Continuing our series on the key features of the Affordable Care Act, we will now look into the changes that took effect in 2011 that sought to improve quality and lower cost of healthcare. The majority of these changes effected seniors enrolled in Medicare. The ACA aims to increase the quality and affordability of health insurance, lower the uninsured rate, and reduce the costs of healthcare for individuals and the government. However, a number of the mechanisms – mandates, subsidies, and insurance exchanges – are to be rolled out over four years and beyond. Below is an overview of some of the key quality improvement provisions that took effect in 2011.

Improving Quality and Lowering Costs

The Affordable Care Act provides prescription drug discounts for seniors when buying Medicare Part D covered brand-name drugs. Some Medicare drug plans have a coverage gap, or a donut hole in its policy. The ACA aims to eliminate this gap in coverage over the next seven years, until it is finally closed in 2020. As for generic drugs, in 2013, Medicare pays 21% of the price for generic drugs during the coverage gap, while the enrollee pays the remaining 79%. This will decrease until it reaches 25% in 2020.

The law provides certain free preventive services, such as annual wellness visits and personalized prevention plans for seniors on Medicare. These wellness visits are now covered without cost sharing under Part B. Some additional preventive services include: bone mass measurement, cholesterol and other cardiovascular screenings, diabetes screenings, mammograms, and prostate cancer screenings. A full list can be found at here.

The Community Care Transitions Program will help high risk Medicare beneficiaries who are hospitalized avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities.

Additional information can be found at the U.S. Department of Health and Human Services website: www.hhs.gov/healthcare