On August 22, 2012 CMS Announced 500 primary care practices that will participate in the Comprehensive Primary Care (CPC) demonstration project in a new partnership between payers and primary care providers. Backed by the ACA, the goal of this multi-payer initiative is to deliver better coordinated, higher quality, patient-centered care, and to reduce costs.
The CPC’s goal was to enroll about 75 primary care practices in several regions spanning eight states: Arkansas, Colorado, New Jersey, New York, Ohio & Kentucky, Oklahoma, Oregon. Practices were chosen in a competitive process based on several criteria.
- Use of health information technology
- Ability to demonstrate recognition of advanced primary care delivery by accreditation bodies
- Service to patients covered by participating payers
- Participation in practice transformation and improvement activities
- Diversity of geography, practice size and ownership structure.
The chosen practices are to begin delivering health care services under the program in the fall of 2012, and are projected to serve over 300,000 people with Medicare. For more details and a complete list of participating primary care practices visit the CMS Innovation web site and read the CMS press release.
Sources:
http://www.innovations.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/index.html
http://www.innovations.cms.gov/Files/fact-sheet/Comprehensive-Primary-Care-Initiative-Fact-Sheet.pdf
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New BenefitView Dashboard Lets Employers Track Retirees’ Medicare Enrollment Progress
August 22, 2012
The newly available Extend Health BenefitView™ dashboard lets employers ensure no retiree is left behind during the enrollment process. BenefitView gives employers access to something they’ve never had before on a Medicare exchange: real-time, interactive reporting on the experience of their retirees as they transition from the employer’s group coverage to their own individual Medicare plans on an exchange.
In “Retiree Medicare exchange previews improved transparency,” Employee Benefit News sheds light on how valuable this degree of insight is to HR professionals leading their companies and employees through a health care benefit transition this significant.
BenefitView is the culmination of eight years of our insight into delivering a premium health insurance exchange experience for consumers and employers on the Extend Health private Medicare exchange.
BenefitView answers burning HR questions
BenefitView offers employers immediate answers to questions around goals and milestones when transitioning from a group plan to the individual Medicare market:
- Have retirees responded to our communications?
- Are their calls to benefit advisors getting through in good time?
- Are they making and completing their appointments with benefit advisors?
- How long are those calls taking on average?
- Are they choosing plans and which ones?
- Are there groups that we may need to do additional outreach to?
BenefitView gives employers up-to-the-minute, unfiltered answers to these questions with the click of the mouse.
BenefitView users and creators tell us what they think
We talked to representatives from a few of the employers who have used BenefitView for mid-year transitions. Here’s what they had to say.
“Before our transition started, we wanted to make sure our retirees first understood that they were going to get more choice and control over their Medicare health benefits. Then we wanted to provide retirees with all the right information they needed to participate,” said Melissa (Missy) Hartfiel, benefits planner, Global Compensation and Benefits for International Paper. “With BenefitView, we can instantly see all the data on our progress – the number of retirees contacted, the number of calls and enrollments completed, how quickly our retirees were being answered, and the length of those calls. This inspired a lot of confidence in the Extend Health solution. As a non-techy, I also appreciated that BenefitView is visual and easy to use – there was no learning curve and I got all the data I wanted with one click.”
“The data HR professionals see in BenefitView is the same data that Extend Health sees in-house,” said David Lash, senior director of product management for Extend Health. “This actually makes our weekly progress meetings with employers much more strategic. We don’t have to spend time communicating numbers or determining where we are in the process. We’ve been looking at the same numbers all along and we are able to focus our energy on optimizing the course for each phase of the transition. It’s much more efficient for everyone. More than the technology involved, our goal for this tool was to create this premium experience for employers.”
“Employers sponsor and subsidize these transitions of their retirees to individual plans to assure that every retiree gets a chance to have the supplemental Medicare coverage they want while managing company costs and future liabilities,” said Brian Bohlig, chief marketing officer for Extend Health. “It’s very important to employers, to us and most importantly to retirees that these transitions go as smoothly as possible. Extend Health has always provided employers frequent and comprehensive progress reporting to ensure smooth transitions – but now we’ve made it real time and on demand. BenefitView makes communication between Extend Health and employers seamless, and protects employers from finding out after the fact that their retirees missed out on getting the health care coverage they needed or wanted.”
Another Extend Health client, Oak Ridge National Laboratories, also experienced the difference BenefitView could make in the process of selecting individual Medicare plans. “With BenefitView, I was able to give our HR Director up-to-the minute progress reports whenever she asked for them,” said benefits manager Scott McIntyre. “As we neared the end of our enrollment period, we were checking BenefitView daily and adjusting our communications and outreach to make sure we were giving all of our retirees every chance to participate. BenefitView allowed us to keep our finger on the pulse of what was happening with our retiree transition whenever we wanted.”
BenefitView specifications
Real-time information available to employers through BenefitView includes:
- Number of retirees enrolled versus the total number eligible in time remaining
- Percent of eligible retirees contacted
- Number of appointments scheduled
- Number of appointments met
- Plan types selected across different populations
- Average premiums across different populations
- Number of unique plans selected
- Number of unique carriers selected
- Total number of calls
- Average wait times for before reaching a benefit advisor
- Average time to handle calls
Get a BenefitView demo
Contact Extend Health online or by phone 1.888.232.1653 for a demonstration of BenefitView. Check out BenefitView online yourself.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
Helpful KFF FAQ on the $716 billion in Medicare “cuts.”
August 21, 2012
Kaiser Health News recently published a helpful FAQ on “Decoding the $716 Billion in Medicare Reductions.” This FAQ addresses some of the questions being raised in the Medicare debate, including where the $716 billion figure came from, where reductions in Medicare spending are expected, and more. It’s a good read and we invite your comments.
http://www.kaiserhealthnews.org/Stories/2012/August/17/faq-716-billion-medicare-reductions.aspx
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
GAO Report on Medicaid Expansion
August 10, 2012
The GAO recently released the new report title Medicaid Expansion: States’ Implementation of the Patient Protections and Affordable Care Act. The report contains results of research conducted to see what states are doing to implement Medicaid expansion, learn what their responsibilities are, and identify what challenges they face. It addresses the following issues relating to implementing Medicaid expansion:
- State responsibilities
- Actions taken to prepare
- States’ views on the financial implications of expansion
The GAO conducted a web-based survey and interviewed Medicaid officials in six states: Colorado, Georgia, Iowa, Minnesota, New York, and Virginia. They selected these states based on:
- Size of expected enrollment
- Enrollment rates
- Geographic dispersion
- Insurance coverage provided to childless adults
The ACA requires Medicaid eligibility to be expanded to non-elderly people with incomes at or below 133% or the federal poverty level (FPL). It also specifies that each state must change how it determines Medicaid eligibility, as well as streamline eligibility and enrollment systems that will coordinate enrollment across Medicaid, Children’s Health Insurance Program (CHIP) and the state health insurance exchanges.
The bill allows states to opt out of the expansion, but stipulates that they will lose their existing federal Medicaid funds if they do so. When the Supreme Court ruled on the constitutionality of the health care law in June of 2012, it modified the provision on Medicaid expansion by allowing states to opt out without losing their existing federal Medicaid funding. This change prompted the Congressional Budget Office (CBO) to update its budget estimates, reflecting projections that fewer people will be covered by Medicaid and CHIP, while more people will be enrolled through state health insurance exchanges and uninsured than in its previous estimate. The GAO completed its field work on this study prior to the Supreme Court’s ruling, so the impact of that decision was not included in their analysis. However, the requirements for states that choose to participate in the Medicaid expansion have not changed as a result of the Supreme Court decision and the report is still a useful snapshot of how these states are getting on with preparations for it.
Requirements for states that participate in Medicaid expansion
By January 1, 2014 states must:
- Expand eligibility to non-elderly people with incomes at or below 133% of FPL
- Streamline their enrollment process
- Transition to Modified Adjusted Gross Income (MAGI) to determine income eligibility
- Identify those who are newly eligible to obtain federal matching funds
- Simplify and streamline the eligibility determination process
Table 1: ACA provisions included in the GAO study.
|
ACA Provision |
Description |
| Medicaid eligibility | Expand eligibility to non-elderly people with incomes at or below 133% of FPL. |
| Modified adjusted gross income (MAGI) | Transition to using MAGI to determine income eligibility. |
| Early expansion option | States can expand coverage to newly eligible people prior to January 1, 2014. |
| Maintenance of effort | States must maintain eligibility standards until an exchange is fully operational. |
| Federal matching | Federal matching funds will be provided to states for newly eligible adults. |
| Streamlined eligibility and enrollment systems | “States must provide a process for individuals to apply for or renew their Medicaid eligibility through a website that enrolls individuals in the appropriate program (Medicaid, CHIP, or exchanges) no matter to which program they originally apply.” |
The GAO found that the states studied are taking steps to prepare for Medicaid expansion, but they face some challenges including the need for additional federal regulations and guidance. CMS has issued a final Medicaid rule and indicated that more guidance will be forthcoming. In addition, the majority of state budget directors interviewed believe the following factors will contribute to the cost of expanding Medicaid.
- Administration required to manage Medicaid enrollment
- Acquisition or modification of information technology systems to support Medicaid
- Enrolling people who were previously eligible, but have not so far enrolled in Medicaid
They also expressed uncertainty about:
- The impact of shifting exiting Medicaid enrollees into health benefit exchanges
- Fiscal capacity and the state’s share of Medicaid expenditures
- Guidance needed to develop budget estimates
- Additional regulations and/or guidance needed on
- How to apply MAGI
- Conversion of Medicaid eligibility standards
- Access to eligibility data through the Federal Data Services Hub
After reviewing and commenting on the study, HHS agreed to provide states with additional regulations and/or guidance on MAGI conversion and FMAP computation. HHS also reiterated that the decision to participate in Medicaid expansion is up to the state – there is no deadline date for their decision – and federal matching funds are available to help states cover information technology costs for modernizing eligibility systems, which don’t have to be paid back if the state decides not to expand Medicaid.
Previous blog post: CBO update estimates $84 billion savings from SCOTUS decision
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Tweet Chat on Health Care Costs
August 10, 2012
Extend Health held a tweet chat today on health care costs. There were some great questions and excellent answers from John Barkett, Dir. of Policy Affairs at ExtendHealth fielded questions. John worked in congress on health care and his wealth of knowledge was evident in the answers he provided.
If you missed our tweet chat you can read a complete recap of the event. Hope to see you at the next one!
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Way to go Garland Senior Fair!
August 8, 2012
Extend Health exhibited at the Garland Senior Fair in Texas this past Sat, Aug 4. There was a great turnout of over 350 people from the community and surrounding areas including seniors, their families, community leaders and service providers like us, who care about seniors and senior issues.
State Representative Angie Chen Button thanked Dwight and Ivory in person for exhibiting at the fair, fulfilling an invitation that she extended to Bryce Williams, Towers Watson Managing Director of Extend Health, at the ribbon-cutting of the first Extend Health service center in Richardson this past May.
Richardson Mayor Bob Townsend encouraged everyone to make good use of the resources available. And many other community leaders, including City of Rowlett Senior Advisory Board members Pamela Bell and Wayne Baxter, met with attendees and the community groups and companies exhibiting.
Dwight Turner and Ivory Rooks, both senior benefit advisors for Extend Health, who have years of experience helping seniors choose the best Medicare plans for them, served as Extend Health ambassadors. They answered people’s questions about Medicare and shared resources with them, explaining the role Extend Health can play in helping to connect people with the best coverage for their needs.
According to Dwight, “We put the care into shopping for Medicare!“
Ivory added, “It was great to be able to connect in person with people and extend a helping hand.”
Extend Health contributed a Texas-themed gift basket, which was raffled off to a lucky winner. The day was welcome chance to connect in person with many in a community that is very important to Extend Health.
We recently announced that Extend Health is bringing over 500 jobs to the community with the opening of its second service center in the Richardson Telecom Corridor.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
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