While the Affordable Care Act (ACA), or as it is more popularly known “Obamacare”, has made a few people see red upon reviewing their new health insurance premium, the ACA has made a substantial impact in care costs for those who use Medicare.
Posted on 2/28/15
By Melissa Anderson
Statistics show that under the ACA, 39 million individuals that utilize the government health care program received preventive services with no cost sharing in 2014. The United States Department of Health and Human Services (HHS) released new information on February 24 that shows that millions of seniors and people with disabilities covered under Medicare enjoyed prescription drug savings and improved benefits in 2014 as a result of the Affordable Care Act.
Those who are covered by Medicare in North Dakota should have reasons to be pleased as well since the enactment of the ACA has significantly helped reduce the medical and prescription costs of residents. North Dakota residents have saved $33,174,775 since the ACA was enacted in 2010. Over 11,300 people covered by Medicare in North Dakota collectively saved $9,607,014, which averages out to about $850 per Medicare beneficiary, all thanks to the ACA’s closing of the Part D prescription drug donut hole.
The use of preventive services, such as cardiovascular screenings, numerous cancer screenings, diabetes, and vaccinations, have been included in the health care law and expanded among those people covered by Medicare. In North Dakota, approximately 72,500 people with Medicare, including those enrolled in Medicare Advantage, took advantage of at least one preventive service at no cost to them in 2014.
“Thanks to the Affordable Care Act, seniors and people with disabilities have saved over $15 billion on prescription drugs, and these savings will only increase over time as we close the Medicare coverage gap known as the donut hole,” said U.S. HHS Secretary Sylvia M. Burwell. “By providing access to affordable prescription drugs and preventive services with no cost sharing, the Affordable Care Act is working for seniors to help keep them healthier.”
As part of the HHS’s “better care, smarter spending, healthier people” approach to improving health care delivery, making prescription drugs more affordable and certain preventive services more attainable through no cost sharing are some of the many initiatives advanced by the Affordable Care Act meant to improve the health care and insurance systems.
To achieve the goals of providing better care, more efficient spending and improving the health of U.S. citizens, the national HHS is focused on three key areas: connecting payment to quality of care, improve and innovate the delivery of health care, and sharing information more broadly to providers, consumers, and others to support better decisions while maintaining privacy.
To achieve this the Center for Medicare and Medicaid services has many new programs and initiatives to facilitate the reaching of the goals set to improve the American health care system. One such initiative that many readily see is Electronic Health Records. This method of record keeping helps to assist in the sharing of information among medical professionals to evaluate patients’ medical status, coordinate care, eliminate redundant procedures, and provide high-quality care. Electronic health records increase the speed and ease that hospitals and doctors are able to coordinate care and achieve improvements in health care quality.
The Center for Medicare and Medicaid Services are also providing access to cost, charge, and quality data. The data covers hundreds of services (inpatient, outpatient, and physician services) cost versus charge as well as quality scores for hundreds of thousands of hospitals, physicians, nursing homes, and other providers. The information is available on the Medicare website. These websites are part of an Administration-wide effort to increase the availability and accessibility of information on quality, utilization and costs for effective, informed decision-making.
The ACA makes Medicare prescription drug coverage more affordable by gradually closing the gap in coverage, otherwise known as the “donut hole”, where beneficiaries had to pay the full cost of their prescriptions out of pocket, before catastrophic coverage for prescriptions took effect. The ACA is meant to close the “donut hole” by 2020, making 2015 the halfway point. When the health care law took effect in 2010, anyone with a Medicare prescription drug plan who reached the prescription drug donut hole received a $250 rebate. In 2011, beneficiaries in the donut hole began receiving discounts on covered brand-name drugs and savings on generic drugs.
People with Medicare Part D who fall into the donut hole in 2015 will receive discounts and savings of 55 percent on the cost of brand name drugs and 35 percent on the cost of generic drugs.
By removing barriers to preventative services, Americans and health care professionals can better prevent illness, detect problems early when treatment works best, and monitor health conditions.
For more information concerning the initiatives for the improvement of the American health care system please visit: www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26.html.