« The Dual Agenda: February 24, 2016 Issue

State Highlights

California

California state Senator Ricardo Lara introduced the Medical DREAMER Opportunity Act, a bill that aims to address the chronic shortage of medical professionals in underserved communities. The bill will ensure that all people, regardless of their immigration status, have access to the state’s scholarship and loan forgiveness programs for health professionals. Community Catalyst’s partners at the California Pan-Ethnic Health Network (CPEHN) worked in collaboration with Senator Lara, Pre-Health Dreamers and Med Dreamers at UCLA to identify a solution to address the academic and professional barriers faced by undocumented students pursuing medical professions.

Maryland

On Feb. 15 the Maryland Citizens’ Health Initiative, in partnership with LifeBridge Health and faith leaders from throughout the state, launched the Maryland Faith Community Health Network with a training program for faith leaders eager to participate in the project. This innovative pilot program, which is based on the Congregational Health Network in Memphis, TN, is designed to enhance cooperation between hospitals and faith organizations to improve the health of patients. Hospitals in Maryland are eager to find ways to improve the health of communities as they are now paid through a “global budget” which provides them with a flat fee for caring for an entire community. The project has been enthusiastically embraced in Maryland, and advocates are hoping to expand the project statewide if the pilot proves successful.

Massachusetts

The Massachusetts Department of Public Health is finalizing regulations for voluntary certifications of Community Health Workers (CHWs). The move is highlighted in a National Public Radio story about how a skilled CHW can make a real difference in the life of chronically ill, low-income patients who do not have family or friends to help them manage their health. CHWs have the potential to provide culturally and linguistically appropriate services that will keep people out of the hospital and improve their health. The Affordable Care Act created new opportunities for delivery systems to invest in CHWs, and slowly but surely, the role is becoming more clearly defined.

Michigan

Crain’s Detroit Business recently published a series of related articles about challenges facing MI HealthLink, the state’s dual eligible demonstration project. One of the articles reports on the state’s lack of progress in developing a key element of the project: the so-called “Care Bridge.” This is an electronic database that was supposed to coordinate health care for MI HealthLink members by seamlessly transferring their information among health plans, mental health organizations and physicians. However, the Care Bridge is not expected to be fully operational for two to three years. A related blog questions the state’s ability to reach the demonstration’s goals and a third article points to low enrollment as a source of provider frustration.

Minnesota

The University of Minnesota recently released an evaluation of Minnesota's Health Care Home (HCH) initiative from 2010 through 2014. The evaluation found that the health care home initiative resulted in approximately one billion dollars in savings and that clinics participating in a  the initiative outperformed other clinics on quality measures including addressing racial disparities.

New Jersey

New Jersey recently overhauled a Medicaid transportation contract after receiving numerous complaints over a period of years from providers, residents and community organizers in Camden and Trenton about the state’s Medicaid transportation broker, LogistiCare. Camden Churches Organized for People, Faith in New Jersey and the Camden Coalition of Healthcare Providers shed light on stories from patients whose health had been jeopardized because of late or missed rides which, in some cases, resulted in expensive hospital emergency care. The state’s latest Request for Proposals includes many of the contract improvements that consumer advocates and patients lobbied for earlier last year.

New York

The Centers for Medicare and Medicaid Services (CMS) has posted on its website the three-way contract for the New York Fully Integrated Duals Advantage Program for individuals with intellectual and developmental disabilities, often referred to as FIDA-IDD. Approximately 20,000 dually eligible individuals in the downstate region of New York will have an opportunity to enroll in the new program. The FIDA-IDD expands on the original FIDA dual eligible demonstration project launched in January 2015.

 HMA reported that plans participating in the original FIDA demonstration will receive Medicare rate increases retroactive to Jan. 1. The increases acknowledge a historical under-prediction of what it costs to manage care for dually eligible individuals. According to HMA, in Manhattan and the Bronx the Medicare rate will increase by about 5.7 percent while other areas will see an increase of up to 10.5 percent.

Ohio

In response to the proposed Anthem-Cigna and Aetna-Humana mergers, UHCAN Ohio and other consumer groups submitted comments to the Director of the Ohio Department of Insurance, Lieutenant Governor Mary Taylor, requesting that she hold hearings on the mergers, which have the potential to reduce competition in Ohio’s health care market and impact consumer choice and health care quality.

Rhode Island

The Rhode Island Executive Office of Health and Human Services (EOHHS) has released a Request for Proposals (RFP) for parties interested in running the Ombudsman Program for the state’s dual eligible demonstration project.  Questions about the RFP should be submitted to EOHHS by Friday, Feb. 26, at 10:30 am, and proposals are due March 15, at 10:00 am.

Washington

The Washington State Health Care Authority is hosting a series of webinars for care coordinators and allied staff participating in the state’s health home demonstration project. Topics include (1) coaching and engaging clients with mental health needs and (2) long-term services and supports. These webinars are part of a statewide health home care coordinator training program.

The state of Washington has developed a Frequently Asked Questions document about the Accountable Communities of Health (ACH) the state is implementing as part of its Innovation Plan, known as “Healthier Washington.” There are nine ACHs across Washington. Each is made up of a group of leaders from a variety of sectors in a given geographical area with a common interest in improving health. With support from the state, they are voluntarily organizing to coordinate activities, jointly implement health-related projects and advise state agencies on how to best address health needs within their area. Advocates in Washington are working with the ACHs and the state to insure a robust consumer voice in the new structures. 

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