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New ACAP Fact Sheet Highlights Plan Efforts to Address Underlying Social Factors Which Affect Health

A new ACAP fact sheet looks at innovative ways that Safety Net Health Plans are working to positively influence the life circumstances of their members that fall outside the traditional purview of the health care system: family support systems, housing, nutrition, income, education, and other dynamics. These factors are frequently referred to as “social determinants of health.” The paper profiles more than a dozen initiatives undertaken across the country - from a "food prescription" program in Portland, Ore., to a book club in Chicago to an effort to provide housing in Pittsburgh. 

The paper in full is available here.

Hennepin Health Honored for Innovative Work with High-Risk Populations

Hennepin Health, an innovative health reform partnership between Minnesota’s Medicaid agency and Hennepin County, was honored by the Association for Community Affiliated Plans (ACAP) with its ninth “Supporting the Safety Net Award” at ACAP’s CEO Summit today in Washington, D.C.

Hennepin Health is a demonstration project that integrates medical, behavioral, and human services needs in a patient-centered model of care. The program has improved health outcomes dramatically and has lowered the total cost of providing care and services to a population that traditionally is very expensive to treat. The initiative is a collaboration of Minnesota’s Medicaid agency, Hennepin County Human Services and Public Health, Hennepin County Medical Center, NorthPoint Health & Wellness Center, and Metropolitan Health Plan. 

“Hennepin Health embodies what’s best about the care delivered by Safety Net Health Plans— whole-person care that leads to better health, at lower cost,” said ACAP CEO Margaret A. Murray. “It also shows the powerful improvement that plans can make on members’ lives, when they forge partnerships outside the traditional silo of health care and address the underlying social factors that have such influence over people’s health status.” Read More > 

CareOregon's Amy Vance Wins ACAP "Making a Difference" Award

Amy Vance, a Health Resilience Specialist at CareOregon, was today named the fifth recipient of the ACAP “Making a Difference” award. Ms. Vance, who has significant experience as a social worker serving members of the community with mental health and addiction issues, was noted for her extraordinary efforts to find affordable alternatives to narcotic management for patients who suffer from chronic pain. The “Making a Difference” award recognizes an ACAP-member plan employee whose performance reflects ACAP’s mission by improving their community, supporting underserved populations, and fulfilling community needs. Read more >

New ACAP Fact Sheet Profiles Efforts to Reduce Avoidable Emergency Room Usage

A new ACAP fact sheet profiles the efforts of six Safety Net Health Plans to lower inappropriate or avoidable use of emergency departments. For many conditions, it's better for patient and health plan alike to have care delivered in a doctor's office as opposed to the emergency room. But often patients rightly seek care in the ED for symptoms that are urgent -- for instance, it's difficult for patients to discern whether chest pain indicates heartburn or a heart attack. Others opt to visit the emergency room instead of a primary care office because they have significant challenges in arranging for child care, time off work, or transportation. 

The fact sheet looks at six efforts to reduce inappropriate or avoidable emergency room visits, that employ a range of strategies, including expanded hours of service, enhanced care coordination, data sharing, use of health navigators and effective management of care tranistions. Read the paper >

ACAP Applauds Introduction of Medicaid and CHIP Continuous Quality Act in U.S. Senate

ACAP applauds the introduction of S. 1980, the Medicaid and CHIP Continuous Quality Act of 2014, which was introduced in the United States Senate by Senator Jay Rockefeller (D-W.V.) on the five-year anniversary of the Children's Health Insurance Program Reauthorization Act. The bill will provide twelve-month continuous enrollment for people eligible for Medicaid and CHIP and direct the Secretary of Health and Human Services to establish standardized quality measures of the care provided to Medicaid and CHIP beneficiaries. 

“ACAP applauds Senator Rockefeller for his efforts to provide Medicaid and CHIP beneficiaries with reliable health insurance coverage and establish uniform quality measures for the Medicaid and CHIP program,” said Murray. “This bill will lead to more efficient, effective use of scarce public health care resources... [p]roviding 12-month continuous enrollment in Medicaid and CHIP brings these critical programs in line with private health plans, Medicare and other health care programs. We call upon all Senators to join Senator Rockefeller and promptly pass the Medicaid and CHIP Continuous Quality Act.” 

More about the MCQA bill > | Press statement >

ACAP Fact Sheet Looks at Preferred Drug Lists

A new ACAP Fact Sheet takes a look at state policies with respect to Preferred Drug Lists, or PDLs. For Medicaid managed care plans in states that "carve in" prescription drugs -- that is, include prescriptions under the purview of the Medicaid MCO -- PDLs are one way to promote use of relatively inexpensive, effective medications. Drugs on the PDL can be prescribed without health plan authorization. Read the paper >

Dennis Heaphy Named Winner of 2014 Leadership in Advocacy Award

ACAP honored Dennis Heaphy, a health care analyst for the Disability Policy Consortium in Massachusetts and co-chair of Disability Advocates Advancing our Healthcare Rights with 2014 Leadership in Advocacy Award. Mr. Heaphy was recognized for his efforts to assure key consumer protections for persons with disabilities as aspects of the Affordable Care Act were implemented, including demonstration projects designed to serve persons dually eligible for Medicare and Medicaid. Read more >

ACAP Analysis: 4 in 10 Issuers Participating in Marketplaces Also Offer Coverage Through a Medicaid Managed Care Plan 

Note: Data updated December 13, 2013.
Issue Brief | List of Issuers (Excel)

A new ACAP analysis examines a comprehensive list of issuers offering Qualified Health Plans (QHP) in Marketplaces across the country and notes which issuers also offer health coverage through a Medicaid managed care plan in the same state.  The analysis counts 286 separate QHP issuers in the 50 states and the District of Columbia, counting issuers once for each state in which they participate in a Marketplace.  Of those 286 issuers, more than 4 in 10—117 overall—also offer coverage through a Medicaid MCO in the same state. This suggests that there is significant overlap between Marketplace plan offerings and Medicaid managed care in many states, which would help to limit the impact of “churn.” Read more >

H.R. 1698 Would Bring Enrollment Stability to Medicaid, CHIP Programs

Representatives Gene Green (D-Texas) and Joe Barton (R-Texas) recently introduced H.R. 1698, the Stabilize Medicaid and CHIP Coverage Act of 2013, which would provide for 12-month continuous enrollment for Medicaid and CHIP. Every year millions of people enroll in the two programs, only to subsequently lose their coverage despite still being eligible. 

“ACAP applauds Representatives Green and Barton for their leadership in seeking to provide Medicaid and CHIP beneficiaries with a source of coverage they can count on,stabilizing health care services for those who need it most," said ACAP CEO Margaret A. Murray in a statement

ACAP has developed a Web site that provides a wide range of resources on "churn" and its ill effects, including maps detailing the variance in enrollment continuity rates among various subgroups and from state to state. For more details, visit coverageyoucancounton.org. 

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