 March 31, 2006 |
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Upcoming ACAP Calls
4/11: Medicare SNP Roundtable 4/20: COO Roundtable 4/27: CIO Roundtable 5/2: New! Ombudsman/Member Advocate Roundtable
Upcoming Events Calendar
 
ACAP Links
 
ACAP Members
Affinity Health Plan Alameda Alliance for Health AlohaCare Boston Medical Center HealthNet Plan CareOregon CareSource Colorado Access Commonwealth Care Alliance Community Choice Health Plan Community Health Network of Connecticut Community Health Plan of Washington Contra Costa Health Plan Health Plus Health Right, Inc. Hudson Health Plan L.A. Care Health Plan MDWise Medically Fragile Children's Program Mercy Care Plan Monroe Plan for Medical Care, Inc. Neighborhood Health Plan Neighborhood Health Plan of Rhode Island Network Health Santa Clara Family Health Plan Total Care Virginia Premier |
| HIGHLIGHTS |
ACAP Annual Meeting On March 20-21 the ACAP board met in Los Angeles for their annual meeting. The board accepted the annual report which is required by the bylaws. In 2005 ACAP experienced both great growth in its membership as well as its influence in Washington in keeping with the vision of the board when they expanded the membership in 2003 to include other not-for-profit, Medicaid-focused plans beyond the original membership of community health center affiliated plans. ACAP started the year with 17 members and grew to 22 with the addition of Alameda Alliance, Commonwealth Care Alliance, LA Care, MercyCare, Santa Clara Health Plan and Virginia Premier. ACAP plans now care for over 3 million Medicaid beneficiaries, or almost half of all those enrolled in Medicaid-focused health plans. As a result of the increase in membership, ACAP has for the first time hired an outside lobbyist to help us achieve our goal to support continuation and improvement of publicly sponsored coverage programs, particularly focused on Medicaid managed care. The highlight of the year was the Senate passage of the ACAP-endorsed proposal to extend the Medicaid drug rebate to the health plans. This passed 54-45 as part of a Senate amendment to the Deficit Reduction Act of 2005. ACAP also played an active role in advocating for changes to the Medicaid program that would control the growth in the program, while not hurting Medicaid beneficiaries. Another notable accomplishment this year was ACAP's publication of 2 working papers and 5 fact sheets as part of its goal to serve as an authority on publicly sponsored coverage programs. Finally, ACAP continued its lively series of roundtables for a record 15 different staff groupings to address one of our goals which is to strengthen ACAP members operationally to improve their quality, efficiency and competitiveness. These roundtables meet three times a year to share both successes and struggles. In addition, the CFOs met in person at the February, 2005 Board meeting. The face-to-face senior staff meetings have proven valuable in promoting peer-to-peer exchange and generating topics for future roundtables, future surveys, and upcoming meetings. ACAP COOs Meet in Los Angeles ACAP COOs met for the first time at a meeting in Los Angeles. COOs from 12 ACAP plans participated in the meeting. In the morning, the plans gave a brief overview of their plan structure and discussed key challenges for 2006. The most common challenges plans are facing are: expansion populations, improving financial strength and managing rising health care costs, and challenges specific to the circumstances within their states (budget cuts, unfunded mandates, etc.) COOs then discussed common strategies for controlling health care costs within their plans, the challenges and opportunities in serving special needs populations, instituting plan-wide quality control and consistent work plans across the plan, and the challenges and opportunities brought on by implementation of Medicare Part D. Presentations from the meeting are saved in the members only section of the website. As follow up to this meeting, ACAP COOs would like to continue the discussion of plan-wide quality control on the next COO Roundtable. Future topics for continued discussion include further discussion of what ACAP plans are doing to effectively serve special needs populations and continued discussion of cost containment strategies and measuring return on investment. ACAP Meets with CMS Administrator Meg Murray, Darnell Dent, Bob Thompson and Chris Koppen met with Mark McClellan, the Administrator of CMS, on March 26 to introduce ACAP to him and his staff and discuss with him some of our legislative agenda items. We reviewed for him what types of plans ACAP represents. We then discussed the need for CMS to begin to fund a comparison of HEDIS results from Medicaid managed care. We reviewed for him the last such study which showed the Medicaid plans were improving their childhood immunization HEDIS statistics and actually doing better on adolescent well child visits than plans serving commercial populations. He asked his Medicaid staff to continue to work on this with us and agreed it was important to be able to document the quality of care provided to Medicaid managed care enrollees. We also reviewed with him the letter ACAP sent to CMS on actuarial soundness. He said his staff would review it and get back to us with a response. Not surprisingly, he seemed most interested in what our plans were doing in Medicare and asked to let him know if there were areas in which the plans thought CMS could better coordinate the regulation of Medicaid and Medicare products. ACAP will get back to the CMS leadership on this issue. ACAP Announces Its Supporting the Safety Net Award ACAP is pleased to announce it is seeking nominations for its first annual Supporting the Safety Net Award. This award will be given to a community entity (CHC, hospital, community provider) or individual that has demonstrated substantial commitment to serving safety net populations. Nominees can be self-nominated with a letter of support from an ACAP plan, or an ACAP member plan can directly nominate one of its community partners. The application process with nomination instructions will be distributed to ACAP plans and announced on ACAP's website the week of April 3, 2006. Hold the Date: CEO Summit to Be Held in July ACAP will once again host a CEO Summit for CEOs and senior staff of Medicaid-focused health plans. The meeting will be held on July 25-26 at the Westin Grand hotel. Professor Bob Hurley will once again be the keynote speaker with new information on the financial and operational status of our industry. The hotel can be reached at (202) 429-0100 or by clicking on this link. Rooms have been set aside at the Westin Grand for $229 a night plus taxes etc. The cut off date for the hotel is June 23.  |
| PUBLIC POLICY AND ADVOCACY |
House Budget Committee Passes Budget for FY 2007 by Vote of 22-17 The House of Representatives started the process of producing an FY2007 Budget this week with the House Budget Committee marking up its version of the budget on Wednesday, which passed by a vote of 22-17. Although not rejecting the President's call for entitlement cuts altogether, the House version of the budget would not cut Medicare and Medicaid as deeply as proposed by the President. However, the House Budget would reduce mandatory spending by $6.8 billion over 5 years, with $4 billion to be taken out of programs under the jurisdiction of the Ways and Means Committee. Because Ways and Means does not have jurisdiction over Medicaid, it is likely that these cuts could come from Medicare and other programs such as employment insurance. The strongest concerns to the health community are those cuts in non-defense, non-homeland security discretionary spending. The House accepted the President's request for a cap on discretionary spending of $873 billion that would force cuts in the Labor-Health and Human Services-Education budgets of 2% -- about $4.2 billion. The Senate rejected the President's overall spending cap during their Budget mark-up last week - exceeding it by $16 billion, including the approval of an amendment providing $7 billion more for Labor-HHS-Education funding. However, the House Budget Committee's bill is likely to face a tough time getting approval from the full House of Representatives. Twenty-three moderate Republicans sent a letter calling for increased funding for health and education programs and the leader of that effort threatened to defeat the bill without some concessions. With a 15 vote margin, the Republican leadership will be forced to address some of the moderates' demands, but will have to do so without generating threats from the conservative core of members. ACAP will continue to monitor developments in the budget. ACAP Sends Letter to CMS with Recommendations for Implementation of Medicaid Citizenship Documentation ACAP has sent a letter to CMS Administrator Mark McClellan concerning provisions in the Deficit Reduction Act of 2005 (DRA) that require individuals applying for Medicaid to present satisfactory documentary evidence of citizenship. The letter highlights that these provisions have the potential to disrupt initial enrollment or annual renewal for millions of low-income citizens on Medicaid, including members of our plans. In the letter, ACAP calls for clear and timely guidance on these provisions, and also urges CMS to use a clause in the DRA that allows CMS to specify additional documents to prove citizenship, over and above the documents outlined in the DRA. The letter can be found on the Policy section of the ACAP website. Reminder: April Medicare SNP Call The next Medicare SNP Roundtable is Tuesday, April 11th at 3 pm Eastern time. A reminder email and agenda items will be circulated prior to the call. Recap: March Medicare SNP Call On our last Medicare SNP Roundtable, David Digiuseppe from Community Health Plan of Washington discussed some of the major issues and challenges they are facing as they design their Medicare SNP benefit package. Much of the discussion focused on whether to offer the standard Medicare benefit design or offer additional benefits. |
| EXCELLENCE AND ACCOUNTABILITY |
Reminder: COO Roundtable The next COO Roundtable is Thursday, April 20 at 3 pm Eastern time. On this call, COOs will review highlights from the recent ACAP COO meeting in Los Angeles and prioritize follow-up items for future roundtable calls. One follow-up item ACAP COOs wanted to discuss on this roundtable was the comparison and discussion of Senior Management reporting tools (some plans refer to them as "Monday Morning" reports reviewed each week by the Senior Management team). Please send copies of your plan's template Senior Management report to Peggy Oehlmann by Tuesday April 18. She will post them in the members only section of the website. A reminder email and discussion questions will be circulated prior to the call. Reminder: CIO Roundtable The next CIO Roundtable is Thursday, April 27 at 3 pm Eastern time. A reminder email and agenda items will be circulated prior to the call.
Access ACAP Roundtable and Best Practices Conference Calls
New! Ombudsman RoundtableThe call-in number is 1-719-457-0336. Passcode: 109833 All calls at 3 pm Eastern time, 2 pm Central, 1 pm Mountain, 12 pm Pacific, and 10 am Hawaii, unless otherwise noted. Several ACAP plans have requested a roundtable conference call for Ombudsman/Member Advocates. This call is scheduled for Tuesday May 2 at 3 pm Eastern time. Plans will discuss the various roles assumed by ombudsman/member advocate within respective ACAP plans. A reminder email and discussion questions will be circulated prior to the call. Recap: Chief Medical Officers Roundtable On the last Chief Medical Officers Roundtable, Mack Johnston, MD of NHPRI facilitated a discussion of how plans are developing an e-strategy to more effectively use health information technology with members and providers. CareOregon has a grant program to fund clinic initiatives. The funding is not IT-specific, but many provider groups have used this funding for electronic health records and building disease registries. The plans discussed the need to be able to integrate multiple platforms used by providers and were interested in learning more about such programs or software. CMOs also discussed ACAP's proposed Benchmarking initiative and proposed relevant measures they would like captured in the project. CMOs were also informed of ACAP's upcoming Supporting the Safety Net Award. Recap: Marketing Directors Roundtable On the last Marketing Directors Roundtable, Marketing Directors discussed ACAP's proposed Benchmarking initiative and proposed relevant measures they would like captured in the project. Marketing Directors also discussed promotion of ACAP's upcoming Supporting the Safety Net Award. Recap: Customer Service Directors Roundtable On the last Customer Service Directors Roundtable, Customer Service Directors discussed ACAP's proposed Benchmarking initiative. Customer Service Directors discussed measures they would like to see captured in the project. Plans also discussed their bonus programs to improve attendance, reduce tardiness and enhance quality control. Currently, NHP, MDWise, and Hudson Health Plan have programs that award either bonuses or marketing/give-away materials for those with good attendance. For the next Customer Service Directors call on 6/29, Customer Service Directors would like to compare a "Top 10" list of the types of inquires received by Customer Service Directors. ACAP will distribute a brief survey template and ask plans to complete prior to the 6/29 call. 2006 Schedule of Roundtables The schedule of roundtable conference calls for ACAP senior staffing groups (CMOs, CFOs, Compliance, etc.) is published in the Members Only section of ACAP's website. |
| NEWSFLASH |
Upcoming Conference Promotes National Health Care Reform in Wake of Katrina The link between poor emergency care in the wake of Hurricane Katrina and the nation's inability to provide health care for everyone will be examined at "After Katrina: Achieving Access and Equity in Health Care," a conference sponsored by the Hudson Center for Health Equity & Quality (Hcheq) and Hudson Health Plan. The focus will be how information technology and policy can be used to improve the nation's health care system. The conference will be held at Abigail Kirsch at Tappan Hill in Tarrytown, NY, on Monday, May 8, 2006 from 8 a.m. to 2 p.m. Continuing medical and nursing education credits are available. Please see the website for more information at http://hcheq.org/afterkatrina.html#program ACAP Discount for 14th Annual Medicaid Managed Care Congress The Institute for International Research will present the 14th Annual Medicaid Managed Care Congress, the best practices event for States and Plans looking to improve healthcare quality and control costs. The event is scheduled for June 19-21, 2006 at the Hyatt Regency in Baltimore, MD. Participants will hear keynote presentations from Frederick P. Cerise, Secretary, Louisiana Dept. of Health & Hospitals, Patrick J. Kennedy, Congressman, Rhode Island, and G. Kirk Olsen, CEO, Molina Healthcare of Utah.
ACAP Job Bank
IIR's Medicaid Managed Care Congress includes 3-days of workshops, case studies and interactive panel discussions with the nations leading Medicaid experts. With representatives from over 20 states, the event provides strategies to improve fiscal operations with sessions on Managed Care expansion into SSI and Long Term Care, implementing Consumer Directed Care accounts for Medicaid populations and effective strategies for using encounter data for rate setting and quality improvement. ACAP maintains a job listing site on its website for jobs related to Medicaid managed care and health policy, both in Washington and regionally. If you would like to post a job announcement, please send it to Meg Murray at mmurray@communityplans.net. The job announcements are at http://www.communityplans.net/jobs/jobs.asp. ACAP members receive a 15% discount. Please contact Peggy Oehlmann at poehlmann@communityplans.net for information on the ACAP discount. A more detailed agenda is available at: http://www.iirusa.com/MMCC06. ACAP will also coordinate a dinner for ACAP plan representatives attending the meeting. Please contact Peggy Oehlmann if you are interested in attending the ACAP dinner. CT Plans Sued Over Rate Transparency Connecticut Attorney General Richard Blumenthal (D) filed a motion to intervene in a dispute regarding whether managed health care companies must release Medicaid reimbursement rate information to the public, the AP/Hartford Courant reports. According to the AP/Courant, three managed health care companies appealed the state Freedom of Information Commission's order that Medicaid reimbursement rates are subject to public disclosure because they pertain to a public function. In addition, legal aid groups maintain that the state Department of Social Services, Anthem Blue Cross and Blue Shield of Connecticut and Community Health Network of Connecticut should be fined because they extended their contracts without language that the companies are subject to FOI regulations, the AP/Courant reports. Health Net of Connecticut, one of the companies that appealed the decision, has not yet extended its contract. The legal aid groups are investigating whether low reimbursement rates have caused low-income Medicaid beneficiaries to face difficulty obtaining care from specialists, the AP/Courant reports. Blumenthal said, "Disclosure is vital because of questions about whether (the managed care companies) are delivering the coverage they have been contracted to provide." Social Services Commissioner Patricia Wilson-Coker said DSS has tried to comply with the FOI order but companies have refused to provide the documents necessary to do so, adding that extending previous contracts was necessary to prevent the disruption of services. Colleen Murphy, executive director of the state's FOI Commission, said private companies performing duties that are the "functional equivalent" of public agencies must disclose those records under a 2001 law that pertains to companies with state contracts exceeding $2.5 million (AP/Hartford Courant, 3/18). Linda Blankenship Leaves Community Health Plan Linda Blankenship, Senior Vice President and CIO of Community Health Plan and Community Health Network of Washington left in early March to return to CAMRAY Consulting Group, LLC as managing partner where she will continue her work in IT value maximization for health plans and providers. CAMRAY Consulting Group, LLC is a healthcare IT consulting firm specializing in helping healthcare organizations achieve their short and long term strategic business objectives through the value maximization of information technology. CAMRAY provides strategic planning, solution selection and guidance for successful implementation of IT solutions in health plan and provider environments. |
| Upcoming Events |
April Events |
| Mon | Tues | Wed | Thurs | Fri | Sat/Sun |
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1/2 |
| 3 |
4 |
5 |
6 |
7 |
8/9 |
| 10 |
11 Medicare SNP Roundtable |
12 |
13 |
14 |
15/16 |
| 17 |
18 |
19 |
20 COO Roundtable |
21 |
22/23 |
| 24 |
25 |
26 |
27 CIO Roundtable |
28 |
29/30 |
May Events |
| Mon | Tues | Wed | Thurs | Fri | Sat/Sun |
| 1 |
2 New! Ombudsman/Member Advocate Roundtable |
3 |
4 CFO Roundtable |
5 |
6/7 |
| 8 |
9 |
10 |
11 Provider Relations Roundtable |
12 |
13/14 |
| 15 |
16 |
17 |
18 Quality Management/Disease Management Directors Roundtable |
19 |
20/21 |
| 22 |
23 |
24 |
25 Compliance Roundtable |
26 |
27/28 |
| 29 Memorial Day |
30 |
31 |
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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. |
| Darnell Dent, Chairman | Margaret A. Murray, Executive Director, mmurray@communityplans.net, 202.331.4601 |
Association for Community Affiliated Plans 1400 Eye Street, NW, Suite 330 Washington, DC 20005 http://www.communityplans.net Contact Us |