Health systems & services
Perspectives on Essential Health Benefits
Workshop Report
by Cheryl Ulmer, Bernadette McFadden, and Cassandra Cacace, Rapporteurs; Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans; Board on Health Care Services; Institute of Medicine
Description
The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children). Other provisions will go into effect during 2014, including the requirement for all individuals to purchase health insurance. In 2014, insurance purchasers will be allowed, but not obliged, to buy their coverage through newly established health insurance exchanges (HIEs)--marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance. The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits (EHBs). The Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend criteria and methods for determining and updating the EHBs. In response, the IOM convened two workshops in 2011 where experts from federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices. Essential Health Benefits summarizes the presentations in this workshop. The committee's recommendations will be released in a subsequent report.
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http://www.nap.edu/13182
National Academies Press
The National Academies Press (NAP) publish the reports of the National Academies of Sciences, Engineering and Medicine. They published more than 200 books a year on a wide range of topics.
View all titlesBibliographic Information
- Publisher National Academies Press
- Publication Date February 2012
- Orginal LanguageEnglish
- ISBN/Identifier 9780309215435
- Publication Country or regionUnited States
- FormatPaperback
- Primary Price 45 USD
- Pages182
- ReadershipProfessional and scholarly
- Publish StatusPublished
- Dimensions11 x 8.5 inches
- Biblio NotesRelated Digital edition - 9780309215442 . Copyright year 2012.
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