MACHC
Weekly E-Blast:  
Voicing the latest news on Communities in Need
In This Issue

Next Enrollment Period starts
 November 15, 2014!!!
Have news to share with us? Want to be featured on our next E-Digest? Want to read about something in particular? Please email us at aneeqa@machc.com. 

Let's Stay Connected
    
June 23, 2014 
MACHC SPOTLIGHT
MACHC Website Under Construction..... 

New Updates coming this SUMMER 

Technical Assistance Request Form 
---to be submitted prior to receiving any TA from MACHC---

CONGRATULATIONS Three Lower Counties on collecting over 3000 signatures for the Access is the Answer Campaign. 

TLC has been a wonderful example and we hope more health centers get involved! 

 

 

Join the Access is the Answer Campaign and advocate for CHC Funding! (template attached)

Health Centers are facing an unprecedented threat and a unique opportunity in 2014. Like every year, Health Centers will have to fight to secure annual funding from Washington. But unlike any year in Health Center history, this year we face a looming Health Center funding cliff - a potential 70% reduction in Health Center program funding scheduled to take effect in 2016. As Health Center Advocates we will also have to make sure that programs, like Medicaid, that are essential to our survival remain intact and strong in the face of efforts to save money.

These are threats to Health Centers AND to the more than 22 million patients Health Centers currently serve and the millions more that Health Centers will need to grow to serve in our communities. Your advocacy through the Access is the Answer campaign is essential if we are to ensure that Health Centers will be there for everyone who needs access to health care.

What can YOU do?

To make the Access is the Answer campaign a success, commit to taking 3 easy action steps:

Number 1: Sign the Access is the Answer petition. 

Number 2: Work with your Health Center leadership to collect Access is the Answer support letters from local elected officials

Number 3:  Work with your Health Center leadership to collect community support letters. 

The value of advocacy:

All politics is local. Congress and the President do really pay attention to the voices of those back home in the community. That means the most effective advocacy has to come from YOU back home.

The Access is the Answer Campaign will be asking Advocates to weigh in on many issues as the campaign goes forward, but if YOU and tens of thousands of Advocates take the 3 steps, we will be laying the foundation for success in a fight neither Health Centers nor our patients can afford to lose. Thanks for joining the Access is the Answer campaign and building the power of Health Center Advocacy.  

MACHC Happenings

MACHC EVENTS

(1) 
PolicyPLUS Webinar
June 25th, 2014 12:30 PM   through   
1:30 PM
HRSA has announced they plan to schedule over 700 Operational Site Visits this year.
That, combined with the ramped up scrutiny from other accrediting and recognition agencies, is why having an online policy, credentialing, and quality management solution like PolicyPLUS has never been more important.  PolicyPLUS has partnered with MACHC to provide you with an powerfully effective, secure, simple to use, and affordable solution.  Several of your fellow  MACHC members are already enjoying the benefits of PolicyPLUS.  Join us on the webinar to see if you could benefit too.
PolicyPLUS™ your convenient online database that Stores, Manages, & Archives your Policies, Procedures, Credentials & QA/QI

  

(2) MACHC Outreach & Enrollment Team Call
When: June 27th
Call in: 1-866-740-1260 Access code: 4319483
Bi- weekly team updates, best practices shared and issues discussed. 

  

(3) MA
CHC Board Retreat

 When: July 10 - 11th, 2014

Where: TBA
Look out for more details here in the coming weeks.
 
(4) MACHC Emergency Preparedness Call
When: Wednesday, July 23, 2014
Discuss MACHC's EP activities with members thus far, future efforts. Additionally, discuss ways to be more active and show FQHC value to others through DHMH HPP calls.
 
(5) SAVE
 THE DATE
MACHC's Annual Conference
When: Thursday, September 18th - Friday, September 19th, 2014 
Where: Dover Downs Conference Center, Dover, DE
  • OTHER EVENTS
  •  
  •   

  •  (1) SAMHSA-HRSA Webinar: Health 

     BPHC is hosting a webinar to provide an overview of topics including LGBT health disparities, demographics, and terminology, as well as key strategies for bringing high quality care to the LGBT community at health centers. 

     

    (2) Health Centers Serving LGBT Populations Enrichment Webinar - Tuesday, June 24, 2014, 1:30pm - 2:30pm, ET

    BPHC is hosting a webinar to provide an overview of LGBT health disparities, demographics and terminology, as well as key strategies for bringing high quality care to the LGBT community at health centers. 
    View more information on this webinar

     

    (3) New Medicare Prospective Payment System (PPS) for Federally Qualified Health Centers (FQHCs): Operational Requirements Call - Wednesday, June 25, 2014, 1:30pm - 3:00pm, ET:
    As required by Section 10501 of the Affordable Care Act, FQHCs will transition to PSS beginning October 1, 2014. This National Provider webinar will provide information on operational requirements of the new payment system.  

     

     

    (4) An Introduction to FEMA Public Assistance for Healthcare Facilities Webinar! 

    YNHHS-CEPDR is offering a one-hour webinar describing the basics of the FEMA Public Assistance program and how it applies to healthcare facilities, free of charge.  The webinar will review expenditures that healthcare facilities typically incur during a disaster response and which may be eligible for reimbursement under the Public Assistance Program, as well as eligibility criteria for reimbursement. The webinar will take place on June 26th from 1:00PM EDT.  

    Click here to register

     

    (5Leveraging Multiple State Data Sources to Drive Improvement in Population Health Outcomes

    States have a variety of metrics and data sources that potentially can be used to assess and improve population health outcomes. In order to maximize this potential, states need effective strategies to collect, analyze, integrate, and use data from various sources, and to share it across multiple agencies and health care organizations for activities that drive improvement for all populations. This webinar will feature an overview of state opportunities to identify and use data from a variety of sources to examine subpopulations, identify needs, and target interventions to address the needs of distinct populations. The webinar will also feature a discussion among three states that have taken innovative approaches to using data to drive meaningful changes in health outcomes for various subpopulations with critical needs. Maryland will discuss applications of its health information exchange (the Chesapeake Regional Information System for our Patients - CRISP) to identify issues and areas of focus, Ohio will describe partnership between Medicaid, managed care plans, and public health agencies to use data to address infant mortality and improve perinatal care quality, and Louisiana will highlight how it uses various data sources to create new quality and pay for performance metrics with the goal of improving birth outcomes. Following the panel discussion webinar participants will have an opportunity to ask questions of the presenters.

     

    (6) ANNUAL 340B COALITION CONFERENCE

    When: July 14 - 16

    Now is the time to register for the 18th Annual 340B Coalition Conference, which takes place in Washington, D.C.The federal government will be publishing new regulations that will significantly impact all program stakeholders. 340B's rapidly evolving nature makes it important for all stakeholders to stay on top of program changes. Whether you work for a health care provider, contract pharmacy, pharmaceutical manufacturer, 340B-oriented business, or government agency, there is no better way to stay informed and have a voice in shaping the program's future than to attend.

     

    Register now at www.340Bcoalition.org to take advantage of the early bird rates which expire June 1st. If you have questions, please contact Sam Wilhelm-Ross at (202) 536-2280 or sam.wilhelm-ross@snhpa.org. Special discounts are available for members of the 340B Coalition Organizations and Drug Discount Monitorsubscribers. Click here to watch our video about the conference. 

    (7) STD/HIV Prevention Training Center at Johns Hopkins
    Increase your knowledge regarding Sexually Transmitted Infections
    Take our STD Intensive Course!
    Course dates: (Baltimore); July 21-25, 2014 (Baltimore);
    Cost of the class is $250.00 for the entire week. CE is provided
     One week course
     Emphasis on reportable and selected prevalent STIs and associated syndromes
     3 days of Lecture, one day in the lab, one day in the clinic and some case studies
     50% of class time clinical and laboratory experience
     Registration is limited to 10 full-time participants
    For more information and registration details, CLICK HERE

     

    (8) SAVE - THE - DATE 

    2014 COMMUNITY HEALTH INSTITUTE (CHI) & EXPO at MANCHESTER GRAND HYATT

    AUGUST 23-27, 2014

    REGISTRATION IS NOT YET OPEN!

    Community Health Institute (CHI) & EXPO is THE largest and most important annual gathering of 2000 community health center  managers, clinicians, employees, board members and leaders. Every aspect of the community health center movement is represented and  fully-vested at CHI, making it an excellent networking opportunity. CHI provides essential up-to-date information, training and technical  assistance on the latest community health center challenges, providing professionals in the industry with cutting-edge strategies for community health center success                                       

    Emergency Preparedness Events:

     

    ATTENTION MD FQHCS - Please check inbox for MACHC Emergency Preparedness & Management Call on Wednesday, July 23rd at 10 AM. Mark it on your calendars! Representation from each FQHC is required.

     

    *For those of you who missed MACHC's Table Top Exercise (TTX) this past Thursday, June 12th and are interested in the materials, please email Aneeqa Chowdhury at aneeqa@machc.com. 

     

    During the month of June, OP&R and MEMA are co-sponsoring two ICS position-specific awareness trainings, to be held at DHMH Headquarters in Baltimore. Please see below for detailed information and registration links. 

     

    June 30: Incident Command and Planning Section Chief

    DHMH Training and Exercise Project

    ICS Position Specific Awareness Training - Incident Commander and Planning Section Chief

    Course Announcement

    In coordination with the Department of Health and Mental Hygiene (DHMH), the Maryland Emergency Management Agency (MEMA), Active Learning and Exercise Branch invites you to participate in the ICS Position Specific Awareness Training - Incident Commander and Planning Section Chief training course. This course is awareness-level only.

    Date: June 30, 2014

    Time: 8:30 am to 4:30 pm

    Location: Lobby Conference Room L-3, 201 W. Preston Street, Baltimore, MD 21201

    Overview: This awareness-level course will provide local- and State-level emergency responders with an introductory understanding of the duties, responsibilities, and the capabilities of an effective Incident Commander (IC) and an effective Planning Section Chief (PSC). 

    The IC is responsible for the overall management of the response. The IC directs and/or controls resources by virtue of explicit legal, agency, or delegated authority. The IC is responsible for all aspects of the response and therefore sets priorities and defines the ICS organization for the particular response.  

    The PSC is responsible for the collection, evaluation, dissemination and use of information about the development of the incident and the status of resources. 

    Prerequisites: IS-100.b; IS-200.b; IS-700.a; and IS-800.b; (or equivalent)
    Recommended: ICS-300; and ICS-400

    Logistics: Lunch will not be provided.  Attire is business casual or daily uniform.

    Register: Registration closes on June29, 2014.  To register, please click here.

    Before registering for the class, students must create an account on the MEMA Learning Management System (LMS) website and obtain a FEMA Student Identification Number (SID). Links to the FEMA SID registration site and the MEMA LMS account registration website are found at the above link.

    For additional assistance, contact Reed Correll at reed.correll@maryland.gov

     

     

    *These are excellent training opportunities for those who may need to brush up on their skills or gain fresh knowledge and insight into the Incident Command System.
    Policy, Advocacy and Legislation
    National News
    Spanish-Language Version of Policy Information Notice (PIN) 2014-01: Health Center Program Governance  
    Spanish-Language Version of Policy Information Notice (PIN) 2014-01: Health Center Program Governance  -PIN 2014-01 provides detailed information about Health Center Program governance requirements. A new Spanish version of PIN 2014-01 now available. 

    World View: How the U.S. Compares in HealthCare 

     by Amy Simmons Farber

    The U.S. healthcare system may be the most expensive in the world, but we're not getting what we pay for in terms of quality.  A report by the Commonwealth Fund   says it performed worse than other industrialized nations when it came to measures of access, patient safety, coordination, efficiency and equity.  Among the nations studied were Australia, Canada, Germany, The Netherlands, and New Zealand.   The report looked at surveys of patients and primary care physicians from 2007-2009 and found that one notable way the U.S. differs from other countries is the absence of universal health insurance coverage.  The report also said other nations ensure the accessibility of care not just through universal insurance, but also with better ties between patients and the physician practices that serve as their long-term medical homes.  While the data used for the Commonwealth study is prior to the implementation of the Affordable Care Act (signed into law in 2010 and implemented in 2014), it should offer a baseline and some insight into the improvement of affordability of insurance and access to care.

     

    Other key findings:

    • Compared with the other 10 countries, the U.S. fares best on provision and receipt of preventive and patient-centered care.
    • Without universal coverage-people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost. Patients in the U.S. have rapid access to specialized health care services; however, they are less likely to report rapid access to primary care than people in leading countries in the study.
    •  Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs.
    Our two cents: the expansion of Community Health Centers will ensure that more people in need will have access to primary care. We also know that health centers are more likely to see new uninsured patients than other providers, and their patients are more likely to have a usual source of care than the uninsured or privately insured.  Also, uninsured health center patients are half as likely as other uninsured to delay care because of cost, go without needed care, or be unable to refill a prescription. Check out the 

    Senate LHHS Subcommittee Approves Increase in Funding for Health Centers in FY2015

    The Senate Labor, Health and Human Services (LHHS) Subcommittee on Appropriations approved their Fiscal Year (FY) 2015 spending bill by a voice vote. Under the legislation, Health Centers will receive approximately $1.49 billion in level discretionary funding. The Affordable Care Act (ACA) also provides $3.6 billion in mandatory funding through the Health Center Fund for FY2015. This represents a combined total FY15 program level for Health Centers of approximately $5.1 billion under the Senate FY15 LHHS bill consistent with NACHC's request. 

    HRSA issued two new Program Assistance Letters (PALs): PAL #2014-07: Scope Alignment Validation in HRSA Electronic Handbooks, and PAL #2014-08, Health Center Program Requirements Oversight. Both of these PALs include important information impacting Health Centers' compliance with Program Requirements and potential consequences of non-compliance. 

    New Report Released on Best Practices for Enabling Services

    The Association of Asian Pacific Community Health Organizations (AAPCHO) recently released a report highlighting the most promising enabling services used in Health Centers today and innovative strategies Health Centers have used to provide these services. 

    Start Planning: National Health Center Week Resources Available

    National Health Center Week 2014 - Celebrating America's Health Centers: Local Engines for Healthier Communities - is coming up fast (August 10th-16th). Now is the time to start planning and POSTING your events for this year's celebration. Access tools and resources on the NHCW website including best practices to recruit local event sponsors, event ideas, fact sheets, and media tools and templates. Be sure to check out the NHCW Store to order event items and giveaways for your celebrations - NHCW t-shirts will be 15% off from June 23rd to June 30th! Get started today to make sure your NHCW celebration is a success - post event information on the NHCW website today. The password to post events is: healthy. 

     

    Public Notice: Proposed Medicaid state plan amendment governing health homes for individuals with serious mental health conditions

    Hoping to better address the needs of those suffering from mental health ailments, the DC Department of Health Care Finance and Department of Behavioral Health are proposing a new Health Home State Plan that seeks to:

    • Improve the integration of physical and behavioral health care
    • Lower rates of hospital emergency department use
    • Reduce avoidable hospital admissions and re-admissions
    • Reduce healthcare costs
    • Improve the experience of care, quality of life and consumer satisfaction, and Improve health outcomes.

    Say what? Many patients struggling to learn the foreign language of health insurance

    Now armed with insurance and ready to seek out health care services, many individuals across the country are finding themselves lost when it comes to utilizing their coverage.  "Giving somebody an insurance card and not really telling them what that insurance is going to do for them is not going to produce the health outcomes that we all want to see," said Brendan Saloner, a post-doctoral researcher at the University of Pennsylvania. "If the goal is to improve health and lower costs ... it is really important to equip consumers with the education they need."

    Hoping to improve health outcomes and reduce rates of heart disease and stroke, the U.S. Food and Drug Administration is working to set new standards for sodium levels in foods sold in stores and restaurants.

    New State Reform Blog Post
    State Refor(u)m's latest blog post explores the role for community health workers (CHWs) in a changing health care delivery system. CHWs can help improve outcomes in many different areas of the health care system, including prevention, chronic disease management and achieving health equity. Because CHWs have diverse roles, there are many different approaches to payment methods and education processes.
    State News
    DELAWARE

    Delaware state health improvement plan welcomes comments

    The Delaware Division of Public Health is accepting public comments until June 31 for the first state health improvement plan. 
    DPH collaborated with nonprofits and medical providers to create a statewide health assessment. The assessment was then used to develop and improve the plan's goals.
    The two priority goals are to assure the means to increase healthy eating and active living, and to improve access to mental health and substance abuse services across the state. 
    For more information, visit dhss.delaware.gov
     
    MARYLAND
    STATE OF THE HEALTH EXCHANGE FIX
    146 days. That's how much time the Maryland Health Benefit Exchange has left to implement a brand-new, fully functional website for individuals to shop for health insurance, reports Alissa Gulin for the Daily Record. MHBE officials pledged to have the new system - which would replace the original, malfunctioning Maryland Health Connection site - up and running by Nov. 15, when the next open enrollment period begins. But it's nearly impossible to verify if the agency is on schedule and on budget, and it's unclear who - if anyone - has external oversight of the project. 

    Maryland hospital will stop hiring smokers

    A hospital in Maryland's capital city will stop hiring people who smoke.

    Anne Arundel Medical Center said in a news release posted on its website Thursday that beginning July 1, 2015, the hospital will no longer hire nicotine users.

    The hospital also said tobacco use, including e-cigarettes will be banned anywhere on its campuses starting next month.

    The hospital system, with its main facility in Annapolis and other facilities in Bowie, Kent Island, Odenton, Pasadena and Gambrills, employs more than 4,000 people.

    The hospital will test for nicotine as part of its routine drug-screening urine test.

    Current employees who smoke will not lose their jobs, the hospital said.

    Finance & Business
    New Technical Assistance Opportunity for States Implementing Multi-Payer Payment Reform 
    With support from Kaiser Permanente Community Benefit, NASHP is pleased to announce an opportunity for state teams with responsibility for payment and delivery system reform to join a small learning community of peers. State teams selected to participate will join this Project Community and gain access to targeted phone-based technical assistance from leading experts, interactive learning experiences through a dedicated listserv, and virtual structured peer learning with other state officials. Please contact Tess Shiras (tshiras@nashp.org) to request a short application.
     

    ICD-10 Webcast for Pediatrics Available Online

    The Centers for Medicare & Medicaid Services (CMS) has posted a newly released webcast on ICD-10 documentation and coding concepts for pediatrics. This is one of a series of "Road to 10" webcasts and CMS ICD-10 resources. An AHIMA-certified coder presents on the webcast, which focuses on unique ICD-10 clinical documentation needs and hot topics for pediatrics such as the physician perspective/clinical impact of ICD-10, documentation requirements for certain conditions, documentation changes and new concepts, and the use of "unspecified" codes in ICD-10. CMS will also offer other webinars in the "Road to 10" series that will follow the same outline and objectives for other specialties, including obstetrics and gynecology, family practice, and internal medicine.

     

    The Center for Medicare & Medicaid Services (CMS) will hold its second call on the Medicare FQHC PPS on June 25, 2014. The call will focus on the operational requirements including the new "G-codes", billing and claims processing, cost reporting and coding. 
    The
    Latest News on ACA
     
    OUR WORK IS NOT OVER

      

     

    Virtual Convening on Health Care for the Uninsured 

    Please 

    for an exciting "virtual convening" on strategies for providing affordable health care to low-income immigrants and other people who remain uninsured after the Affordable Care Act. 


    Wednesday, June 25
    1:00-2:30 PDT/4:00-5:30 EDT
    For more information and to register:


    Our outstanding panelists for this public-private sector discussion are:

       * Tangerine Brigham, Department of Health Services, Los Angeles County
       * Betzabel Estudillo, California Immigrant Policy Center
       * John Jurenko (invited), New York City Health and Hospitals Corporation
       * Danielle R. Lewis, DC Department of Health Care Finance 

    NILC Submits FOIA Request on Identity Proofing in ACA 

    A very large number of immigrants and their family members have been unable to submit their applications online because they lack sufficient credit history to verify their identity electronically. Yesterday, NILC submitted a

    Freedom of Information Act (FOIA) request to the U.S. Dept. of Health and Human Services (HHS) seeking information about the federal government's rationale for implementing such a rigorous verification process, as well as data on the number of people who have been blocked from completing the enrollment process due to identity verification problems.   

    Immigrant Families Who Had Problems Applying:
    Special Enrollment Periods (SEPs) & Requests for Additional Information

    SEPs. While the first open enrollment period ended March 31, individuals who encountered problems enrolling in health insurance through the marketplace may qualify for a special enrollment period. You can learn more about qualifying life events that make people eligible for a special enrollment period at Healthcare.gov. People who encountered a processing error related to their immigration status or a system error that prevented them from enrolling online may also qualify for a special enrollment period. And don't forget that if a person is eligible for Medicaid or the Children's Health Insurance Program (CHIP), he or she can enroll at any time throughout the year.

    Requests for Citizenship or Immigration Status Information. Nearly 1.5 million immigrant families were tripped up by technical problems with the electronic citizenship and immigration status verification system. These families have received, or will receive, notices requesting additional information or documentation of an applicant's citizenship or immigration status. Even if an applicant for health care already uploaded or mailed in this information, it's important to do so again! For more information from HHS go to https://www.healthcare.gov/blog/the-marketplace-might-need-more-information-from-you/
     
    Latest Workaround for Lawfully Present Immigrants Incorrectly Denied Subsidies. HHS recently added a workaround for lawfully present applicants who were incorrectly referred to Medicaid and received a Medicaid denial because they did not meet Medicaid's immigration requirements, rather than receiving subsidies (premium tax credits) to make private insurance more affordable in the marketplaces. These people can now return to their marketplace application, indicate they were found not eligible for Medicaid because of their immigration status, and should then receive an accurate eligibility determination for subsidies in the marketplace. Then, these individuals will need to call the marketplace (1-800-318-2596) to request a special enrollment period because of system error so they can enroll. For more information from HHS on this workaround, go to http://marketplace.cms.gov/help-us/question-for-applications-denied-medicaid.pdf

     

     

    Most people satisfied with healthcare system

    According to a new Gallup poll, 66% of Americans are satisfied with the U.S. health care system, with those who are insured offering the most positive feedback.

     

    CMS Summer Webinar Schedule

    Reminder: CMS is on a bi-weekly webinar schedule for the summer season. We will continue to send our weekly newsletters every week throughout the summer.  Please be sure to mark these dates on your calendar.

    Friday, June 20: No Webinar
    THURSDAY, June 26: Webinar at 2 p.m. (Note this week we are holding the webinar on Thursday due to internal CMS constraints)
    Friday, July 4: Federal Holiday, no Webinar
    Wednesday, July 9: IRS Webinar on the Shared Responsibility Payment at 2 p.m.
    Friday, July 11: Webinar at 2 p.m.
    Friday, July 18: No Webinar
    Friday, July 25: Webinar at 2 p.m.

    NOTE: All times are listed in EST. The webinar schedule is subject to change in order to deliver late-breaking information.

     

    Reminder: Navigator Funding Opportunity Announcement (FOA) Released
    Last week, the Department of Health and Human Services (HHS) announced a funding opportunity for organizations and individuals to operate as Navigators in Federally-facilitated Marketplaces (FFMs) and State Partnership Marketplaces (SPMs).  To see the FOA for the Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Marketplaces go to Grants.gov and search for CFDA 93.332. HHS will award up to $60,000,000 to recipients across all service areas of FFMs (including SPMs). For more information, please review the FOA and last week's (6/10/14) assister newsletter. Additional details, including the pre-application webinar slides and FAQs are available at: http://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/assistance.html.

      

    Key Dates for Pre-Application Calls

    Key Dates to Remember

    • Letter of Intent to Apply (required) Due: June 30, 2014
    • Applications Due: July 10, 2014
    • Anticipated Award Date: September 8, 2014
    Reminder: Cost-Sharing Reductions are Only Available for Silver Plans

    A reminder to assisters that cost-sharing reductions (CSRs) are only available for Silver qualified health plans. If you're assisting a consumer who is eligible for CSRs, make sure that as you discuss the consumer's plan options and remind them that they will have lower out-of-pocket costs for deductibles, coinsurance, and copayments only if they pick a plan from the Silver plan category. Note that if the consumer is a member of a federally recognized tribe, they may qualify for additional cost-sharing benefits.

    Also please remember the difference between the advanced premium tax credit (APTC) and CSRs.  

    • APTC can be applied to all metal levels, but CSRs are only for Silver plans. 
    • Neither CSRs nor the APTC can be applied to catastrophic plans.

    For more information, please see:

      

    IV. Reminder: Coverage to Care-Resources for Assisters to Help Connect the Newly Insured to Care

    As we presented on Friday, May 30 and described in our Tuesday, June 3 assister newsletter, we have launched a new nationwide initiative, Coverage to Care, to help assisters and consumers, and all the newly covered, get the information they need to know:

    • How to make the most of your health care coverage
    • How to find the right doctor
    • When and where to seek treatment
    • Why getting the right preventive services is important

    Roadmap and Videos to Help with New Coverage

    To help answer questions you might have about your new health care coverage, and to use it appropriately to get the care and preventive services that are right for you and the consumers you assist, Coverage to Care has a number of tools available at http://marketplace.cms.gov/c2c.  Many are available in both English and Spanish, and more resources will be developed over the next few months.

      

    "A Roadmap to Better Care and a Healthier You" includes eight steps which walk consumers through everything they need to know to make the most of their coverage, including what common health care coverage terms mean; how to prepare for an appointment with a provider; what to expect when visiting the doctor's office; and how to take advantage of preventive services that can help a consumer stay healthy. The Roadmap also has a lot of information consumers can refer back to as they journey to better health and well-being, including a list of resources and a personal health screening log. A Spanish version can be found here: A Roadmap to Better Care and a Healthier You (Spanish).

    Another tool is a series of videos that contain tips for consumers to navigate their new health plan and fully enjoy its benefits. Videos include segments on "Understanding the Plan;" "Words to Know;" "Finding a Provider;" "Making an Appointment;" and "My First Visit."

    It's great to have the security and peace of mind that comes from having quality health care coverage.  But it's important to fully understand when, where, and how to use it to get the right care in the right place at the right time-and not just when you're sick, but also to stay well. The Coverage to Careresources can help consumers do that, and help them stay healthy and make the most of their health coverage. 

    For the related press release, see: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-06-16.html

    For the related blog post, see: https://www.healthcare.gov/blog/from-coverage-to-care-a-roadmap-for-using-your-new-coverage/

    As a reminder, here is the presentation from May 30: 

    For other helpful outreach and enrollment resources, please click here

    For General FAQs on HRSA Health Center Outreach and Enrollment Assistance Supplemental Funding, click here

    Transformational Team Talk & Outreach Upates

    Change Agent Newtwork Kick-Off Meeting

    On June 25, 2014 from 1:00 p.m. - 3:30 p.m. EST, the Maryland Health Benefit Exchange (MHBE) will host a Kick-Off meeting of the Change Agent Network (CAN). This session will provide information on your critical role as a Change Champion in rolling out the new Maryland Health Benefit Exchange system. 


    Meeting details:
    Date: June 25, 2014
    Time: 1:00 - 3:30 pm
    Location: Sky Lobby, 750 Pratt Street, Baltimore, Maryland, 21202

    Web-Ex Details:

    Webinar Link for Change Champions:  https://marylandhbe.webex.com/marylandhbe/onstage/g.php?t=a&d=668738339

    Call in:
    1-650-479-3207
    Access code: 668 738 339 

     

    Standing Advisory Committee - Maryland Health Benefit Exchange 

    Facilitator: Deputy Director, MHBE, Jonathan Kromm 

    • MHBE trying to get Connectors more involved
    • MHBE to release county level enrollment data on the MHBE Outreach & Enrollment email on June 24th.
    • Sigma & United in talks to become QHPs. Proposed plans and rates are being reviewed by Maryland Insurance Agency and not yet released.
    • Contrary to previous information regarding Connecticut's system not having up to the par Medicaid capabilities, the system will have similar Medicaid capability like that we have had
    • Special Enrollment Period (SEP) for COBRA eligible consumers has been extended to July 15th
    • Trainings will take place in October!
    • Another chance for ACSE designation coming up!

     

    On June 25, 2014 from 1:00 p.m. - 3:30 p.m. EST, the Maryland Health Benefit Exchange (MHBE) will host a Kick-Off meeting of the Change Agent Network (CAN). This session will provide information on the rolling out the new Maryland Health Benefit Exchange system.

    Meeting details:
    Date: June 25, 2014
    Time: 1:00 - 3:30 pm
    Location: Sky Lobby, 750 Pratt Street, Baltimore, Maryland, 21202

       

     

     

    The MHBE Call Center Hours of Operation & Holiday Closings for the period of May 1, 2014 through September 30, 2014 will be as follows:

     

    Hours of Operation

    Mon - Fri - 8am-6pm

    Sat - 8am - 2pm

    Sun - CLOSED

     

    Holiday Closings

    Memorial Day - May 26

    Independence Day - July 4

    Labor Day - September 1

     

    Grants & Funding Opportunities

    Expanded Services Opportunity for Existing Community Health Centers!

    Application Deadline:  July 1, 2014. Awards anticipated in September 2014.
    HRSA sent notification to eligible health centers of this funding opportunity with individual health center awards calculated with a base amount of $178,000, plus supplements based on numbers of total and uninsured patients reported served by the health center in 2013. Funding will be incorporated into grantees' ongoing base awards, dependent upon projections being met. In order to receive funding, applicants must propose to use at least 50% of funds to increase access to comprehensive primary health care services to new underserved patients by:  

    Hiring medical providers, Expanding medical services, and/or Expanding hours of operation.  

     

    Application Deadline: Applications accepted on an ongoing basis
    Funding for hunger prevention, self-sufficiency, healthcare, and education to those who are underserved. Pennsylvania is one of the eligible states.
     
    Application Deadline: Applications accepted on an ongoing basis
    Provides seed funding to emerging nonprofits, or to new projects of established organizations in the areas of education; environment; health and human services; and hunger and nutrition. Pennsylvania is one of 13 eligible states.
     
    Application Deadline:  Applications Accepted on an Ongoing Basis
    The Community Response Fund supports organizations, activities, and events that address access to needed oral health care and community resources that improve oral health. Programs that address an immediate response to an urgent issue that impacts access to clinical care, provide short-term access to needed care for the underserved, or sustain organizations experiencing short-term challenges are the focus. A limited number of program concepts that provide longer term solutions or essential services for particularly underserved populations will also be considered. The program will also support Missions of Mercy clinics.
    Patient Centered Medical Home (PCMH) Corner 
    Report: PCMH model leads to reduced cost of care, improved population health 

    patient-centered medical home (PCMH) model resulted in reduced costs of care, unnecessary emergency room (ER) and hospital visits, and improved population health, according to a research report by the Patient-Centered Primary Care Collaborative.

    The Collaborative partnered with Milbank Memorial Fund to produce the report, "The Patient-Centered Medical Home's Impact on Cost & Quality: An Annual Update of the Evidence, 2012-2013," to examine cost and utilization, population health and prevention, access to care, and patient or clinician satisfaction under PCMH.

    The report focused on studies released between August 2012 and December 2013 and revealed common metrics, including:

    • Decreases in the cost of care: 61 percent of peer-reviewed studies and 57 percent of industry reports noted drops in per member, per month costs, return on investment and total cost of care.

    • Reductions in the use of unnecessary or avoidable services: 61 percent of peer-reviewed studies and 57 percent of industry-generated reports showed drops in ER or urgent care visits, while 31 percent of peer-reviewed studies and 57 percent of industry-generated reports saw declines in inpatient admissions, with hospital readmissions falling in 13 percent of peer-reviewed studies and 29 percent of industry-generated ones.

    • Improvements in population-health indicators and preventive services: 31 percent of peer-reviewed studies and 29 percent of industry-generated studies saw better controlled HbA1c, blood pressure and LDL levels, as well as an increase in screening and immunization rates.

    • Improvements in access to care: 31 percent of peer-reviewed studies and 29 percent of industry-generated studies noted better overall access to primary care doctors, as well as non-face-to-face visits.Improvements in patient satisfaction: 23 percent of peer-reviewed and 14 percent of industry-generated studies saw a rise in overall satisfaction, the number of patients who recommended the practice to family and friends, and increased satisfaction with provider communications.

    The report also found PCMHs play a role in strengthening the larger healthcare systems, especially accountable care organizations. "Many of the nation's highest-performing ACOs embrace their strong PCMH component, and for this reason, PCMHs are well-positioned to lead and drive change across ACOs," the report states.

    The PCMH model is also being incorporated into significant payment reforms, including Congressional reforms to the Medicare sustainable growth rate, which would aid in moving the U.S. healthcare system away from fee-for-service toward alternative payment methods, including ones build around the PCMH model, according to the report.

    A study from the University of California Los Angeles and the University of Southern California in 2013 showed success of PCMHs even in an urban, safety-net setting, FierceHealthcare previously reported. The Galaxy Health program, which debuted at Los Angeles County+USC Medical Center (LAC+USC) in 2012, proved that intuitive and inexpensive interventions improve patient care and physician and staff morale.

     

    States, Insurers Increase Reliance on PCMH/ACO Models

    In Arkansas, Medicaid officials have worked to design a payment structure that rewards efficiency and supports primary care doctors in the implementation of team-based strategies, coordinated chronic care delivery and achievement of better patient outcomes, according to a  Health Affairs blog post. The state didn't want to penalize efficient practices, so it rewards providers that hit a targeted, risk-adjusted per-member per-year spending level that doesn't rely on actually spending less and offers smaller rewards for less efficient practices that reduce their spending. Elsewhere, insurers like Horizon Blue Cross Blue Shield of New Jersey and Aetna have announced their intention to boost member enrollment over the new few years in a PCMH or accountable care organization
    Clinical Quality 

    Quality Management (QM): A Primer for Clinicians   Tuesday, June 24, 2014 from 1:30 - 2:30 PM EDT 

     

    There is still time to join Tuesday, June 24, 2014 from 1:30 - 2:30 PM EDT for a live hour-long webinar! The session will feature both formal presentation of quality-focused material, interactive Q&A following each section, and links to relevant and useful additional resources. 
    *Please note, call-in 
    only option available.
    Why you should attend this webinar 

    PowerPoint-based content will address three primary areas:
    • Quality in the Rapidly-Evolving Environment:
      A changing health care focus, with new health center opportunities and accountabilities; current health center requirements / initiatives and their implications for quality; today's quality challenge
    • The Nuts & Bolts of Quality Management (QM):
      Defining quality in a systems context; the Strategic Quality Triad; the distinct phases of  QM; measurement and process improvement; quality, cost, and value
    • Quality as a Unifying Construct:
      The "quality umbrella"; the QM Plan as an organizational road map; structuring for quality; a unifying quality hierarchy (metrics, categories, and Metric Paks)

    Registration Rate: NO CHARGE, but please register by the deadline! 

    For additional information, contact Katja Laepke at klaepke@nachc.com or (301) 347-0400.

     

    Chronic Fatigue Syndrome Resources  

    The Centers for Disease Control and Prevention (CDC) developed new Chronic Fatigue Syndrome (CFS) resources, including factsheets for parents, educators, and healthcare providers. Share these resources to raise awareness and spread knowledge about CFS.

     

    CMS Posts 2014 Clinical Quality Measures, Electronic Specifications and Resources

    Beginning in 2014, the reporting of clinical quality measures will change for all providers. Electronic Health Record technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria, and eligible professionals, eligible hospitals and critical access hospitals will report using the new 2014 criteria regardless of whether they are participating in Stage 1 or Stage 2 of the Medicare and Medicaid EHR Incentive Programs.

    The final 2014 CQMs for eligible professionals and eligible hospitalsare now available, as well as the specifications for electronic reporting and access to the related value sets. These files can be accessed from the 2014 CMS Clinical Quality Measures webpage.

    Reporting Electronically in 2014

    Beginning in 2014, all Medicare EPs and eligible hospitals beyond their first year of demonstrating meaningful use must electronically report their CQM data to CMS. Medicaid EPs and eligible hospitals that are eligible only for the Medicaid EHR Incentive Program will report their CQM data to their state.

    e-Specifications

    The value sets of the electronic specifications code the CQMs in your EHR, allowing you to export the measure results and report them in attestation. EPs and eligible hospitals can view the value sets on the National Library of Medicine Value Set Authority Center webpage.Resources for 2014 CQMs

    To help providers navigate the new CQMs, CMS has developed and posted new resources, including:

    Want more information about the EHR Incentive Programs?

    Make sure to visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

    Health Observances This Week

     

       
      Promote HIV testing on Friday, June 27, 2014 by planning a National HIV Testing Day event, sharing fact sheets, and using new media to encourage everyone to Take the Test, Take Control. 

     

    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 |
    4319 Forbes Blvd. Lanham, MD 20706    |    www.machc.com    |    301.577.0097
     

    Copyright 2013. All Rights Reserved.