ACAP Commends Congress for Ending Annual "Doc Fix" Ritual
ACAP CEO Margaret A. Murray expressed support for Congressional passage of the Medicare Access and CHIP Reauthorization Act of 2015. "The string of eleventh-hour “doc fix” agreements that had been part and parcel of the SGR was a disservice to physicians who served Medicare beneficiaries. Leaders of both parties in the House and Senate deserve significant credit for working in a bipartisan way to bring this practice to an end.
“That said, we at ACAP would like to see them apply the same logic to the Children’s Health Insurance Program (CHIP) and Medicare Advantage Dual-Eligible Special Needs (D-SNP) programs." Read the statement >
ACAP Applauds Steps to Consider Full-Benefit, Partial-Benefit Dual Eligibles Separately
In a recent statement on the 2016 Rate Announcement and Final Call Letter issued by the Centers for Medicare & Medicaid Services, ACAP CEO Margaret A. Murray voiced support for CMS's decision to consider accounting for full-benefit and partial-benefit dual eligibles separately in risk adjustment calculations. "We’re pleased that CMS directly addressed one of the concerns we raised in our comment letter by exploring treating full-benefit and partial-benefit dual eligibles separately in the risk-adjustment model. This change alone will improve the accuracy of payments to [Dual Eligible Special Needs Plans] that serve chronically ill and vulnerable populations." Read the statement >
4 in 10 Marketplace Issuers Offer a Medicaid Plan in the Same State; Featured in Georgetown CCF Blog
A new ACAP study finds that nearly 4 in 10 organizations that offer coverage through Qualified Health Plans (QHP) in public Health Insurance Marketplaces operate a Medicaid managed care plan in the same state, providing an opportunity for consumers with low incomes to select a source of coverage that may remain continuous, even if their incomes rise above the threshold for Medicaid eligibility. Such plans may also provide a single source of coverage to families with ‘split eligibility’—where, for instance, parents may be eligible for subsidized Marketplace coverage while their children are eligible for Medicaid or CHIP.
Read more > | Issue Brief > | Spreadsheet >
A March 23 post on A Children's Health Policy Blog authored by Meg Murray and Jennifer Babcock ties the findings of the brief to policies aimed at maximizing the benefits of "overlap issuers."
"The Affordable Care Act established an environment wherein most individuals have options of coverage regardless of income," they write. "Millions of individuals are expected to shift between Medicaid and the Marketplaces, so a significant remaining challenge is to ensure continuity and coordination of coverage as this occurs. A robust choice of overlap issuers in the Marketplace... will provide an array of options to ensure that the Affordable Care Act works for lower-income populations." Full blog post >
New Report Profiles Safety Net Health Plan Care Coordination Initiatives
A new ACAP fact sheet examines programs from four Safety Net Health Plans aimed at improving ways in which health plans coordinate care for specific populations in their membership. Care coordination is a hallmark of managed care in general, and Safety Net Health Plans in particular. Many Medicaid MCOs have devoted substantial resources to better organize the way care is delivered—especially to members who have a current or future high level of medical need. The paper was authored by The Menges Group.