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Course Details

ACA Overview: Value-Based Insurance Design, CO-Ops, and Reforms in 2014


The Patient Protection and Affordable Care Act has great potential to expand health care insurance to members of our community who previously found it unaffordable. It is essential to keep the health care community in Maine informed about the key provisions and systems in place to help their patients understand and purchase one of the variety of plans that are available to them. In many cases, patients go to health care providers for advice and providers must be prepared to provide direction – so take this opportunity to learn more about the Patient Protection and Affordable Care Act.

The following three educational activities are included in this program: Value-Based Insurance Design, Consumer Operated and Oriented Health Plans (CO-Ops), and Reforms in 2014. These sessions provide consumers and health care professionals in Maine with in-depth, informed perspective on new health care options available in the marketplace, definitions on key terms and concepts that define how and why these new options are available, and insights about other changes in health care influenced by the Patient Protection and Affordable Care Act. You may select the individual session(s) you wish to complete.

Lunder-Dineen is proud to collaborate with Maine Community Health Options to provide free education about critical and evolving healthcare options in Maine.

This program is not accredited.

Learning Objectives

At the end of the sessions in this program, participants should be able to perform the activities listed below:

Value-Based Insurance Design

  • Recall the three intentions of value-based insurance design.
  • Compare and contrast the design for coverage benefits and out-of-pocket expenses.
  • Consider the role providers play in encouraging members to receive needed care.

Consumer Operated and Oriented Health Plans (CO-Ops)

  • Discuss the structure of the Quality Improvement Plan to advance member governance and transparency.
  • Identify the four health plan standards for outreach to members required of a Qualified Health Plan.
  • Review the steps taken to develop the strategy for coordinated care.

Reforms in 2014

  • Discuss the role of a member participating in a non-profit health insurance cooperative.
  • Recall the ten essential benefits provided in the Patient Protection and Affordable Care Act.
  • Review the types of plans and coverage available in the Health Insurance Marketplace.
Target Audience

This program is intended for: Clinical providers.