapter the student should be able to: Describe the expansion of healthcare insurance under.
Health Insurance Information Update 2015 Presented by:
AMERICAN ACADEMY OF ACTUARIES ©2016 American Academy of Actuaries. All rights reserved. Drivers of 2017 Health Insurance Premium Changes Drivers of 2017.

The Times They Are a Changin’ –
Individual private insurance
Per Enrollee Growth in Medicare Spending and Private Health Insurance Premiums (for Common Benefits), NOTE: Per enrollee includes primary.
Health Care - What’s Next April 22, 2017
Exhibit 1 The Number of Uninsured People Under Age 65 Declined to 27.5 Million in 2016 Source: Source: U.S. Census Bureau, 2013, 2014, 2015, and 2016.
Chart 1.17: Medicare Enrollees,(1) 1995 – 2015
Healthcare 101 by Steven Lash
Expenditures in Billions (Projected)
Illustrative Health Reform Goals and Tracking Performance
Net Impact of Insurance Exchange Options on Federal Budget and National Health Expenditures, 2010–2020   Option 1 Public Plan at Medicare Rates Option.
Health Care Reform and Medicaid
Assistant Commissioner Marc D. Young Oklahoma Insurance Department
Transitional Healthcare Benefit / TRICARE
Medical Loss Ratios and Rebates by Insurance Market Segment, 2011–2013
Credit per employee $9,435—projected family premium 50% employer
Affordable Care Act Basics
People Percent of population Millions 2012 National 2012 Lowest state
Presentation transcript:

Today’s Talk 2 Expanding opportunities due to the Affordable Care Act (ACA) Examples in L.A. Care Health Plan tasks Questions

ACA Creates New Opportunities in Healthcare 3 Affordable Care Act (ACA), otherwise known as Obamacare, is the driving force. Health Plans are expanding to meet expected enrollment growth. Actuaries and healthcare analytics play an important role.

L.A. Care Health Plan as an example Revenue: $1.2 Billion Current Revenue: $3.3 Billion Projected 2017 Revenue: $7.5 Billion Current Member Enrollment: 1.3 million lives 200,000 Medi-Cal enrollees added in January ,000 Exchange/Marketplace enrollees since January ,000 Dual eligibles (Medi-Cal and Medicare) during this year.

Health Plan Tasks Set insurance premiums Establish provider rates Develop risk stabilization and mitigation programs Reinsurance Risk adjusters Risk corridors Estimates reserves (IBNP) 5

Questions? 6

Feedback: Privacy Policy Feedback
Do Not Sell My Personal Information
About project: SlidePlayer Terms of Service

© 2025 SlidePlayer.com. Inc. All rights reserved.