Safety Net Health Plans and Health Information Technology
Safety net health plans (SNHPs) are critical components of today’s health care system. They care for millions of people enrolled in public health programs and are essential to the successful operation of today’s Medicaid program. Because SNHPs’ success relies on their ability to use health information and to communicate effectively with their network of health care providers, legislation examining the role of and addressing the need for health IT on these and other providers is essential.
Unfortunately, SNHPs confront many challenges with respect to today’s health IT market. Unlike for-profit or other publicly-traded companies, the greatest challenge facing SNHPs is a lack of access to public capital that would allow them to pay for health IT upgrades. Without access to capital, SNHPs cannot marshal resources to modernize their health IT systems. Failing to upgrade the health IT capacities of these plans will undermine their ability to effectively serve Medicaid enrollees. In addition, public health programs, the network of safety net providers, and patients will also suffer because these health plans care for millions of beneficiaries.
Last year, both the House and Senate debated and passed different versions of legislation to improve the nation’s health information technology infrastructure. While both bills sought to address issues that providers confront in paying for and accessing health IT, neither the House nor Senate bills included SNHPs in their health IT improvements. This meant that the major health care delivery system for millions of people was excluded from Congressional efforts meant to improve the health care system at large.
We believe that SNHPs have an important role in providing health care services in this country – particularly with respect to public health programs, safety net providers, and low-income publicly-insured and uninsured Americans. However, these plans need help with improving their IT infrastructure and a seat at the table if they are to continue serving these beneficiaries and providing a voice on behalf of these programs. Therefore, ACAP is asking all members to support the inclusion of SNHPs in the health IT bill and to identify these plans as:
“SAFETY NET HEALTH PLANS – The term “safety net health plan” means a managed care organization as defined in section 1932(a)(1)(B)(i) of the Social Security Act (42 USC 1396u-2(a)(1)(B)(i)) that is exempt from or not subject to federal income tax, or that is owned by an entity or entities exempt from or not subject to federal income tax, and for which no less than 75 percent of the enrolled population receives benefits under a Federal health care program as defined in section 1128B(f)(1) (42 USC 1320a-7b(f)(1)) or a health care plan or program which is funded, in whole or in part, by a State (other than a program for government employees).
If Congress uses this definition in instances where entities and organizations are eligible for health IT funding and to participate in discussions involving health IT improvements, they will ensure that millions of Americans aren’t left behind in efforts to bring the health care system into the 21st century.
Safety Net Health Plans and Health Information Technology
Safety net health plans (SNHPs) are critical components of today’s health care system. They care for millions of people enrolled in public health programs and are essential to the successful operation of today’s Medicaid program. Because SNHPs’ success relies on their ability to use health information and to communicate effectively with their network of health care providers, legislation examining the role of and addressing the need for health IT on these and other providers is essential.
Unfortunately, SNHPs confront many challenges with respect to today’s health IT market. Unlike for-profit or other publicly-traded companies, the greatest challenge facing SNHPs is a lack of access to public capital that would allow them to pay for health IT upgrades. Without access to capital, SNHPs cannot marshal resources to modernize their health IT systems. Failing to upgrade the health IT capacities of these plans will undermine their ability to effectively serve Medicaid enrollees. In addition, public health programs, the network of safety net providers, and patients will also suffer because these health plans care for millions of beneficiaries.
Last year, both the House and Senate debated and passed different versions of legislation to improve the nation’s health information technology infrastructure. While both bills sought to address issues that providers confront in paying for and accessing health IT, neither the House nor Senate bills included SNHPs in their health IT improvements. This meant that the major health care delivery system for millions of people was excluded from Congressional efforts meant to improve the health care system at large.
We believe that SNHPs have an important role in providing health care services in this country – particularly with respect to public health programs, safety net providers, and low-income publicly-insured and uninsured Americans. However, these plans need help with improving their IT infrastructure and a seat at the table if they are to continue serving these beneficiaries and providing a voice on behalf of these programs. Therefore, ACAP is asking all members to support the inclusion of SNHPs in the health IT bill and to identify these plans as:
“SAFETY NET HEALTH PLANS – The term “safety net health plan” means a managed care organization as defined in section 1932(a)(1)(B)(i) of the Social Security Act (42 USC 1396u-2(a)(1)(B)(i)) that is exempt from or not subject to federal income tax, or that is owned by an entity or entities exempt from or not subject to federal income tax, and for which no less than 75 percent of the enrolled population receives benefits under a Federal health care program as defined in section 1128B(f)(1) (42 USC 1320a-7b(f)(1)) or a health care plan or program which is funded, in whole or in part, by a State (other than a program for government employees).
If Congress uses this definition in instances where entities and organizations are eligible for health IT funding and to participate in discussions involving health IT improvements, they will ensure that millions of Americans aren’t left behind in efforts to bring the health care system into the 21st century.