ACAP Newsletter

November 14, 2006
ACAP Newsletter


HIGHLIGHTS

Neighborhood Health Plan of Rhode Island Named #1 Medicaid Health Plan in America, Monroe Plan in Top 10
The U.S. News & World Report and the National Committee for Quality Assurance (NCQA) named the Neighborhood Health Plan (NHPRI) of Rhode Island the top Medicaid health plan in the U.S. in its November 6, 2006 edition.
Click to read this article.

November 7 Election Brings Big Changes
After months of contentious campaigning, the American people finally had an opportunity to speak on November 7 and, apparently, they had a lot to say. For the first time since 1994, Americans entrusted control of Congress to the Democrats, ending 12 years of Republican control in the House and four years of control in the Senate.
Click to read this article.


PUBLIC POLICY AND ADVOCACY

ACAP Sends Letter to the Hill in Support of Filling 2007 SCHIP Funding Gap
Click to read this article.

Kaiser Report Shows Slowing Growth of Medicaid Costs, Partly Due to Medicaid Managed Care
Click to read this article.


EXCELLENCE AND ACCOUNTABILITY

Reminder: Chief Medical Officers Roundtable
Click to read this article.

Reminder: Pharmacy Directors Roundtable
Click to read this article.

Reminder: Medicare SNP Roundtable For Plans in the Planning Phase
Click to read this article.

Reminder: Medicare SNP Roundtable For Operational Plans
Click to read this article.

Reminder: Policy Roundtable
Click to read this article.

Reminder: Customer Service Directors Roundtable
Click to read this article.

Reminder: Provider Relations Directors Roundtable
Click to read this article.

Reminder: Quality Management/Disease Management Directors Roundtable
Click to read this article.

Recap: Ombudsman Roundtable
Click to read this article.

Recap: Policy Roundtable
Click to read this article.

Recap: Compliance Officer Roundtable
Click to read this article.

Recap: Claims Roundtable
Click to read this article.

Recap: Medicare Roundtable for Plans in the Planning Phase
Click to read this article.

CHCS Quality Summit on Racial/Ethnic Disparities
Click to read this article.


NEWSFLASH

ACAP Invited to Speak at IOM Meeting on Safety Net
Click to read this article.

ACAP Speaks at Third National Medicare Congress Washington, DC
Click to read this article.

Hudson Health Plan Recently Recognized by Westchester Hispanic Coalition at the Dia de Los Muertos Gala
Click to read this article.

Neighborhood Health Plan of Rhode Island Receives an Award for Their New Video Conference Medical Technology
Click to read this article.

Denver Health Medical Plan Joins ACAP
Click to read this article.

CareSource Foundation Awards First Grants
Click to read this article.

Colorado Access Helps Employees That They Dismissed
Click to read this article.

Bruce Lesley Leaves Senator Bingaman's Office
Click to read this article.

NACHC Recruiting Students for Health Center Focused Medical School
Click to read this article.


ACAP VENDOR ALLIANCES

ACAP Members Can Now Save with CommonWealth Purchasing Group
Click to read this article.

   
Upcoming ACAP Calls
11/16: CMO Roundtable
11/21: Medicare Roundtable for plans planning on or considering entering Medicare (Note special time of 2:30 PM EST)
11/28: Medicare Roundtable for operational plans
11/30: Pharmacy Roundtable
12/5: Policy Roundtable (Note different call-in number)
12/5: Customer Service Roundtable
12/7: Provider Relations Roundtable
12/14: Quality Management/Disease Management Directors Roundtable


Upcoming Events Calendar

Click to view calendar.





HIGHLIGHTS

Neighborhood Health Plan of Rhode Island Named #1 Medicaid Health Plan in America, Monroe Plan in Top 10

The U.S. News & World Report and the National Committee for Quality Assurance (NCQA) named the Neighborhood Health Plan (NHPRI) of Rhode Island the top Medicaid health plan in the U.S. in its November 6, 2006 edition.

The rankings are based on Medicaid member satisfaction and quality of care as determined by data from NCQA's Quality Compass® 2006, which reports on 112 Medicaid health plans. Health plan members are surveyed on access to care and overall satisfaction, and NCQA included a review of prevention measures and treatment outcomes to devise overall quality scores for plans.

ACAP Board Member and NHPRI CEO Mark E. Reynolds was quoted as saying "We appreciate this national recognition, especially because much of it is based on feedback from our own members."

Three of the top four ranked Medicaid health plans are located in Rhode Island. In addition, 4 of the top 10 health plans were from New York State, including Excellus BlueCross BlueShield Health Plan (ranked number 6), whose Medicaid program is run by ACAP member Monroe Plan for Medical Care, Inc.

In related news, the Alliance for Advancing Nonprofit Healthcare, which also analyzed the 2006 rankings of health plans, stated that most of the top-ranked Medicaid managed care organizations are offered by nonprofit health plans. Of the 71 Medicaid managed care organizations that are ranked by U.S. News & World Report, 19 of the top 25 (76 percent) are nonprofit.

November 7 Election Brings Big Changes

After months of contentious campaigning, the American people finally had an opportunity to speak on November 7 and, apparently, they had a lot to say. For the first time since 1994, Americans entrusted control of Congress to the Democrats, ending 12 years of Republican control in the House and four years of control in the Senate. To give a sense of how resounding the rebuke was, not one incumbent Democrat lost his or her seat -- a similar thing occurred in the 1994 election later dubbed the "Republican Revolution." Voters identified the prolonged war in Iraq, highly visible sex and corruption scandals, the perception of governing incompetence, and an economic recovery that has failed to help them as the main reasons for their support of Democrats. When all the votes are counted (there are still nine races outstanding), Democrats will likely have a 232-203 majority in the House and a 51-49 majority in the Senate.

Many of the new Democratic members have more moderate/conservative leanings. Although the Senate will have its first socialist member in Bernie Sanders from Vermont, most House and Senate members come from much more conservative "red" states, including Indiana, Arizona, Ohio, Montana, Kentucky, and North Carolina. The Senate Democratic caucus will also be more moderate with new members like former Secretary of the Navy, ex-Republican Jim Webb (VA), the pro-life Bob Casey, Jr. (PA), and buzz cut wearing, gun-toting farmer Jon Tester (MT). Many observers (and most Republicans) are betting that the notoriously fractious Democrats will have a hard time managing their liberal base, while maintaining the viability of their new moderate/conservative members. This feat won't be made any easier with every special interest caucus looking for their seat at the table -- most notably the reinvigorated conservative Blue Dog Coalition. Blue Dogs have been most vocal about demanding their pound of flesh, but managing all these interests will require the presumptive Speaker of the House Nancy Pelosi and the incoming Democratic Majority Leader to keep their troops in line to retain their majority.

The Democratic victory will not only bring in their ability to move an agenda (which, along with the Democrats, has been locked in the basement since 2000), it will also mean new leadership in Congress. Conventional wisdom suggests that Nancy Pelosi will be the new Speaker of the House and Harry Reid will be the Senate Majority Leader. There is a battle brewing for Democratic Majority Leader between current Minority Whip Steny Hoyer (MD) and Representative John Murtha (PA), the outspoken former Marine who called for a redeployment of troops in Iraq. It appears the position of Majority Whip will go to Rep. James Clyburn (SC, former chair of the Congressional Black Caucus). The key health committee chairmen will look strikingly similar to the last time that Democrats controlled Congress. The House Ways and Means Committee will be chaired by Rep. Charlie Rangel (NY) while the Health Subcommittee will be chaired by Rep. Pete Stark (CA). Rep. John Dingell will be the House Energy and Commerce Committee Chair, while (at this point), either Reps. Frank Pallone (NJ) or Ed Towns (NY) could be the Health subcommittee chair. On the Senate side, Senator Max Baucus (MT) will be chair of the Senate Finance Committee and Ted Kennedy (MA) will be chair of the Senate Health, Education, Labor, and Pensions Committee.

Of course, when one party wins, the other party loses. As a result of the election, the Congressional Republican make-up has become much more conservative and much more regionalized. Many high-profile Republican moderates lost their seats in this election as a Democratic wave continued the regional political realignment appears to be continuing in America. Americans rejected moderates like Senators Lincoln Chafee (RI) and Mike DeWine (OH), and Representatives Nancy Johnson (CT), Charlie Bass (NH), Jim Leach (IA), and Gil Gutnecht (MN). They also threw out people tainted with scandal, including John Sweeney (NY), Mark Foley (FL), Don Sherwood (PA), and the seats formerly held by Republican Majority Leader Tom Delay (TX) and Bob Ney (OH). Finally, they rejected several members that were perceived as too extreme for their State or district, including Senator Rick Santorum (PA) and Representatives JD Hayworth (AZ), and Richard Pombo (CA). This loss has sown general confusion and soul searching among Republicans, many of whom have never worked as a Congressional minority. Most conservatives are calling for a return to "Republican first principles" of promoting tax cutting and less government. It remains to be seen who will emerge as the Republican leaders in Congress, although it is assumed that the Senate Minority Leader will be Mitch McConnell (KY). Speaker Denny Hastert has stepped down and will not seek a leadership position. At this point, the position of House Minority Leader could be fought out between current Majority Leader John Boehner, conservative chair of the Republican Study Committee Mike Pence (IN), and Rep. Joe Barton (TX) who is the current Chair of the House Energy and Commerce Committee. Of course, this is speculation and any new member could emerge as a front runner.

One thing that is widely agreed on is that health care will be a top priority for the new Democratic Congress, even if the agenda is "small ball" and not a lot of swinging for the fences. Democrats consistently said that, if they were victorious, their health priorities would include "fixing" the Medicare drug benefit by allowing the Federal government to negotiate prices of prescription drugs, authorizing Federal funding for embryonic stem cell research, allowing Americans to reimport cheaper prescription drugs from Canada, and cutting payments to Medicare Advantage plans. In addition, incoming House Energy and Commerce Chair John Dingell has said that he wants to reexamine issues related to the FDA, including generic drugs and perceived marketing abuses by drug companies (most likely a review of direct to consumer advertising) and other Medicare related issues, including filling the donut hole. In addition, Dems will be able to put their mark on outstanding issues from this year, including SCHIP reauthorization and health information technology.

Of course, most observers understand that Democrats must temper any "big ideas" with a heavy dose of economic and political reality. Democrats must secure their majority (e.g. "not scare people") and therefore are unlikely to promote contentious big ticket items, like major health coverage expansions or universal coverage. In addition, they have only slim margins of control, meaning that any small faction can control the agenda. They also have a President waiting at the end of the line to veto Democrat-only legislation. Likewise, with the slow demise of the moderate Republican, there are likely to be few Republicans seeking bipartisanship -- meaning Democrats will have to do the heavy lifting alone. Finally, the combination of massive budget deficits and the Democratic commitment to restore the pay-as-you-go rules will require spending cuts for any spending increases or tax cuts. All of these things are likely to conspire to push Democrats to seek smaller wins -- seek to restore confidence in competent government, promote popular initiatives that will save money, and conduct significant oversight of the Administration -- all while laying the groundwork for the next election in 2008.

Lame Duck Congressional Session

The elections took a lot of the fight out of Republicans and it appears that the remaining lame duck session could go by without much anxiety. Republicans and Democrats are passing a continuing resolution to fund the government through mid-December when it appears that a final major omnibus appropriations package may be sent through the Congress. It also remains likely that something may be done on fixing Medicare physician payments, although it remains to be seen what solution will be found. We believe that other issues that ACAP has been following -- such as health information technology, health disparities, and possibly SCHIP funding -- will not make any progress and will be left to the Democratic Congress next year.

Families USA Holds Nationwide Call November 14: New Congress, a New Agenda for Health Care

In related news, Families USA will hold a conference call to discuss what can be expected from the 110th Congress on health care issues. The call will be held on Tuesday, November 14th, at 3:00 PM Eastern Time.

During the call, Ron Pollack, Families USA Executive Director, will answer the following questions:
  • What do the changes in House and Senate membership mean for health care advocates?
  • What are your predictions about the top health-related priorities for the new Congress?
  • What's on the horizon for Medicaid, Medicare and State Children's Health Insurance Program in 2007?
  • How should Congress tackle the critical health care problems facing America's families?
To RSVP, please visit the following website: http://ga3.org/familiesusa/events/election_111306/details.tcl.



PUBLIC POLICY AND ADVOCACY

ACAP Sends Letter to the Hill in Support of Filling 2007 SCHIP Funding Gap

On October 27, ACAP distributed a letter to Senate and House Committee leadership expressing support for addressing the SCHIP funding shortfall this year and encouraged all ACAP members to submit similar letters to their Congressional delegations.

In 2007, two states with ACAP Plans (MA and RI) will experience a SCHIP shortfall, but by 2008, five ACAP states (AZ, CA, HI, MA, RI) will be among the 24 projected to run out of funds. By 2012, nine ACAP states (AZ, CA, HI, MA, NY, OH, OR, RI, VA) will be among the 36 with shortfalls. Without a fix, additional states will suffer shortfalls in the future.

ACAP Sharing Services
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.

Kaiser Report Shows Slowing Growth of Medicaid Costs, Partly Due to Medicaid Managed Care

A survey of states conducted by the Kaiser Commission on Medicaid and the Uninsured determined that average total Medicaid spending across all states increased just 2.8 percent in 2006, the lowest growth rate in any year over the past decade. 2006 was also the first year since 1998 in which state revenue growth outpaced Medicaid costs.

Among the reasons for the slowed growth are decreased growth in enrollment due to an improving economy, shifts in drug costs to the Medicare program, and implementation of cost containment strategies by states.

Managed Care continues to be an important cost containment strategy. Fourteen states contained costs by expanding Medicaid managed care in 2006 (17 plan to expand managed care in 2007). Expansions included spreading managed care to new service areas (10 states), adding eligibility groups (three states), and imposing mandatory enrollment (four states).



EXCELLENCE AND ACCOUNTABILITY

Reminder: Chief Medical Officers Roundtable

On Thursday, November 16, 2006 at 3 pm Eastern time for Chief Medical Officers. On this call, CMOs will discuss the following:
  • A behavioral health project that ACAP will launch in December,
  • ACAP CAHPS survey results.
  • Mack Johnston, MD, will present highlights from NHPRI's Video Conferencing Medical Interpreting Program.
Materials will be posted prior to the call at: http://www.communityplans.net/members/cmo%20roundtable.asp.

ACAP Job Bank
ACAP 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.

Reminder: Pharmacy Directors Roundtable

The next ACAP Pharmacy Directors Roundtable is Thursday, November 30 at 3 pm eastern time. On this call, Pharmacy Directors will discuss pharmacy delivery in rural areas. An agenda and any materials will be posted prior to the call at: http://www.communityplans.net/members/pharmaceutical%20roundtable.asp. Please contact Peggy Oehlmann at poehlmann@communityplans.net if you have items to add to the agenda.

Reminder: Medicare SNP Roundtable For Plans in the Planning Phase

The next ACAP Medicare Roundtable for plans in the planning phase will be November 21st at 2:30 EST (note different time). Beth Marootian and the Member Services team from NHPRI will lead a discussion with participants on Member Service for duals. During the discussion, they will cover the necessary skill set of member services representatives, scheduling for 8 -8 coverage, most common questions, how to advocate for members, integration with Medical Management, and training. Please contact Elizabeth Ward at eward@communityplans.net if you have items to add to the agenda.

Reminder: Medicare SNP Roundtable For Operational Plans

The next ACAP Medicare Roundtable for operational plans will be November 28th at 3:00 EST. Elizabeth Bryan from Mercy Care will lead off a discussion about risk adjustment and coding for risk adjustment. We will also discuss the use of consultants to assist with this process. (Please note: the topic originally scheduled for November 28th, staff training for Medicare, will be reschedule for early December). Please contact Elizabeth Ward at eward@communityplans.net if you have items to add to the agenda.

Reminder: Policy Roundtable

The next ACAP Policy Roundtable will be held Tuesday, December 5 at 3 pm eastern standard time. An agenda and any materials will be posted prior to the call at http://www.communityplans.net/members/policyroundtable.asp. Currently, agenda items include a legislative update, including a discussion on the election results, legislative earmarks, provider taxes, and a SCHIP reauthorization update. Please contact Jenny Babcock at jbabcock@communityplans.net or 202-331-4605 if you would like to suggest additional agenda items.

Reminder: Customer Service Directors Roundtable

The next ACAP Customer Service Directors Roundtable is Tuesday, December 5 at 3 pm eastern time. An agenda and any materials will be posted prior to the call at: http://www.communityplans.net/members/custservice.asp. Please contact Peggy Oehlmann at poehlmann@communityplans.net if you have items to add to the agenda.

Reminder: Provider Relations Directors Roundtable

The next ACAP Provider Relations Directors Roundtable is Thursday, December 7 at 3 pm eastern time. An agenda and any materials will be posted prior to the call at: http://www.communityplans.net/members/providerroundtable.asp. Please contact Peggy Oehlmann at poehlmann@communityplans.net if you have items to add to the agenda.

Reminder: Quality Management/Disease Management Directors Roundtable

The next ACAP QM/DM Directors Roundtable is Thursday, December 14 at 3 pm eastern time. An agenda and any materials will be posted prior to the call at: http://www.communityplans.net/members/qm%20roundtable.asp. Please contact Peggy Oehlmann at poehlmann@communityplans.net if you have items to add to the agenda.

Recap: Ombudsman Roundtable

On Thursday, October 19, ACAP Ombudsmen discussed best practices and strategies for using member advisory boards. Virginia Premier's Director of Member Operations, Teesa Nevins, walked through how their plan uses its member advisory board, including the frequency of meetings, typical agendas, and how meetings are publicized. Several other plans have also used member advisory boards or are in the process of establishing them.

Recap: Policy Roundtable

On Wednesday, October 25, the ACAP Policy Roundtable discussed the new DRA citizenship documentation requirements, the SCHIP 2007 funding shortfall and SCHIP reauthorization, SFC actuarial soundness state response letters, the DRA state grants to non-emergency providers, and a potential ACAP webblog for policy issues. Members also received a legislative update.

Recap: Compliance Officer Roundtable

On Thursday, October 26 ACAP Compliance Officers discussed key themes and follow up items from the September Compliance Officers meeting. A summary of the meeting can be found at: http://www.communityplans.net/members/compliance%20officers.asp. The Employee Education Provisions of the False Claims provisions of the Deficit Reduction Act (DRA) were discussed on this call. Maryann Schwab of CHPW walked through a presentation on the false claims provisions and highlighted key things: states have significant financial incentive to adopt laws that model the federal false claims provisions but must do so by 1/1/07. As of the October call, only 15 states had done so. ACAP will continue to monitor this issue.

Recap: Claims Roundtable

On Wednesday, November 8, Claims Directors discussed plan procedures for auditing various types of provider claims, as well as had a discussion of software programs, vendors, and available benchmarks. There was significant discussion of how plans audit facilities claims. Most plans do a back-end claims audit, but several also have software that flags potentially questionable claims before checks are sent. Plans were also curious about best practices/benchmarks specific to Medicaid claims, but have been unable to find a meaningful resource to date.

Recap: Medicare Roundtable for Plans in the Planning Phase

On Friday, October 20th, Medicare Care Directors Pat Curran from CareOregon and Kathy Kravish from AlohaCare discussed Medicare and Medicaid integration issues, enrollment issues, and a number of other question posed by participants.

CHCS Quality Summit on Racial/Ethnic Disparities

CHCS announces a new Quality Summit on Improving Health Care for Racially and Ethnically Diverse Populations. For the agenda and registration information, please go to: http://www.chcs.org/publications3960/publications_show.htm?doc_id=387847&inactive=1



NEWSFLASH

ACAP Invited to Speak at IOM Meeting on Safety Net

In 2000 the IOM published a study entitled America's Safety Net Plans: Intact but Endangered, which looked at the challenges and the responses by Safety Net Health Plans to the competitive health care market. Meg Murray discussed how ACAP plans have supported the safety net through direct grants to CHCs and other clinics as well as providing administrative support for a public hospital's medical homes initiatives. Bob Hurley, a professor at VCU, discussed how Medicaid managed care continues to develop. There has been a resurgence of interest in the program by some multi-product firms (such as Wellpoint, Kaiser and United). He noted that contrary to the concerns when the IOM report was issued, that there are relatively few concerns today about the adverse impacts of Medicaid managed care on the safety net.

ACAP Speaks at Third National Medicare Congress Washington, DC

Elizabeth Ward from ACAP recently spoke at the National Medicare Congress held October 15-17th. This forum was designed to discuss critical business, legislative, and regulatory aspects of the Medicare program with a focus on future trends and their strategic implications for the health care system. Liz spoke on a panel entitled Dual Eligible Populations and Special Needs Plans (SNPs): Current and Future Strategies. She discussed ACAP's Medicare SNP plans and the opportunities and challenges our plans see to better integrate Medicare and Medicaid to serve this vulnerable population. The presentation is available at http://www.medicarecongress.com/agenda/day1.html.

Hudson Health Plan Recently Recognized by Westchester Hispanic Coalition at the Dia de Los Muertos Gala

The Westchester Hispanic Coalition saluted Hudson Health Plan as its corporate honoree at the Dia De Los Muertos Gala on Nov. 2, 2006 for their healthcare services to the Latino community of Westchester. The Westchester Hispanic Coalition is a private not-for-profit human services agency dedicated to the economic and social development of the Latino community.

The Coalition awarded the honor to Hudson Health Plan because of their commitment to enrolling everyone who is eligible for Medicaid Managed Care, Child Health Plus, and Family Health Plus programs, as well as demonstrating expertise in reaching out to the Latino community throughout its coverage area. "Honoring Hudson Health Plan is a way of recognizing its commitment to providing quality health care in a culturally appropriate manner and treating the Latino community with dignity and respect," says Graciela Heymann, Executive Director of the Westchester Hispanic Coalition. "I deeply respect Hudson Health Plan's efforts in advocating for universal health care," continued Ms. Heymann.

Georganne Chapin, President and CEO of Hudson Health Plan, expressed her delight in receiving this years corporate award. "I am thrilled to receive this award on behalf of Hudson Health Plan. Both the Westchester Hispanic Coalition and Hudson Health Plan encompass a strong belief that everybody should have health coverage and access to excellent health care. The Westchester Hispanic Coalition works with great dedication and advocates for resources that are sorely needed by many Latinos in this county."

Neighborhood Health Plan of Rhode Island Receives an Award for Their New Video Conference Medical Technology

Providence Business News and the Rhode Island Economic Development Corporation awarded the prestigious Innovation of the Year Award to Neighborhood Health Plan of Rhode Island for their Video Conference Medical Interpreting at the first annual 2006 Rhode Island Innovation Awards ceremony.

The Rhode Island Innovation Awards recognize the top seven organizations or individuals who bring innovative products, services, and processes to the market. Neighborhood was recognized for being the first health insurer in the country to use Video Conference technology to provide high quality medical interpreting for the non-English speaking population.

Mark Reynolds, CEO of Neighborhood, explains the program. "Video Conference Interpreting is a pilot program that helps Spanish-speaking patients confidentially communicate during office visits with their doctor in their language. Through the use of a secure video link established at Neighborhood, patients and their doctors can connect with a trained, qualified Spanish-speaking medical interpreter in real-time during the office visit. The patient and doctor located at the hospital are linked by camera and monitors to the medical interpreter located at Neighborhood. Through two-way video and audio communication, the patient can ask questions of the doctor -- and vice versa -- which are translated by the offsite interpreter. No one else can see or hear the visit and the session is not taped."

Video Conferencing was first initiated in March of 2006 and is currently used at Saint Joseph's Hospital for Specialty Care's Pediatric Department and Women & Infants Hospital Women's Primary Care Clinic. Neighborhood has received over 800 requests for this service.

Denver Health Medical Plan Joins ACAP

ACAP's newest member is the not-for-profit HMO, Denver Health Medical Plan, Inc. (DHMP) in Colorado. DMHP is part of Denver Health, Colorado's primary "safety net" institution which includes the health plan as well as a public hospital, the Denver Public Health Department, a 9-clinic network of Family Health Centers throughout Denver and a 12-clinic network of school-based health centers in Denver public schools. DHMP's CEO is Doug Clinksales.

The Denver Health Medical Plan offers members health care services at any facility within the Denver Health system, with low co-pays. Members have access to any of the nine Family Health Centers located throughout the City and County of Denver, as well as the Denver Health Medical Plan Clinic, and dedicated solely to plan members. The following programs are offered by the Denver Health Plan:
  • Denver Health Medicaid Choice -- The plan covers 32,990 Medicaid beneficiaries.
  • Child Health Plan Plus (CHP+) --Denver Health Medical Plan offers the Child Health Plan Plus, a low-cost health insurance program for children from birth through age 18. They cover about 4000 children.
  • Denver Health Medicare Choice -- As of January 1, 2006, Denver Health began offering a Medicare Advantage Special Needs Plan, with Part D Prescription drug coverage, called Denver Health Medicare Choice.
  • Health Plans for Denver Health, Denver Career Service Authority and Denver Employee Retirement Plan Employees - - Denver Health Medical Plan offers two low-cost health care plans for employees of Denver Health, the City and County of Denver Career Service Authority, and the Denver Employee Retirement Plan. These commercial products cover around 8500 people.
In 2001, DHMP earned a Commendable Accreditation by the National Committee on Quality Assurance (NCQA).

CareSource Foundation Awards First Grants

The CareSource Foundation, launched this past June, recently announced the first round of health care grant awards. The Foundation focuses funding on four key areas including issues of the uninsured, critical health trends, community health issues and broad collaboration with other organizations and funders. The CareSource Foundation was developed to provide strategic healthcare solutions for the underserved through grants, outreach, medical expertise, community partnerships and volunteerism. Awards totaling $125,000 were granted to the following organizations by the foundation:
  • AIDS Resource Center Ohio: $15,000 grant for the "Linkage to Care" program which provides HIV education, testing and treatment for over 300 at-risk women and children in 35 Ohio counties.
  • Dayton Children's Medical Center: $33,000 grant for a comprehensive asthma management program for children involving education, case management, breathing equipment, access to medication, and on-site evaluative services.
  • The Grandview/Cassano Health Center: $17,000 grant to develop and implement "Diabetes & Obesity Wellness Opportunities Program" for at-risk youth and families.
  • Reach Out Montgomery County: $10,000 grant to support free or reduced-fee medical services to the uninsured with special emphasis on access to primary care and prescription medication for children.
  • Unified Health Solutions: $5,000 grant for "Project Bridges" in-school health, academic and medical screening program.
  • Hospice of Dayton: $20,000 grant for the "Indigent Women's Care Fund" to support critical end-of-life education, services and programs for women throughout the Dayton region.
  • Samaritan Health Foundation: $25,000 grant to the Samaritan Homeless Clinic to identify and locate homeless individuals in need of primary care, substance abuse and mental health services. Grant will help treat chronic health conditions including hypertension, depression, diabetes, STDs, gum disease, substance dependence and asthma.
"Funding for critical health issues is so important -- especially now," said CareSource Foundation Board of Trustees member Tom Breitenbach, president and CEO of Premier Health Partners. "These grants address some of the most prevalent in our state including poverty, AIDS, children's health, and issues of the medically uninsured. The CareSource Foundation is proving to be a highly responsive community partner."

Colorado Access Helps Employees That They Dismissed

Bob Mook of Denver Business Journal recently reported on Colorado Access' efforts to help its employees find new jobs. Colorado Access had to eliminate 130 positions in July when it was forced to drop its Medicaid program. However Colorado Access took care of its employees by offering seminars, counseling and even a job fair to workers in order to keep morale up for the 120 remaining employees. Their actions preserved the nonprofit's reputation in local health care circles. Don Hall, former president and CEO of Colorado Access, commented, "I think we sent a signal for the people staying that if they should lose their job, this is how they're going to be treated." Additionally, Hall conveyed that the laid-off workers remained productive despite being informed of the cuts two months in advance.

When faced with the dilemma of layoffs, Colorado Access delivered the best severance pay it could. Hall states, "Being a nonprofit, we couldn't come up with a big package, but we could give them the tools they needed like lunch seminars, lessons in preparing a résumé, dressing for interviews and job-hunting skills."

In addition to the seminars and help sessions, Colorado Access' human resources department also organized an on-site job fair, which drew representatives from 24 companies that were mostly from the health-care sector. Hall commented, "Recruiters called the event the best job fair they've attended. Everyone in the room was qualified for work and they had all the records in front of them. My understanding is that everybody who wanted a job -- except management -- found a job."

Bruce Lesley Leaves Senator Bingaman's Office

Bruce Lesley has left Senator Jeff Bingman's (D-NM) office after six years of service. He will now take on a new challenge as President of FirstFocus. FirstFocus is a bipartisan children's advocacy group whose mission is to help make children and families a priority of federal policymakers.

NACHC Recruiting Students for Health Center Focused Medical School

NACHC and A.T. Still University have partnered in the design of a health center focused medical school. The new medical school was commended and approved in late September 2006 by accrediting and licensing bodies.

The New Medical School is a decentralized learning model with an enhanced health center training focus:
  • Year One: Students spend the first year at A.T. Still University's Mesa, Arizona campus
  • Years Two, Three, and Four: Students move to one of ten national community health center mini-campuses.
  • The 10 mini-campuses are staffed by both faculty from the medical school and the health center.
  • Through the mini-campuses, a comprehensive community-based team-learning experience for the student includes classroom work, primary care clinical experience, and affiliated specialty rotations.
INTERESTED INDIVIDUALS

If you have already identified a community-minded aspiring healer, please share the attached documents and links and forward Gary Cloud their name and contact information:

Questions and Answers Contact:

Gary Cloud - Hometown
A.T. Still University
5850 E. Still Circle
Mesa, Arizona 85206
480-219-6013
FAX 480-219-6110
gcloud@atsu.edu




ACAP VENDOR ALLIANCES

ACAP Members Can Now Save with CommonWealth Purchasing Group

The Association of Community Affiliated Plans is pleased to announce an important new business relationship with CommonWealth Purchasing Group, LLC. CommonWealth is a group purchasing program for community health centers and other community-based, not-for-profit health and human services organizations which offers members significant savings on an array of supplies, services, and products. In this time of limited funding and growing demand for services, saving money on supplies and other purchases is an excellent way to stretch precious dollars, and community health centers and other providers are increasingly turning to group purchasing as a powerful tool to improve financial performance. ACAP has endorsed the CommonWealth program and members can now access these savings opportunities directly.

Two ACAP members ⎯Neighborhood Health Plan in Boston and Neighborhood Health Plan-Rhode Island ⎯ are already participating in the CommonWealth program. Both of these plans report significant savings on office supplies, printing, computers and related equipment, and other products. The national ACAP office is a member of CommonWealth, and we are saving on our office supplies.

Savings through group purchasing programs are achieved through the power of collective buying. CommonWealth, which has more than 175 members in 22 states, combines the $25 million annual purchasing power of these members to negotiate deep discounts and superior levels of service. CommonWealth currently offers 20 contracts, including medical supplies, office supplies, printing services, pharmaceuticals, computer equipment and software, office copiers, and many others. Within each product line CommonWealth negotiates a contract with a single vendor, maximizing the leverage of shared purchasing to provide members with the best possible combination of price and service.

Discounted pricing is only one benefit of the CommonWealth program. Vendors will also analyze members purchasing to identify areas of additional savings, such as the use of lower-cost house brands or generic products. And vendors will work with members to standardize inventory and ordering; eliminating unnecessary inventory and making best use of guaranteed delivery frees up working capital and reduces storage and handling problems. In addition, most of their vendors provide free ground shipping and next day delivery.

These benefits are available to ACAP members at no cost or obligation. CommonWealth members are free to choose whichever contracts best meet their needs, and are under no obligation to use any minimum number of contracts or to meet any minimum purchase amounts. There is never any penalty or other barrier if a member decides to discontinue use of a contract. A business analysis ⎯at no cost and or obligation⎯ is available to ACAP members interested in more specific information about how the CommonWealth program would work for them.

CommonWealth Purchasing Group is based in Boston and is a subsidiary of the Massachusetts League of Community Health Centers, the Primary Care Association for Massachusetts. We urge you to examine what CommonWealth can do for you. For more information, contact Rick Bryant, CommonWealth's Director, at 617.426.2767, ext 250 or at rbryant@cwpurchasing.com.



Upcoming Events

November Events

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ACAP Strategic Planning Session

ACAP Strategic Planning Session
4/5 




10 
11/12 
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16 
Final Medicaid Commission Meeting, Arlington, VA

CMO Roundtable
17 
Final Medicaid Commission Meeting, Arlington, VA
18/19 
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Thanksgiving
24 
25/26 
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30 
Pharmacy Roundtable
 
 

December Events

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2/3 


Policy Roundtable

Customer Service Roundtable


Provider Relations Roundtable

9/10 
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Quality Management/Disease Management Directors Roundtable
15 
16/17 
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23/24 
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30/31 


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
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