Aimed at those who are responsible for gathering and reporting the data elements. The Uniform Data System (UDS) in-person training is a full day program covering the preparation of the 2013 UDS Report. The training addresses each of the tables, including a discussion of the changes that have been made and the definitions necessary to complete the reports. The UDS training is aimed at those who are responsible for gathering and reporting the data elements included in the UDS report, as well as management and clinical staff who need to understand the definitions and concepts used.
Obama Announces Change To Address Health Insurance Cancellations
President Obama announced Thursday an administrative change in one of the bedrock ideas of the new health-care law, allowing people with individual insurance policies to keep them for another year even if they do not comply with the law's rules for minimum benefits. "This fix won't solve every problem for every person, but it's going to help a lot of people," Obama said in making the announcement. He said that "doing more" would require congressional action.
HHS Announces 236 New Access Point Grants!
Last week, the Department of Health and Human Services (HHS) announced 236 New Access Point (NAP) awards in communities across the country. A list of awards can be viewed here. Funded with $150 million of the Affordable Care Act's Health Center Fund available for Fiscal Year (FY) 2014, these NAPs were previously approved but unfunded applications from the FY2013 round of 32 NAPs. These awards will increase access to primary care for over 1.25 million underserved patients at Community Health Centers nationally. The full NACHC statement can be viewed here.
Health and Human Services Secretary Kathleen Sebelius announced enrollment numbers today for the federal and state online health insurance marketplaces that opened Oct. 1. According to the HHS statement, a total of 106,185 Americans selected coverage through the health exchanges -- 79,391, or 74.8 percent, though a state marketplace; and 26,794 people, or 25.2 percent, through a federal exchange. HHS determined that "enrollment" includes people who have selected a plan who either have or have not yet paid the first month's premium. Medicaid enrollment data was also released.
Doctors Treat New Condition: Questions About Health LawCarolyn Senger, a preventive medicine doctor, regularly treats uninsured patients, coaching them how to stay healthy. Now she is teaching them one more thing -- how to sign up for insurance under the nation's Affordable Care Act. 'Not only can I help you with your health, but I can also help you get some coverage,' Senger says to her patients. Despite the ongoing controversy over the website and the rocky rollout of the law, the Obama administration still hopes that millions will sign up for new insurance options before the March 31 deadline. To make that happen, health officials are counting on physicians to shift the conversation from the online problems to the benefits of coverage. They are motivated by a longstanding principle: People trust their doctors
Consumers shopping for coverage on the new health insurance exchanges have been focused on the lowest-cost options. But some shoppers are trying to determine which plans offer the widest array of doctors and hospitals - and are finding that can be trickier than it sounds.
Funding supports new primary care sites in 236 communities to serve more than 1.25 million additional patients
The U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius today announced $150 million in awards under the Affordable Care Act to support 236 new health center sites across the country. These investments will help care for approximately 1.25 million additional patients.
Drug makers scored a significant win last week in their effort to increase sales from the rollout of the health-care overhaul, when the Obama administration cleared a path for the companies to help pay patients' out-of-pocket costs of prescriptions. At issue was whether drug makers could help cover the cost of copayments on brand-name drugs for patients who get insurance through the overhaul's new insurance exchanges. The pharmaceutical industry spent about $4 billion on copayment assistance to patients in private health plans in 2011, according to an estimate by Amundsen Group, a consulting firm.
WNPR's Jeff Cohen, working in partnership with Kaiser Health News and NPR, reports: "Before the Affordable Care Act was even open for enrollment, Viviana Alvarado was already taking calls from people who wanted to know more. She and about 40 of her colleagues are answering the phones for Maximus, the company Connecticut contracted to run its call center. The contractors running the troubled federal healthcare.gov website have been under intense scrutiny in the past month, but those businesses aren't the only ones being paid to roll out Obamacare"
Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces. If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around. "We need a broad range of people to make this work, and we're not seeing that right now," said Heather Thiltgen of Medical Mutual of Ohio, the state's largest insurer by individual customers. "We're seeing the population skewing older
Today, the U.S. Food and Drug Administration is set to announce a new regulation that will ban trans-fats from foods produced in the United States. While a timeline for phase-out has not yet been determined, FDA officials are committed to ensuring that it is done in a way that "doesn't unduly disrupt markets
Text "Connected" to 96000 to get the latest SMS updates on Maryland Health Connection right on your phone.
Report from the Maryland Health Benefit Exchange about Maryland Health Connection, the state-based health insurance marketplace, as of Friday, November 8, 2013
Overview
Interest in Maryland Health Connection remains high. Since October 1, there have been more than 400,000 unique visitors to our website and more than 54,000 calls to our call centers. As of November 7, 2013, more than 50,000 Maryland households have created accounts with verified identity, more than 37,000 have learned whether or not they are eligible for financial assistance.
As of October 2013, includes 83,991 Marylanders who are signed up to be automatically enrolled in Medicaid coverage on January 1, 2014.
Maryland Health Connection is revising its approach to providing numbers of enrolled Marylanders. Future reports will separate individuals versus households, qualified health plans versus Medicaid, and other information. For this reason, there is no updated enrollment data this week.
On November 8, 2013, the Board of the Maryland Health Benefit Exchange met to discuss the Maryland Health Connection's path to success. Executive Director Rebecca Pearce told the board that the project team continues to focus on three key goals:
* Improving the user experience. While a number of improvements have been made, additional work is underway to make the website faster, reduce error messages, and improve reliability.
* Eligibility assurance. Significant testing and review have confirmed the accuracy of the vast majority of eligibility scenarios, with software updates and other steps planned to address outliers.
* Transmitting enrollment data to carriers and Medicaid. The project is focusing on providing secure files of enrollment data to carriers and Medicaid over the next two weeks.
To support these core goals, the Board agreed with proposed plans related to other aspects of the system. These included:
* Bill payment. Accepting payment is not required of a state-based marketplace, and the Board approved deferring this option until after the core items are addressed. The ACA requires insurance carriers to be ready to accept the first payment from consumers, and our carriers are prepared to bill and receive the first payment from our enrollees.
* The Small Business Health Options Program (SHOP). Maryland has a well-functioning small group market which offers the same prices as those that will be offered through the small group exchange, known as the SHOP. The Board approved a plan to open the SHOP on April 1, 2014, which will allow more time for testing and coordination over the next several months.
* Spanish language. The Board approved a plan to launch a Spanish language version of the front end of the website by the end of November, with full translation of the application to come as soon as available. The Maryland Health Benefit Exchange also anticipates investing more in bi-lingual support.
* Provider search. The Board approved a plan to keep Maryland's provider search engine on an alternative website and to move it into the application after sufficient testing is completed.
Executive Director Pearce stated, "We are focusing our short-term strategy for success. I appreciate the Board's support of these critical priorities."
Data
The following information covers from October 1 through midnight the evening of November 7:
* Unique website visitors , 10/1-11/7: 404,581.
* Calls to call center , 10/1-11/7: 54,263.
* Accounts created with verified identity , 10/1-11/7: 52,581.
* Account-holders who have received eligibility determination for their household, 10/1-11/7 : 37,101.
* Marylanders to be Automatically Enrolled in Medicaid Expansion, October 2013: 83,991.
Information for Users of MarylandHealthConnection.Gov
Many Marylanders are now able to navigate the website through the entire process; they can establish accounts, find out about eligibility for Medicaid and subsidies, shop for plans, and choose to enroll. Some, however, are still having trouble getting through end-to-end because of technical problems that we are working to address. Options for consumers when having trouble:
* Visit the Consumer Information Update page for important notices before beginning. The page is found under the "News and Events" tab under the heading of "Consumer Information." These notices include advice on how to navigate some of the issues on the website as we work to address them.
* Try again at a later time. At times of peak usage, heavy volume can still cause errors and delays.
* Call the Consumer Support Center at 1-855-642-8572 toll-free to discuss the issue or start an application by phone. Hours of operation are Monday through Friday, 8 am. - 8 pm., Saturday 8 am. - 6 pm., and Sunday 8 am. - 2 pm.
* Talk to a consumer assistance worker or authorized insurance agent for assistance. The link to contact information for connector entities in each of the State's six regions can be found on the Prepare for Enrollment page which is accessible from the landing page at the front of the website, or under the "Individuals and Families" tab under the heading of "Consumer Assistance."
Timeframe for completing applications:
* Open enrollment extends through March 31, 2014, and the earliest coverage can become effective is January 1, 2014. Consumers purchasing qualified health plans (as opposed to qualifying for Medicaid), who want coverage beginning January 1, must complete their applications and make their first payments by mid-December.
Feedback:
* If consumers using the site run into any issues and want to provide feedback, they can do so via the link found on the Consumer Information Update page. Information from users is sent to Maryland Health Connection's technical team working to improve the user experience on the site.
Website availability:
* As the technical team continues to improve the experience of using the website, it may from time to time be temporarily unavailable. In addition, in order to perform routine maintenance, certain functions may be unavailable from 11 pm. to 5 am. daily throughout the month of November.
Accessibility for Spanish language users:
* Marylanders can download from the site a range of materials in Spanish, including videos and written overviews of Maryland Health Connection, fact sheets on income eligibility, Medicaid, health insurance, fraud protection, and assistance for small businesses, and answers to frequently asked questions. The Spanish version of the application for health coverage and financial assistance is also available, and bi-lingual staff can provide consumers assistance in Spanish through the call center and connector entities.
* We are working to make Maryland Health Connection's website available in Spanish as soon as possible. We expect the front section of the site, i.e., the "Prepare for Enrollment" and other consumer information pages for individuals, families, and small businesses, to be ready first.
Accessibility for persons with disabilities:
* Consumer information materials will soon be available in Braille and large print. More information about when the website will be compatible for blind consumers' software will also be provided soon. Consumers seeking services for the deaf or hard of hearing may call the Consumer Support Center toll-free at 1-855-642-8573.
Security of information on website:
* Maryland Health Connection, supported by experts in IT security at government agencies and through our IT team, has taken many steps to assure the security of the data entered on the website.
Accessing information about health plan benefits, rates, and providers before creating an account:
* We have posted a webpage, Prepare for Enrollment which provides information on plans, shows sample rates for a range of scenarios, and provides instructions on the documents needed for the application for financial assistance. In addition, a Provider Search Tool which is accessed through a link on the "Prepare for Enrollment" page, allows consumers to search for a doctor and find out the plans in which their doctor participates. A link to this tool is also made available to consumers during the actual plan selection process.
eHealth Inc., the nation's largest online seller of health insurance, is offering to run Obamacare enrollment for the federal government while the balky healthcare.gov website is being fixed. Gary Lauer, chief executive of eHealth, said in a letter this week to President Obama that his Mountain View, Calif., company was willing to operate the federal exchange through its website as a temporary stopgap to give officials more time to repair the troubled online marketplace. Thousands of small businesses around the U.S. are racing to renew their health insurance policies Dec. 1 to beat large premium increases their brokers say will hit them Jan. 1 when the Affordable Care Act takes full effect. Some health insurance brokers also say 2014 may be the last year many of the companies even offer health insurance
More hospitals are receiving penalties than bonuses in the second year of Medicare's quality incentive program, and the average penalty is steeper than it was last year, government records show.
Medicare has raised payment rates to 1,231 hospitals based on two-dozen quality measurements, including surveys of patient satisfaction and-for the first time-death rates. Another 1,451 hospitals are being paid less for each Medicare patient they treat.
The Latest News on ACA
What's the LATEST
on the ACA this week?
*Success stories/Barriers
Please complete the following two questions as it related to your health center:
1.) Major outreach and enrollment issues/barriers encountered for your health center in this reporting period 7/1/2013 - 9/30/2013?
2.) Key strategies and lessons learned that have contributed to the success of your health center outreach and enrollment efforts in this reporting period?
HHS recently posted stories about individuals who enrolled in the Marketplace at the HHS storyboard. It's encouraging to read through some of these stories, and be reminded about the importance of the work we are doing together to enroll people in coverage. Take a look at this video profiling Daniel, a young man in Florida, or another video about Deborah from New Hampshire, who had a pre-existing condition and is excited about her coverage that starts in January 2014.
Consumers can always share their stories using the hastag #GetCovered on Facebook, Twitter, and Pinterest. (share this with consumers)
Marketplace Tech Update
In the past week, the Marketplace has made great strides to improve the online system and encourage you to utilize the online system as your first option for enrollment. The Marketplace continues to improve the overall user experience each week on HealthCare.gov, so that by the end of November the site will be functioning smoothly for the vast majority of users. CMS is working through the list of items to improve the HealthCare.gov marketplace functionality. The tech team has put into place fixes to address performance and functionality and will continue to make progress each week. They have added a blog entry that will be updated with information about the latest fixes and current plans to improve the website. It contains links to the following:
To make sure that consumers appropriately fill out the application, the Marketplace have a few tips below about attesting that someone will file taxes in 2014 and that the person will not be enrolled in comprehensive Medicaid in 2014.
Filing Taxes: If you are helping someone file an application and they want to be considered for financial assistance, including advance premium tax credits ("APTC") or cost sharing reductions (CSRs), they must file taxes. Filing taxes is a requirement to get APTC. If someone wants to be considered for APTC / CSR, they need to express that they will file taxes in 2014, even if they have not filed taxes in the past. If the consumer does not indicate that they will file taxes in 2014, the consumer will be determined ineligible for APTC because the consumer will have attested on their application to being a non-filer (not filing taxes in 2014). This information is important for all assisters to become familiar with. When you help someone fill out the application, please make sure that the consumer expresses that they will file taxes by checking "Yes" on p. 2 of the family paper application. Question 6 on page 2 asks, "Do you plan to file a federal income tax return NEXT YEAR?" If the consumer wants to be considered for APTC/CSR, they should check "yes" here.
Medicaid that will end before January 1, 2014: If you are helping someone who has Medicaid now but it will end before January 1, 2014, that person can apply to buy private insurance through the Health Insurance Marketplace. Depending on his or her household income and size, he or she may qualify for lower costs on premiums or out-of-pocket costs.
Note: When filling out an application, consumers should not check the box saying the person has Medicaid, because the coverage will be ending. Check "No" or "None of the above" instead. For example, look at p. 6 on the family paper application, step 4, question 1. In addition, please refer to our FAQ on HealthCare.gov at What if I have Medicaid coverage, but I got a notice saying my Medicaid will end?
Medicaid that provides limited benefits: If you are helping someone whose Medicaid coverage pays only for family planning, emergency Medicaid, tuberculosis services, or outpatient hospital services, the consumer can apply for coverage through the Health Insurance Marketplace . He or she could get this coverage in addition to his or her Medicaid coverage. Depending on the household size and income, the person may qualify for lower costs on their monthly premiums and out-of-pocket costs.
Note: When you fill out a Marketplace application and are asked whether the person has coverage now, don't check the box saying you have Medicaid. Check "No" or "None of the above" instead. For example, look at p. 6 on the family paper application, step 4, question 1. What if I have Medicaid now, but I only have limited benefits?
Enrolling in a plan by March 31: CMS posted an FAQ clarifying that consumers who sign up for Marketplace coverage at any time during the initial open enrollment period will not be subject to the shared responsibility payment (the mandate penalty). The policy FAQ can be found on the CCIIO website. Consumer-friendly language can be found on HealthCare.gov at under "Enroll by March 31, 2014 and You Won't Have to Pay the Individual Responsibility Payment."
Issue of the Week: What Works at Outreach and Enrollment Events
We are thrilled to hear about some amazing events that are happening across the country where assisters are reaching out to people and encouraging them to enroll in coverage. Using the early experience, we've put together some tips on "what works" at these outreach and enrollment events.
Timeliness of staff: Make sure your team is responsive, on time and willing to work side-by-side with other groups supporting enrollment, from set up to break down.
Equipment: Make sure you have a plan for coordinating the equipment, for providing laptop computers, a tablet and continuous internet access on site.
Separation of booth space: Have a dedicated area (table and chairs) for enrollment assistance, in addition to an area for outreach. It helps with the flow of attendees to have separate places for people to sit at the booth. Be sure to allow for privacy in the area where you will be helping with enrollment assistance.
Branding: Consider ways to promote a unified "brand." Materials and T-shirts that make the whole group look as one cohesive unit can be effective.
Language capability: Know your population and try to coordinate so that you can provide assistance in the language people feel comfortable with. It's a good idea to have a balance of English-speaking assisters and assisters who speak other languages for some events.
Definition of roles: Develop a "run-of-show document" or do a quick meeting prior to starting the event with all of the event staff to understand what each member of the group is responsible for during the event.
Visitors counter equipment: Have a way to keep an accurate count, consider what additional equipment, like a "booth counter," or whether you have a dedicated staff member to perform that function. After the event, it will be important to have a running tally of booth visitors.
Additional means of capturing attention from event attendees: Think of creative ways to garner attention for the booth! You can attract greater traffic to a booth through innovative mechanisms, such as a Zumba class or by using the PA system to ask on-lookers to stop by if they need additional information on the Health Insurance Marketplace. These are great ways to successfully drive greater traffic to your booth.
Later consultations: Have mechanisms to collect information from booth attendees that need additional information to schedule follow-up consultations. It can be an extremely helpful way to manage traffic, make the most out of brief interactions, and continue the conversation after the fact. Make sure you get the attendee's permission to collect their personally identifiable information!
Helpful Tools and Information
Starting 2014, most individual plans must offer new benefits and protections. Some plans will be changed or replaced with upgraded plans with these protections. If this happens, a consumer can choose to buy a plan in the Health Insurance marketplace instead. All Marketplace plans include the new benefits and protections. If the person switches to a Marketplace plan, he or she may qualify for lower costs based on his or her income.
Given the changes required in 2014, insurance companies offering individual plans have two choices:
They can make upgrades to the person's plan to provide these benefits. If they do, the person will see these changes to his or her plan by the time he or she renews during 2014. For example, if the person's renewal date is in July 2014, he or she would see the changes no later than July.
The insurance company may cancel the plan and decide to offer the person other individual plans.
Under the Health Insurance Portability and Accountability Act (HIPAA), a law in place before the Affordable Care Act was passed, individual policies are generally "guaranteed renewable" at the end of the 12-month contract. The insurance company can increase premiums, increase cost-sharing, and/or reduce the scope of benefits covered.
The insurer may stop offering the plan entirely if it meets all of the following requirements. It must:
Provide the consumer with at least 90 days' notice in writing
Offer the consumer the choice to buy any other individual plan it offers in that market
Treat all covered individuals the same, regardless of health status
Follow any additional state requirements
The only time an insurer can cancel an individual plan without offering the consumer the chance to buy a new plan is if the insurer chooses to end all health insurance in a state's individual market. If an insurer ends all coverage, it can't offer coverage in that state's individual market again for 5 years. It also must notify the state and all plan holders in writing at least 180 days before stopping coverage.
In addition, insurance companies can't market plans in a way that discourages people with significant health needs from enrolling.
If there is concern that an insurance company isn't following these rules, contact the State Department of Insurance.
If the consumer's plan is being cancelled or replaced with one that costs more, he or she can use the Health Insurance Marketplace to find a new health plan.
The Marketplace recently posted a helpful fact sheet that you can review.
You can see consumer-friendly language about plans that are changing or not being renewed in 2014 on HealthCare.gov.
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For other helpful outreach and enrollment resources, please click here.
To help expand and support the nation's supply of primary care practitioners, HHS Secretary Kathleen Sebelius today announced the availability of funds for two programs that receive funding under the Affordable Care Act.
The foundation plans to award up to five health centers, look-alikes, or primary care associations with approximately $200,000 to be dedicated to outreach and enrollment initiatives.
Application Deadline: December 1, 2013 (subject to change)
On behalf of Pittsburgh area funders, the Jewish Healthcare Foundation has announced a unique funding opportunity for nonprofit organizations and community-based groups for outreach, recruitment and training that targets the enrollment of uninsured Pennsylvanians in qualified health insurance plans through the Health Insurance Marketplace. Mini grants ranging from $2,500 to $10,000 will be made available to organizations willing to undertake these efforts.
Application Deadline: January 14, 2014 (3:00 pm ET)
The Robert Wood Johnson Foundation Executive Nurse Fellows program is a three-year advanced leadership program for nurses who aspire to lead and shape health care locally and nationally. Fellows strengthen and improve their leadership abilities related to improving health and health care. Interested health center nurses should feel free to contact Cheri Rinehart, PACHC President & CEO and a graduate of the program, for more information, including other PA health center alumni of the program.
Debunk the Myths: Grant Application Video Series
Federal grants can be excellent funding opportunities for your project, but not understanding the process can lead to a great deal of frustration. This video series will debunk common myths and assist you with your grant applications.
Service Area Competition - New, Competing Continuation, and Supplemental (HRSA-14-021, HRSA-14-022, HRSA14-023, HRSA-14-024, HRSA-14-025, HRSA-14-026, HRSA-14-027, HRSA-14-028)
Through the Service Area Competition (SAC), HRSA will award approximately $468 million in funding to an estimated 310 SAC applicants. A SAC application is a request for Federal financial assistance to support comprehensive primary health care services for a competitively announced underserved area or population. All available service areas (see below) are currently served by Health Center Program grantees whose project periods are ending in FY 2014.
Application Deadlines
Project Period Start Date
HRSA Announcement Number
Grants.gov Deadline (11:59 PM ET)
HRSA EHB Deadline (5:00 PM ET)
November 1, 2013
HRSA-14-021
July 24, 2013
August 7, 2013
December 1, 2013
HRSA-14-022
July 31, 2013
August 14, 2013
January 1, 2014
HRSA-14-023
August 14, 2013
August 28, 2013
February 1, 2014
HRSA-14-024
September 11, 2013
September 25, 2013
March 1, 2014
HRSA-14-025
October 9, 2013
October 23, 2013
April 1, 2014
HRSA-14-026
October 30, 2013
November 13, 2013
May 1, 2014
HRSA-14-027
December 4, 2013
December 18, 2013
June 1, 2014
HRSA-14-028
January 8, 2014
January 22, 2014
*Please click on the title for more information regarding the various grants.
Grants to leverage the capacities of existing broad-based networks of providers and other key stakeholders to disseminate and implement existing evidence for improving the quality of care delivery. Spread of evidence to support change in care delivery requires coordination, buy-in and active participation by diverse providers across multiple settings of care, collaboration with other key stakeholders (including payers and consumers) who are instrumental in shaping care delivery, and adaptation of interventions to local conditions. In recognition of these well-documented challenges and needs, this funding opportunity requires that applicants represent existing networks of providers and other stakeholders that have the knowledge, on-going relationships, expertise, infrastructures, past experience and understanding of local needs and constraints to maximize buy-in, collaboration, and appropriate adaptation to local conditions.
Application Deadline: Applications accepted on an ongoing basis Loan program to Section 330 health centers to obtain a loan guarantee for the financing of a medical facility construction, renovation and modernization.
Health Observances This Week
November is National Alzeimer's Disease Awareness Month
November is National Alzheimer's Disease Awareness Month and National Caregiver Month. In the United States, there are more than 15 million Alzheimer's and dementia caregivers. We want to send these exceptional people a big "thank you" for everything they do. Honor them by sharing your tribute message! Read more: http://www.alz.org/care/honor-caregiver.asp#ixzz2k4s6tp00
Has your FQHC joined the
National Branding Campaign?
With more than 43 billion people eligible to enroll in private insurance starting this October 1, FQHCs strive to create an identifiable unifying identity for themselves. This is where the National Branding Campaign for Our Health Centers comes into place.
The campaign is a national branding effort to strengthen recognition of our Health Centers as a unified and nationwide network of quality community-based primary care providers. Initially created at the state level by the Pennsylvania Association of Community Health Centers (PACHC) and its membership, the National Association of Community Health Centers has expanded the campaign nationwide.
The FQHC Brand Components
MACHC recently hosted a Branding Webinar for MD and DE Health Centers with CEO of PACHC, Cheri Reinhart and Event and Communications Coordinator, Kirsten Keyes, as guest speakers. If you missed the webinar and would like access, please click here.
Mid-Atlantic Association of Community Health Centers | | aneeqa@machc.com |
