 January 7, 2005 |
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Upcoming ACAP Calls
January 12: HR Roundtable January 13: Best Practices Call January 24: Executive Committee Call January 27: Medicare Roundtable February 1: Quality/Disease Management Roundtable February 2: Quality Management Committee
Upcoming Events Calendar
 
ACAP Links
 
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| HIGHLIGHTS |
CareSource Awarded Contract in Indiana CareSource, a member of the Association for Community Affiliated Plans and Ohio's largest Medicaid managed care organization, recently signed a two-year contract to provide health care for recipients in Indiana's Medicaid program - Hoosier Healthwise. CareSource has almost 350,000 members in 13 counties in Ohio. CareSource began providing care for almost 12,000 Hoosier Healthwise recipients on Jan 1st. Under the new contract CareSource plans to expand to about 25,000 Indiana members in the spring of 2005. CareSource will be one of only two nonprofit Medicaid health care plans operating in Indiana. According to Chief Executive Officer Pamela Morris, this will be a selling point for CareSource. In addition to medical services required by the Indiana Office of Medicaid Policy and Planning, CareSource also offers extra benefits such as a 24-hour nurse hotline, enhanced transportation to medical appointments, and case management.
Book Now for ACAP's April Board Meeting
CareSource has been recognized for excellence including:
ACAP CEOs can now make reservations for the April 19-21 board meeting to be held in Honolulu, HI. More information about the preliminary agenda and hotel reservations can be found on the Members Only section of our website.
The Medicaid Managed Care Technical Advisory Group (TAG) which is made up of officials from state Medicaid agencies and CMS invited ACAP to join a planning session to develop an agenda for a larger meeting between the TAG and the Medicaid plans. ACAP suggested that the implementation of actuarial soundness be discussed as well as ACAP's interest in having CMS fund the HEDIS comparison of Medicaid plans again. Other topics that might be on the agenda include SNP contracting, general implementation of the BBA regulation and expansions of managed care to new populations and services. ACAP will alert its members when the call is scheduled and what the final agenda includes. Reminder: February CEO-CFO Meeting Please remember to return your RSVP to ACAP and make your arrangements for the next CEO and CFO meeting scheduled for February 14th and 15th in Washington, DC at the Westin Embassy Row. A tentative agenda is posted on the Members Only section of the ACAP website under Board Meetings. Reservations can be made by calling (202) 293-2100 or by registering online with the ACAP group at http://www.starwoodmeeting.com/StarGroupsWeb/res?id=0411122150&key=80DEC  |
| PUBLIC POLICY AND ADVOCACY |
ACAP Schedules Congressional Meetings for February As the President and Congress begin to develop their budget proposals and agendas, all indications are that 2005 will be a critical year for the Medicaid program. After ACAP's February Board Meeting is a timely opportunity to schedule visits with the Members of Congress and their staff from ACAP states to discuss the value of Medicaid managed care and the innovative initiatives being implemented by ACAP plans. ACAP staff is available to schedule these meetings for you on Wednesday February 16th and will provide you with talking points. You can also schedule them on your own and let us know so we can accompany you. Please contact Andrea at amaresca@communityplans.net for more information. ACAP Sends Letter to Bush Administration The Association for Community Affiliated Plans recently sent a letter to the Office of Management and Budget Director Josh Bolten urging the Administration to refrain from cutting Medicaid benefits or otherwise fundamentally altering the program in its fiscal year 2006 budget proposal. In the letter ACAP stated that such cuts would only erode the health care safety net for America's most vulnerable populations. ACAP went on to say that it is possible to strengthen Medicaid coverage for beneficiaries and, at the same time, ensure that the federal government and state Medicaid programs receive the highest possible value for the dollars they spend on health care. The letter describes how Medicaid managed care plans have helped to control Medicaid expenditures and provide the best value for the resources invested. The letter can be found on the ACAP website at: http://www.ahcahp.org/pandl/default.asp ACAP Joins New Partnership to Protect Medicaid ACAP was recently invited to join the Partnership for Medicaid. The newly formed nationwide coalition is being spearheaded by the National Association for Community Health Centers to bring together providers, health plans, and others from the health care community who are committed to improving the Medicaid program and preserving the fundamental nature of the health care safety net. ACAP will attend its first meeting of the provider group later this month. Governors Speak Out on the Future of Medicaid The National Governors Association (NGA) has launched a bipartisan lobbying effort aimed at preventing new federal limits on Medicaid. According to some reports, the governors plan to form a committee to lobby their Medicaid agenda, which includes a measure that would allow states to make changes to their programs without applying for federal waivers, which can take years to get approved. In December the NGA, led by Governor Mike Huckabee (R-AK) and Gov. Mark Warner (D-VA), sent a bipartisan letter to President Bush stating that while "the status quo in Medicaid is not acceptable," it is "equally unacceptable in any deficit reduction strategy to simply shift federal costs to states." The letter asked federal officials to assume more Medicaid costs under Medicare and not look to Medicaid to reduce the national deficit. The Governors are urging the President and Members of Congress to pursue Medicaid reform outside the budget process to ensure that cuts in the program would not be the primary objective. Experts agree that the rare bipartisan letter indicates that the governors will stand firm in the coming debate to preserve or even increase Medicaid. Feb. 10 Policy Roundtable ACAP has scheduled a Policy Roundtable call for Thursday, February 10th. The purpose of the call is to update plans on policy issues at the federal level. The agenda will include the following topics:
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| EXCELLENCE AND ACCOUNTABILITY |
Info Sharing Among Compliance Officers During the December Compliance Officers Roundtable conference call, the Compliance Officers expressed interest in sharing their compliance charters, policies and procedures, ethics policies, etc. Documents from several ACAP plans are now posted on the Members Only section of ACAP's website under Plan Documents. If you did not submit your charters, etc. and you would like to do so, please send them to Andrea Maresca (amaresca@communityplans.net). Please make sure each document is properly labeled (compliance charter, code of conduct, etc.) Reminder: Jan 13 Webcast Best Practices Call on IT Linkages On January 13th ACAP will hold a webcast Best Practices call on establishing effective IT linkages with community health centers. Please note the call-in number for this call only is: 866-740-1260 and the access code is: 2615447. Doug Bach, CIO of Colorado Access, and Marty Mattei, Pharmacy Director at Colorado Access, will discuss their health plan's efforts to collaborate with their CHC's on IT issues. Specifically, their presentation will focus on how technology impacts a Health Plan in:
HR Roundtable Jan 12 HR Directors and their senior staff will have their first roundtable on January 12th to discuss Performance Measurement and Recognition Programs. Ann Van Etten, Vice President of Human Resources at Affinity Health Plan, will lead a discussion on her health plan's upcoming 2005 initiatives in Performance Measurement and Recognition Programs. She is interested in hearing from other Human Resource Directors about experiences in implementing these types of programs. The call will begin at 3 pm eastern standard/2 pm central/1 pm mountain/12 pm pacific/10 am Hawaii. Call-in information is available at the HR Directors section of the Members-Only page on our website at: http://www.communityplans.net/members/default.asp Jan 27 Call on ACAP Plans Entering Medicare ACAP plans will discuss the new Medicare application expected to be released in mid-January and compare notes on application issues and challenges. Note: All ACAP plans are welcome to participate but this call is specifically focused on application issues for those considering an application to be a Medicare Special Needs plan. The call will be begin at 3 pm eastern standard/2 pm central/1 pm mountain/12 pm pacific/10 am Hawaii. New Customer Service Roundtable Calls Added Mark your calendars! ACAP has added three roundtable calls for Customer Service staff of ACAP plans in 2005. The calls will be held on:
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| FUNDING OPPORTUNITIES & NEWS |
Quality Health Foundation Invites Project Proposals From Maryland and the District of Columbia The Quality Health Foundation (QHF), the mission arm of Delmarva Foundation, a national nonprofit organization committed to improving the quality of health care, has announced a call for proposals for the 2005 grant cycle, which will award grants to eligible organizations that work to improve health care for individuals and communities through improvement projects. Projects of many types will be funded including service demonstration programs that focus on producing high impacts on health outcomes. Applicants must be from Maryland and the District of Columbia, where Delmarva is the Quality Improvement Organization for the area. More information can be found at: http://fdncenter.org/pnd/rfp/rfp_item.jhtml?id=91500009 Robert Wood Johnson Foundation Invites Proposals for Changes in Health Care Financing Initiative Changes in Health Care Financing and Organization (HCFO) is an initiative of the Robert Wood Johnson Foundation that supports policy analysis, research, evaluation, and demonstration projects. Projects may be initiated from within many disciplines, including health services research, economics, sociology, political science, public policy, public health, public administration, law, and business administration. Funded projects should provide public and private decision makers with usable and timely information on health care policy and financing issues. More information can be found at: http://fdncenter.org/pnd/rfp/rfp_item.jhtml?id=69600003 |
| NEWSFLASH |
NY Governor Proposes Shifting Medicaid Costs from Localities to State Recent reports indicate that the administration of New York Governor George Pataki (R) is considering proposals that would shift more Medicaid costs from the localities to the state. According to a New York Times article on the issue, this would provide a share of revenues from sales taxes. Details of the Governor's proposal were unclear at press time but there are reports indicating it would place a cap on local costs and require the state to pick up any year-to-year increase that is roughly above the rate of inflation which localities currently are responsible for covering. The plan is also reported to reduce certain payments to Medicaid providers. In a meeting this week with state lawmakers, a bipartisan group of county executives urged state officials to cap the local share of Medicaid spending at 2003 levels, which is estimated to cost the state $1.8 billion over three years. CA Managed Health Care Department Issues New HMO Regs The California Department of Managed Health Care this week issued regulations requiring HMOs to provide broad coverage of medically necessary prescription drugs. California is the first state to issue such regulations. The regulations implement state legislation which was passed to address lawsuits by two HMOs that sought the right to deny coverage of the sexual-dysfunction drug Viagra and the weight-loss drug Xenical. The regulations must first undergo a public review period before being implemented later this year. The regulations, which apply only to HMO plans that provide prescription drug coverage, would among other things:
A report published in the December issue of the Annals of Emergency Medicine found that using hospital emergency departments to enroll children in government health care programs can help reduce the uninsured rolls and generate enough revenue to pay the program's costs and generate a profit. The findings were based on a 10 month survey that employed a well-trained, dedicated worker who was hired to enroll uninsured children seeking care in the emergency department. Among the findings of the report were:
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| JOBS |
CMO Sought in RI Neighborhood Health Plan of Rhode Island is seeking a Chief Medical Officer to help lead corporate planning and capacity building efforts to improve organizational performance. As member of NHPRI's senior leadership team among other things the CMO will be responsible for the clinical vision of the company; ensure that revenue enhancement, expense reduction and quality and service improvement efforts of the company are effective and consistent with that clinical vision; and lead the development of NHPRI's Clinical Programs. The CMO will also be involved in new efforts including a possible Medicare collaboration, developing programs for adults with disabilities, building coalitions to defend Medicaid, expanding program evaluation capacities and implementing grant funded programs to improve community-based outreach to members. The complete job description and information on how to apply can be found at the ACAP Job Bank at: http://www.communityplans.net/jobs/jobs.asp ACAP Job Bank ACAP maintains a job bank for a range of openings at member plans and health care related organizations. Please send any postings and job announcements to: amaresca@communityplans.net The Community Health Center Network (CHCN) in Alameda, CA is seeking a Medical Director to work with a progressive, forward-thinking network of community health centers in the San Francisco Bay Area. CHCN contracts on behalf of its 7 member health centers for Medi-Cal managed care contracts, and is nationally known for its leadership in community health, clinical information systems, and chronic disease management for diverse patient populations. The Medical Director is part of the executive Leadership Team, and works closely with the health center Medical Directors. The detailed description of the position and application process can be found at the ACAP Job Bank at: http://www.communityplans.net/jobs/jobs.asp |
| Upcoming Events |
January Events |
| Mon | Tues | Wed | Thurs | Fri | Sat/Sun |
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1/2 New Years Day |
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4 Congress reconvenes |
5 CFO Roundtable |
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8/9 |
| 10 Finance Committee Call |
11 |
12 HR Roundtable |
13 Best Practices Call |
14 Hotel registration deadline for ACAP's CEO-CFO Meeting in DC |
15/16 |
| 17 Martin Luther King, Jr. Holiday |
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19 |
20 Presidential Inauguration |
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22/23 |
| 24 Executive Committee Call |
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27 Medicare Roundtable |
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29/30 |
| 31 |
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| Mon | Tues | Wed | Thurs | Fri | Sat/Sun |
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1 Quality/Disease Management Roundtable 3 pm EST |
2 Quality Management Committee 11am EST |
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5/6 |
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10 Policy Roundtable |
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12/13 13th- ACAP CEO-CFO Dinner |
| 14 ACAP CEO-CFO Conference |
15 ACAP CEO-CFO Conference |
16 ACAP Congressional Meetings |
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18 |
19/20 |
| 21 President's Day Holiday |
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24 CFO Roundtable |
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26/27 |
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ACAP Mission: To improve the health of vulnerable populations through the support of Medicaid-focused community affiliated health plans committed to these populations and the providers who serve them. James Hooley, Chairman Margaret A. Murray, Executive Director |
Association for Community Affiliated Plans Contact Us |