state of implementation
Health insurance plans can contribute to population health through such mechanisms as quality improvement plans that target priority health outcomes. Linking efforts across sectors is a strategic use of resources and can multiply the impact on population health.
*Full name: Link targets and strategies for improving population health to those being implemented through Medicare, Medicaid, CHIP, Exchange plans, and the private market.
*Relevance to the ACA:
ACA provisions that relate to insurance and population health include:
§1302 – Requires that all insurance plans offer essential health benefits to be defined by the Secretary of Health and Human Services.
§2705 – Enhances wellness discounts for group health plans.
§2713 – Prohibits cost sharing for preventive services in private insurance.
§4103 – Adds an annual wellness visit for Medicare beneficiaries.
§4104, §4105 - Eliminate cost sharing for preventive services in Medicare.
§4106 - Adds vaccines and preventive services for adults as optional services in Medicaid; increases FMAP for states offering these services.
§4107 – Requires Medicaid coverage of tobacco cessation for pregnant women without cost sharing.
§4108 – Provides grants to states which offer Medicaid beneficiaries incentives to prevent chronic diseases.
HCERA §1202 – Requires Medicaid agencies to pay at least the same amount that Medicare would pay for primary care services delivered by certain primary care providers, and provides increased FMAP for the increased cost from 2013 until 2015.less