 May 30, 2006 |
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Upcoming ACAP Calls
6/1: CMO Roundtable 6/7: Marketing Directors Roundtable 6/15: Medicare Roundtable 6/20: ACAP dinner at MMCC (email Peggy for more information) 6/22: Pharmacy Directors Roundtable 6/29: Customer Service Directors 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 CEO Summit Scheduled for July 25-26 This invitation-only meeting brings CEOs of Medicaid-focused health plans and their senior staff together to discuss where Medicaid managed care is going after the implementation of the Deficit Reduction Act. Ample time will be allotted for open and frank discussion among and between the CEOs and the speakers. In particular, we will leave time for open discussion on actuarial soundness and other issues plans are facing in their states. Speakers include: Bob Hurley, The Financial Status of Medicaid Focused Health Plans Chuck Milligan, Consumer Directed Health Plans in Medicaid Matt Salo, State Implementation of the DRA Deb Enos, Health Plans' Role in Massachusetts Health Reform Other topics include: Designing Effective Provider Incentives Dueling Regulation of Medicaid and SNP programs View from the Medicaid Directors on the DRA View from Capital Hill: Whither Medicaid? Health IT: Is it Really Here? Open Discussion on Actuarial Soundness The registration form can be found at www.ahcahp.org/conf/ceo_summit_06/default.asp  |
| PUBLIC POLICY AND ADVOCACY |
Hudson Health Plan Hosts “After Katrina” Conference Hurricane season begins June 1, but the nation is still not prepared to deal with the health consequences of another devastating storm like Katrina, according to speakers 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 on May 8th in Tarrytown, NY. Speakers agreed that a terrible situation was exacerbated because many evacuees had ongoing medical problems, largely due to inadequate access to health care. The conference featured two eyewitness reports on the health status of Katrina victims from Erik Larsen, MD, FACEP, who served as Medical Director of the National Disaster Medical System at the New Orleans International Airport following Katrina, and David Abramson, PhD, MPH, the principal investigator of a just-published public health assessment of hurricane evacuees in Louisiana. Other conference speakers included Ian Morrison, the futurist and author of Health Care in the New Millennium: Vision, Values, and Leadership, and Senator Hillary Rodman Clinton (D-NY), who addressed the conference in a pre-recorded video. “Louisiana’s population has a higher percentage of people without health insurance than the nation as a whole—21% compared to 15.7%,” said Georganne Chapin, founder of Hcheq and President and CEO of Hudson Health Plan. “The result is that the health status of Louisianans ranks near the bottom of the country. So when Katrina hit, the problem wasn’t just a devastating hurricane, but an ongoing disaster in the public health system as well.” Dr. Larsen concurred. “Emergency medicine is designed to care for people with traumas, which is easier than caring for people with multiple morbidities. We had dozens of people with renal failure who were crashing after five days without dialysis. As a disaster team, we weren’t equipped to treat people who needed such high levels of care,” said Dr. Larsen, who is Associate Director and EMS Coordinator of the Emergency Department at White Plains Hospital Center, White Plains, NY. Six months after the storm, Katrina evacuees still were not getting regular medical care, according Dr. Abramson, who traveled to Louisiana in February to survey the health status of storm evacuees. He found 34 percent of children living in FEMA-subsidized community settings had at least one chronic medical condition, a rate about one-third higher than the national average. Lack of insurance coverage prevented parents from treating their children’s chronic conditions, he explained. “Parents had no alternative to going to the emergency room when things got out of control, and they’d get a supply of medicine to see them through until the next emergency.” Much more could have been done for victims, but the federal government was unwilling to cut through the red tape of Medicaid to cover storm victims, said panelist Deborah Bachrach of Manatt, Phelps & Phillips. She pointed out that after 9/11, the Governor of New York extended emergency Medicaid to residents of New York just eight days after the attack. “Over 350,000 people signed up for the Disaster Relief Medicaid program in the four months following 9/11,” she said. “The lesson is that leadership matters.” For more about the Hudson Center for Health Equity and Quality, visit www.hcheq.org. Health IT Legislation Moves This past week, the House Ways and Means Committee took the first step toward passage of a health information technology bill. Announcing that the House would have a 'health week' in June, the committee held a markup on the Johnson/Deal bill. Although ACAP's lobbyist has been working to include safety net health plans in health legislation, the House package holds few opportunities for plans to participate. The Energy and Commerce Committee intends to markup legislation when Congress returns from its Memorial Day break. ACAP will keep you informed as these issues progress. |
| EXCELLENCE AND ACCOUNTABILITY |
FEHBP Required HEDIS for Plans and FFS The federal Office of Personnel Management released its “call” for bids from health plans who wish to be part of the offering to federal employees and retirees for calendar 2007. For the first time, OPM will be requiring HEDIS data from not only the HMOs but the fee for service plans. The required measures are breast cancer screening, cholesterol management for cardiovascular patients, and comprehensive diabetes care. This is the first time that the federal government has tried to measure quality in its fee-for-service programs. ACAP’s Library of Shared Documents In the Members only section of our website, we have a library of shared documents. This includes documents such as:
Recap: Provider Relations Roundtable On the May 11 Provider Relations Roundtable, Provider Relations Directors discussed marketing to providers. ACAP plans discussed approaches to targeting providers for recruitment, using electronic vehicles for communication (newsletter and website) and strategies for recruiting particular providers (either because of geographic location, specialty, or a particular cultural competency).
Access ACAP Roundtable and Best Practice Conference Calls
Recap: CFO 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 9 am Hawaii, unless otherwise noted. On the May 4 CFO Roundtable, CFOs discussed Stop Loss and Reinsurance programs and explored the possibility of pursuing a group purchasing discount on such policies. ACAP is working with plan CFOs to develop a matrix of brokers and reinsurers. ACAP will also research the possibility of developing a preferred vendor relationship with stop loss reinsurers and report back to CFOs before the next CFO roundtable on September 21. Recap: Quality Management/Disease Management Roundtable On the May 18 QM/DM Directors call, Quality management Directors discussed disease management of co-morbid behavioral health and physical health conditions. In this discussion, ACAP plans compared risk assessment tools, discussed case management models, and Health Risk Assessment tools that ask questions about both physical health and behavioral health needs. ACAP is in the process of collecting information on risk assessment tools used by ACAP plans. If your plan uses a risk assessment tool, please email Peggy Oehlmann with the name of the tool/vendor, model or version used by the plan, and a contact at the plan for follow-up information. This information will be compiled into a table, distributed to ACAP plans, and posted in the Members Only section of ACAP’s website. Recap: Compliance Officers Roundtable On the May 25 Compliance Officers Roundtable, Compliance Officers discussed the preliminary agenda for the upcoming Compliance Officers meeting. This meeting will be held on Thursday, September 28 at the Brooklyn Marriott in Brooklyn, New York. An email with the final agenda, registration procedures, and meeting materials will be circulated within the next few weeks. Compliance Officers also had a brief conversation about the structure of their Compliance programs. This subject will be discussed in more detail at the 9/28 meeting. As part of the discussion, ACAP Compliance Officers agreed to share Compliance Officer job descriptions. Please send job descriptions to Peggy Oehlmann (poehlmann@communityplans.net) and she will post them in the Members Only/Plan Documents section of the website. Reminder: Chief Medical Officers Roundtable The next CMO Roundtable call is scheduled for Thursday June 1 at 3 pm eastern time. On this call, we will discuss procedures for participation in the 2006 NCBD Data Submission process for an ACAP CAHPS analysis. A reminder email and agenda will be circulated prior to the call. Please contact Peggy Oehlmann (poehlmann@communityplans.net) if you have items to add to the agenda. Reminder: Marketing Directors Roundtable The next Marketing Directors Roundtable is Wednesday, June 7 at 3 pm eastern time. A reminder email and agenda will be circulated prior to the call. Please contact Peggy Oehlmann (poehlmann@communityplans.net) if you have items to add to the agenda. Reminder: Pharmacy Directors Roundtable The next Pharmacy Directors Roundtable call is scheduled for Thursday June 22 at 3 pm eastern time. On this call, we will discuss PBMs and risk sharing programs as well as specialty pharmacy management. A reminder email and discussion questions will be circulated prior to the call. Please contact Peggy Oehlmann (poehlmann@communityplans.net) if you have items to add to the agenda. Reminder: Customer Service Directors Roundtable The next Customer Service Directors Roundtable is Wednesday, June 29 at 3 pm eastern time. On the last Customer Service Directors call in March, Customer Service Directors agreed to send a list of “Top 10 inquiries” received by the Customer Service department. Please email Peggy Oehlmann with your plan’s “Top 10 inquiries” by Tuesday, June 20. A reminder email will be sent and a matrix ranking “Top 10 inquiries” will be posted to the website prior to the call. Please contact Peggy Oehlmann (poehlmann@communityplans.net) if you have items to add to the agenda. |
| NEWSFLASH |
Bob Master, MD, Testifies at Medicaid Commission Bob Master, MD, CEO of Commonwealth Care Alliance (CCA), spoke to the Medicaid Commission on the benefits of managed care for severely disabled populations. Dr. Master summarized his remarks by saying:
Electronic Health Information Among Health Centers: Adoption and Barriers The National Association of Community Health Centers recently presented preliminary data on health center adoption rates of electronic medical records (EMR) and key barriers to implementing EMRs. The survey finds that while health centers generally desire to implement EMR systems, they have lower rates of EMR adoption compared to other providers and face severe financial barriers in implementing EMRs. This Fact Sheet was released at a Congressional Briefing on May 12, where Congressional staffers and others heard about the importance of health information technology (HIT) at community-based safety net providers, factors that impede HIT adoption at health centers, and policy options that will address access to HIT. Fact sheet is available at http://www.nachc.com/research/files/CHC%20HIT%20survey%20fact%20sheet.pdf. 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. IIR's Medicaid Managed Care Congress includes 3-days of workshops, case studies and interactive panel discussions with the nation’s 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 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. The dinner will be held on Tuesday, June 20th at a restaurant near the hotel. Please contact Peggy Oehlmann if you are interested in attending the ACAP dinner. |
| Upcoming Events |
June Events |
| Mon | Tues | Wed | Thurs | Fri | Sat/Sun |
| 29 Memorial Day |
30 |
31 |
1 CMO Roundtable |
2 |
3/4 |
| 5 |
6 |
7 Marketing Directors Roundtable |
8 |
9 |
10/11 |
| 12 Program Committee |
13 |
14 |
15 Medicare Roundtable |
16 |
17/18 |
| 19 |
20 ACAP dinner at MMCC Email Peggy for info |
21 |
22 Pharmacy Directors Roundtable |
23 |
24/25 |
| 26 |
27 Finance Committee |
28 Quality Management Committee |
29 Customer Service Directors Roundtable |
30 |
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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 |