Implementing the Affordable Care Act at the Nation's Largest Private Integrated Healthcare Organization
We focus specifically on the first two years of the health insurance marketplaces. We describe: our approaching to preparing for the initial open enrollment period under the ACA; strategies of managing the technological challenges associated with the initial roll-out of the state and Federal marketplace websites; response to consumer confusion due to shifting deadlines and course corrections; and the resulting overwhelming influx of phone calls to our call centers.
We present membership results from year-one of the health insurance marketplaces and describe the demographic, health characteristics, and utilization profile of the enrollees who joined our plan via the marketplaces compared with those who joined via traditional methods.
Finally, we describe how we used the lessons learned from year-one as we prepared for the second open enrollment period under the ACA where our focus was on process improvement and member retention.
As ACA implementation transitions to ACA operations in our organization, our approach continues to be grounded in maintaining the optimal combination of people, process, and technology to ensure continued success.
Learning Areas:Administration, management, leadership
Advocacy for health and health education
Public health or related laws, regulations, standards, or guidelines
Describe how the nation's largest private integrated healthcare organization implemented the Affordable Care Act (ACA). Explain the internal and external implementation challenges and the strategies and tactics used to overcome them. Discuss the plan for the ongoing management of the ACA's provisions.
Keyword(s): Affordable Care Act, Health Care Reform
Qualified on the content I am responsible for because: I am one of the senior executives responsible for the implementation of the Affordable Care Act at Kaiser Permanente. My scientific interests include innovative techniques for delivering low-cost, high-quality healthcare to underserved communities.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.