ACA

Promising Practice: Arizona Center for Rural Health SHAREs Health Insurance Information, Gets People Enrolled

i Oct 31st No Comments by

by Beth Blevins

People in Arizona communities are becoming more aware of their health insurance options through Project SHARE (Students Helping Arizona Register Everyone).

Project SHARE, run by the Arizona Center for Rural Health (AzCRH), trains University of Arizona health sciences students as Certified Application Counselors (CACs) that provide information on enrollment through the Affordable Care Act (ACA) marketplace. Alyssa Padilla, who supervises the SHARE program for the Arizona State Office of Rural Health (AzSORH) under the AzCRH, said that the program helps not just the patients but also the students, who become more rural and health insurance literate.

Second-year UA College of Medicine – Phoenix student and SHARE leader, Jaymus Ryan Lee

“SHARE gives the students a better understanding of social support services and how to connect individuals with those services,” Padilla said. Through SHARE, the students earn volunteer credits that allow them to graduate with distinction. But, more importantly, Padilla said, graduates of the program “are better equipped to answer patients’ questions about coverage on the spot.” To become a SHARE participant, students take five to 10 hours of online federal training in addition to in-person session training, Padilla said.

When surveyed afterwards, participants have said the program has given them a better understanding of the ACA, health insurance premiums and deductibles, and the value of expanding Medicaid in Arizona, Padilla said.

Lauren Dominick said she has already benefited from the program. Dominick, an MD candidate and Project SHARE leader for the UA-College of Medicine–Phoenix, joined last year hoping to develop the skills that will help her better serve current and future patients. “I have gained so much knowledge of how the marketplace works and how to navigate it,” Dominick said. “I’ve helped patients complete their ACA applications and seen the empowerment they experience as they take better control of their health care. The program opens up their opportunities to seek preventative health care rather than just when they have an acute, major issue.”

Unfortunately, Dominick said, as a medical student she has seen many patients with very advanced diseases who were unable to access care earlier. “This is heartbreaking, especially when their condition could have been prevented or effectively managed if they had had access to health care.” Dominick added, “Helping sign people up for insurance makes me feel like I am making a difference and hopefully having a positive impact on their health even before I see them in the clinic or the hospital.”

Kendra Marr, SHARE leader, presents on the SHARE project

Kendra Marr, an MD/PhD student at the UA College of Medicine-Tucson and Tucson SHARE leader, said that another benefit she has found with SHARE is the “wealth of opportunities for collaboration with other clubs and services within the College of Medicine,” including the Commitment to Underserved People (CUP) health clinics. Marr has been working with the free, student-run CUP clinics to form a partnership so that SHARE can refer patients to them and vice versa, and has been holding her SHARE enrollment office hours at the clinics.

Project SHARE has benefited the university as well. “The University of Arizona is a White House Healthy Campus because of Project SHARE and UA Campus Health’s efforts to improve access to health insurance coverage,” Padilla said.

Right now, Project SHARE offers in-person, outreach, education, and one-on-one enrollment services in Pima County and in-person outreach services in Maricopa County, Padilla said. The CACs also can volunteer to staff the Cover Arizona phone number, where they answer insurance questions and schedule appointments for patients across the state.

Typically, 15 to 25 students work for SHARE each year, Padilla said. So far, 90 students from the UA Colleges of Medicine, Nursing, Public Health, and Pharmacy have gone through the SHARE program since its inception in 2015.

In her role with the AzSORH, Padilla oversees the licensing, recruitment, training, and mentoring of the SHARE participants. Most of the funding for the program comes from SORH grants, Padilla said, with small additional amounts of funding from UA College of Medicine CUP, which pays for things like food for the students during their trainings.

Padilla said she hopes other SORHs will consider replicating Project SHARE. The AzSORH has created templates on the processes involved and how-to directions, which Padilla will provide to any interested SORHs. Meanwhile, Padilla said that AzCRH is planning to extend the reach of SHARE to remote areas of her state through partnerships with Critical Access Hospitals and rural faith-based communities.

Since the ACA has been in effect, Padilla said, the uninsured rate in Arizona has been cut in half (to 10 to 11 percent), similar to the national average. “It’s important to note that we have a conservative Republican governor, and we have expanded Medicaid,” she said. “Our hospitals are no longer in the red because we have patients that are now insured due to Medicaid expansion and the ACA.”

“Medicaid expansion has really helped our bottom line,” Padilla concluded. “State Offices of Rural Health support that effort and that message ‑ it can do wonders for our rural and underserved communities.”

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Does your SORH have a “Promising Practice”? We’re interested in the innovative, effective and valuable work that SORHs are doing. Contact Ashley Muninger to set up a short email or phone interview in which you can tell your story.


Back to November Branch

NOSORH to Host Four-Part Webinar Series on State Medicaid Coverage Initiatives Impacting Rural Communities

i May 1st No Comments by

NOSORH’s Policy and Program Monitoring Team (PPMT) is excited to announce an upcoming virtual conference titled State Coverage Initiatives Affecting Rural Communities. This four-part series will examine current and proposed state initiatives affecting Medicaid coverage, with a focus on the impact to rural communities. The four-day series will take place May 14-17, 2018 at 3:00 pm ET daily. SORH and their partners are encouraged to attend, as well as inviting anyone who has an interest in rural health policy.

The first two sessions will feature Harvey Licht of Varela Consulting discussing the landscape of state initiatives, including ACA marketplaces and Medicaid waivers. Session three will focus on ACA Marketplaces at the state level with presentations from leadership in both Alaska and New Mexico’s departments of insurance. Session four will focus on Medicaid waivers, highlighted by policy experts from Indiana and Kentucky. Sessions three and four will focus on state-specific examples of these initiatives in a listening session format, allowing attendees to ask questions during the webinar.

For more information on the terrific line-up of presenters, and to register, see the individual session flyers below:

State Coverage Initiatives Affecting Rural Communities: Part 1 and 2

State Coverage Initiatives Affecting Rural Communities: ACA Marketplaces

State Coverage Initiatives Affecting Rural Communities: Medicaid Waivers


Back to May Branch

Improving Rural Health Network Adequacy

i Mar 2nd No Comments by

NOSORH offered an informative webinar on Improving Rural Health Network Adequacy in February.  In case you missed it, all the materials and recording have been posted to NOSORH’s website.  The Patient Protection and Affordable Care Act (PPACA) has changed the regulatory environment for health network adequacy. New regulations and guidance are being issued at the both Federal and State levels. The webinar explored opportunities for State Offices of Rural Health to participate in the new efforts and approaches to assuring that health networks, including Qualified Health Plans (QHPs) and Accountable Care Organizations (ACOs), have adequate providers and facilities.

As the PPACA continues to rollout, we see that special arrangements are needed to meet inadequate numbers of providers or facilities in rural shortage areas to ensure appropriate access to enrollees. SORHs are knowledgeable about services in these communities and are well placed to participate in efforts to assure appropriate rural health care.

There are several new initiatives designed to improve the regulation of health network adequacy nationwide.  There will be new opportunities at the State and Federal level for SORHs to address this issue with State Medicaid programs, State Insurance Commissioners and Health Exchanges.

Listen to the first webinar on the requirements for Network Adequacy and how SORHs can get involved and help implement strategies that makes the most sense for rural areas.  As this process unfolds, NOSORH will provide more learning opportunities to review the changes in the coming year.

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Back to March Branch

Webinar: Improving Rural Health Network Adequacy (2-24-15)

i Feb 25th No Comments by

Improving Rural Health Network Adequacy Presentation

MDL-74 NAIC Model Network Adequacy Act

Viewable Recording

The Emerging Role of Rural Care Coordination in the Post-ACA Environment – A Knudson

i Jan 20th No Comments by

The Emerging Role of Rural Care Coordination in the Post-ACA Environment – A Knudson

NRHD Webinar: ACA and You (11.20.14)

i Nov 20th No Comments by

ACA and You Webinar Presentation

Viewable Recording

Promising Practices: South Carolina Reaches Out to Uninsured Residents Through the Healthy Outcomes Plan (HOP)

i Nov 6th No Comments by

In an effort to provide consistent medical care to thousands of underserved residents, South Carolina’s “Medicaid System” has implemented a statewide program designed to coordinate care and provide a medical home for some of its most at-risk residents.

Now in its second year, the Healthy Outcomes Plan (HOP) asked every hospital in the state to identify a predetermined number of low-income, uninsured residents who visited the emergency department at least five times in the last year, and who suffered from a chronic condition such as diabetes, cardiovascular disease, hypertension, sickle cell or HIV/AIDS.  The size of the hospital determined the number of residents they were required to identify, with 50 being the minimum for the state’s smallest hospitals.  All of South Carolina’s hospitals are participating in the program.  The state’s three largest metropolitan hospitals had to identify at least 750 residents.  “Activity always follows the dollar,” said Graham Adams, Ph.D, CEO of the South Carolina Office of Rural Health (SCORH).  “The hospitals were incentivized to get on board or they would lose the Disproportionate Share Hospital (DSH) money they were already receiving.  Plus, the state gave additional money to every hospital involved in the program.  Our 19 rural hospitals received 100% of their DSH money.”

Dr. Adams went on to say that HOP is particularly important in the rural areas, where residents are less likely to have a medical home and often wait until they are very ill before visiting an emergency department for care.  SCORH provided technical assistance to rural hospitals in the development of the program.  “Rural providers have a close relationship with their patients and as a result were more successful in identifying and bringing new patients into the program.”  The goal for the first year of HOP was to enroll 8,500 residents.

Now in its second year, Dr. Adams said the program has been beneficial because it provides a medical home and a system of care for people who really need it.  “It gives incentives for medical providers to work together for these folks well-being.  Controlling the chronic illnesses of our residents is one of the biggest benefits so far,” he said.  “Overall, it’s been a very positive thing.”

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Back to November Branch

Affordable Care Act Update (Dan Derksen)

i Aug 26th No Comments by

Affordable Care Act Update (Dan Derksen)

Webinar: ACA Show and Tell (July 31, 2014)

i Jul 31st No Comments by

ACA Show and Tell – SORH Sharing – Presentation

Viewable Recording

FACT SHEET: Affordable Care Act by the Numbers

i Apr 30th No Comments by

THE WHITE HOUSE

Office of the Press Secretary

FOR IMMEDIATE RELEASE

April 17, 2014

FACT SHEET: Affordable Care Act by the Numbers

The Affordable Care Act is working.  It is giving millions of middle class Americans the health care security they deserve, it is slowing the growth of health care costs and it has brought transparency and competition to the Health Insurance Marketplace.

HEALTH CARE BY THE NUMBERS

  • 8 million people signed up for private insurance in the Health Insurance Marketplace. For states that have Federally-Facilitated Marketplaces, 35 percent of those who signed up are under 35 years old and 28 percent are between 18 and 34 years old, virtually the same youth percentage that signed up in Massachusetts in their first year of health reform.
  • 3 million young adults gained coverage thanks to the Affordable Care Act by being able to stay on their parents plan.
  • 3 million more people were enrolled in Medicaid and CHIP as of February, compared to before the Marketplaces opened. Medicaid and CHIP enrollment continues year-round.
  • 5 million people are enrolled in plans that meet ACA standards outside the Marketplace, according to a CBO estimate. When insurers set premiums for next year, they are required to look at everyone who enrolled in plans that meet ACA standards, both on and off the Marketplace.
  • 5.7 million people will be uninsured in 2016 because 24 States have not expanded Medicaid.

HEALTH CARE COST GROWTH IS LOWEST IN DECADES

 health care cost growth

  • Health care costs are growing at the slowest level on record: Since the law passed, real per capita health care spending is estimated to have grown at the lowest rate on record for any three-year period and less than one-third the long-term historical average stretching back to 1960. This slower growth in spending is reflected in Medicare, Medicaid, and private insurance.
  • CBO projects the deficit will shrink more and premiums will be lower than expected: CBO previously estimated that the ACA will reduce the deficit by $1.7 trillion over two decades, and, just this week, CBO concluded that lower-than-expected Marketplace premiums and other recent developments will cut $104 billion from our deficit over the next ten years. The CBO report also projects that lower-than-expected premiums will help to save $5 billion this year, and that lower premiums will persist in the years ahead, remaining 15 percent below projections by 2016 (the only year in which CBO provides a precise estimate).
  • Medicare spending growth is down: Medicare per capita spending is growing at historically low rates.  This week, for the fifth straight year, the CBO reduced its projections for Medicare spending over the next 10 years – this time by $106 billion.  CBO projects that Medicare and Medicaid costs in 2020 will be $180 billion below its 2010 estimates.  Recent economic research suggests that the ACA’s reforms to Medicare may have “spillover effects” that reduce costs and improve quality across the health care system, not just in Medicare.

 estimate numbers on aca

 THE SECURITY OF HEALTH INSURANCE FOR MILLIONS OF MIDDLE CLASS FAMILIES

  • Up to 129 million Americans with pre-existing conditions – including up to 17 million children – no longer have to worry about being denied health coverage or charged higher premiums because of their health status.
  • 71 million Americans with private insurance have gained coverage for at least one free preventive health care service such as mammograms, birth control, or immunizations in 2011 and 2012.
  • In 2013, 37 million people with Medicare received at least one preventive service at no out of pocket cost.
  • Approximately 60 million Americans have gained expanded mental health and substance use disorder benefits and/or federal parity protections.
  • Since the health care law was enacted, almost 8 million seniors have saved nearly $10 billion on prescription drugs as the health care law closes Medicare’s “donut hole.”
  • 105 million Americans no longer have to worry about having their health benefits cut off after they reach a lifetime limit.

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