 July 21, 2006 |
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Upcoming
ACAP Calls 8/2: Human Resources 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 |
Benefits of Medicaid Managed Care Presented at the Medicaid Commission Maggie Brooks, the County Executive of Monroe County in New York and Medicaid Commission member, gave a presentation on the benefits of Medicaid managed care at the Medicaid Commission. She discussed several initiatives that the Monroe Plan, an ACAP member, have used to reduce NICU usage in their plan as well as the ACAP report on savings from managed care expansions. Monroe Plan had found that Prenatal/Perinatal Services were the highest Medical expense diagnostic group and that NICU Admissions were a major driver of costs for this group. In 1998 Monroe had 108 NICU admissions per 1,000 births compared to the upstate New York Medicaid rate of about 110 per 1,000. Beginning in late 1997 Monroe implemented their Healthy Beginnings Prenatal Care Program. The Program consisted of 1) Use of Prenatal Health Risk Assessment Form, 2) enhanced payment for Health Risk Assessment Forms submitted during the first trimester and 3) the engagement of community-based outreach program called BabyLove for psycho-social needs in 2002. By 2004 Monroe's NICU admissions rates had fallen to 34.9 per 1000 while the upstate New York average remained the same as before. County Executive Brooks concluded her remarks by mentioning the ACAP-sponsored Lewin study which found that if states expanded their acute care managed care to all TANF and non-dual SSI the Federal government and states would save $82 B over ten years.  |
| PUBLIC POLICY AND ADVOCACY |
 ACAP's Congressional Update Continuing the recent Congressional assertion of authority over Medicaid, Senator Baucus led 43 of his Senate colleagues in writing a letter to the US Department of Health and Human Services expressing concern about reports that the Department planned to implement the President's Fiscal Year 2007 budget proposals to reduce Medicaid spending by $12.2 billion over five years through regulatory changes to Medicaid provider reimbursement rates. This included a provision impacting provider taxes, including the MCO Provider Tax. The letter argued that Congress rejected those proposals last year by choosing not to include them in the Deficit Reduction Act (DRA). The Senators said that they did not believe it is appropriate for the Department, under the administrative authority of the Centers for Medicare and Medicaid Services (CMS), to make the changes. ACAP Sharing
Services Last week, CMS issued its mid-session analysis of
Medicare and Medicaid spending. Federal Medicaid spending growth
declined from over 12 percent annual increases at the beginning of the
decade to 7.2 percent from 2002-2005, and down to 4.6 percent projected
for fiscal year 2006-2007. CMS said that State Medicaid spending growth
has simultaneously slowed significantly, with many states projecting
lower costs in FY 2006 than FY 2005—citing a greater savings from the
shift of drug coverage for dual eligibles than expected. On Medicare,
Part A and Part B expenditures are higher, primarily because of
continuing rapid growth in the use of Medicare services. Part A
projected expenditures over 5 years (2006-2010) are $17 billion higher
and Part B projected expenditures over 5 years are $30 billion higher
than in the President's Budget.In the members only section of our website, there are several areas that we want to remind you to look at periodically, including a large section of shared documents, which includes disaster recovery plans, compliance documents, job descriptions. We also have several surveys we have done of our plans. |
| EXCELLENCE AND ACCOUNTABILITY |
 Human Resources Directors Roundtable on 8/1 On Tuesday August 1 at 3 pm eastern time, there will be a Human Resources Directors Roundtable. The topic of the call will be Business Continuity Plans for HR Departments. For discussion questions and call-in instructions, please visit the HR Directors Roundtable section of our website at: http://www.communityplans.net/members/hr%20roundtable.asp ACAP Job
Bank Recap: Marketing
Directors RoundtableACAP plans can post job announcements in our job bank. Please see our website for more details. You can email job announcements to Christina Boye at cboye@communityplans.net. On Tuesday July 11 Marketing Directors from ACAP plans participated in a roundtable to share and compare member marketing materials. Materials and presentations from the call are available in the Marketing Directors section of our website: http://www.communityplans.net/members/mrkting%20roundtable.asp |
| NEWSFLASH |
 Colorado Access, Colorado's largest Medicaid Managed Care Organization, Elects to Not Renew Medicaid Physical Health Contract After almost 11 years of serving as Colorado's largest Medicaid managed care plan, the Board of Directors of Colorado Access has elected to not renew the Medicaid physical health contract expiring on August 31, 2006. During the last few years, it has become increasingly difficult for the Plan to maintain its mandatory risk-based capital requirements. The Medicaid physical health line of business has had many enrollment challenges and Colorado Access was recently notified by the Colorado Department of Healthcare Policy and Financing (HCPF) of a pending rate decrease of up to 15 percent. "After considerable analysis there was simply no way we could, in good conscience, pass along a significant rate cut to providers who are already having a tough time making ends meet serving the Medicaid population. My staff will work with HCPF to transition the over 65,000 members back to Medicaid fee-for-service. Because most of our providers are also Medicaid contractors, the members should be able to continue seeing their current providers," said Don Hall, President and CEO of Colorado Access. By not renewing this contract, the company expects to be above the required risk-based capital level in September. The company's losses over the last few years have been directly attributable to the Medicaid physical health line of business. The Board of Colorado Access still believes strongly that a local non-profit company operated by safety net providers can best serve Colorado's low-income populations and remains committed to serving nearly 100,000 members through Access Behavioral Care (Medicaid behavioral health), Child Health Plan Plus (CHP+) and Access Advantage (Medicare Advantage Special Needs Plan). "As we have done for the past 11 years, we will continue to improve access and quality of care for Colorado's most vulnerable populations. We are dedicated to serving the physical and behavioral health needs of our members and that won't change." Of the company's current 250 positions, over 50 percent will be eliminated beginning the first part of October. "The company has made a tremendous impact on the healthcare of Colorado's neediest residents because our staff is made up of incredible people. We are committed to doing everything possible to take care of our impacted employees and help them find positions at other companies," said Hall. "This is one of the saddest days that the company has ever experienced and it is unfortunate that circumstances have forced us to make this decision." Colorado Access is a private, nonprofit health plan that has served the medical and behavioral health needs of the medically underserved for more than a decade. The company's three lines of business are now Access Advantage, Child Health Plan Plus and Access Behavioral Care. Colorado Access is sponsored by The Children's Hospital, Colorado Community Managed Care Network and University of Colorado Hospital/University Physicians, Inc Update on Community Health Center Appropriations The Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education has passed their FY2007 appropriations bill. The highlights of the legislation include the following: FY 2006 Funding Level: $141.531 billion FY 2007 President's Request: $137.794 billion FY 2007 Committee Recommendation: $142.800 billion HHS Programs: $64.181 billion
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| Upcoming Events |
July Events |
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1/2 |
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4 Independence Day |
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6 |
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8/9 |
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11 Marketing Directors Roundtable Executive Committee Call |
12 |
13 |
14 |
15/16 |
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18 |
19 |
20 |
21 |
22/23 |
| 24 ACAP Board Meeting |
25 ACAP CEO Summit |
26 ACAP CEO Summit |
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28 |
29/30 |
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August Events |
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1 HR Directors Roundtable |
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5/6 |
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11 |
12/13 |
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19/20 |
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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. |
| 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 |