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ACAP Highlights Best Practices in Response to Inquiry From House, Senate Committees

On November 15, ACAP responded to a bipartisan request from two key Congressional committees asking for information from ACAP and other leading insurance trade associations about information on best practices in Medicaid managed care. ACAP provided a full response to the request and in its response highlighted a number of specific initiatives from ACAP-member Safety Net Health Plans. In its cover letter to the response, ACAP CEO Meg Murray urged members of the Committees to consider:
  • The need for collaboration and open communication among health plans, states, and the Centers for Medicare & Medicaid Services; 
  • A commitment to patient-centered care and strategies to improve patient engagement; 
  • Clear, transparent rate-setting processes and regulations, and recognition that managed care operates differently and more holistically than fee-for-service; 
  • Innovative value-based purchasing strategies and collaborations with providers; and 
  • An ongoing effort to measure and improve the quality of care provided. Such systematic measurement and improvement does not occur in fee for service, primary care case management or other Medicaid delivery systems. 
ACAP's response to the request is available in full here.

ACAP Marks Launch of Open Enrollment Period for Marketplaces' Second Year

ACAP CEO Margaret A. Murray issued a statement on the eve of the open enrollment period for Health Insurance Marketplaces. "Coverage through Marketplaces has been a boon for people and families with low incomes served by Safety Net Health Plans," she noted. "Low-income families whose members receive coverage through different programs – that is, families where the children may be covered by Medicaid or CHIP while the parents are covered through Marketplace coverage -- stand to benefit especially. Our research found that 4 in 10 Marketplace issuers also offers a Medicaid plan in the same state, which means that many families whose members have “split eligibility” will be able get their coverage from a single source, with a single issuer."

Full statement >>

NCQA Rankings: Safety Net Health Plans Occupy 4 of the 5 Top Rankings For Medicaid Plans in the U.S.

Recently-released rankings of Medicaid health plans from the National Committee for Quality Assurance (NCQA) have found that four of the top five Medicaid plans in the U.S., including the top-ranked plan overall, are ACAP-member Safety Net Health Plans. 

  • Network Health (Mass.) - Ranked #1 overall
  • Neighborhood Health Plan (Mass.) – ranked #3
  • Boston Medical Center HealthNet Plan (Mass.) – ranked #4
  • Neighborhood Health Plan of Rhode Island – ranked #5

Rankings | Press Release

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 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. 

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. 

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

Note: Data updated December 13, 2013.

An 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 >

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