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Webinar: Talking Medicaid

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Listen to a recording of Talking Medicaid, the May 4 webinar sponsored by the Alliance. The slide presentation is also available for downloading.


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Webinar: Talking Medicaid

  1. 1. Talking Medicaid: First Steps in Building Effective Homelessness-Health Care Partnerships May 4, 2011
  2. 2. Health Care Reform in Context <ul><li>The Affordable Care Act (ACA) – 2010 </li></ul><ul><ul><li>Significant Medicaid reforms </li></ul></ul><ul><ul><li>Expanded access to health care for low-income and vulnerable populations </li></ul></ul><ul><li>Changes in Medicaid </li></ul><ul><ul><li>Complicated </li></ul></ul><ul><ul><li>Promise and potential </li></ul></ul><ul><li>Strategy for ending homelessness </li></ul>
  3. 3. Agenda for Today’s Webinar <ul><li>Topics to Cover </li></ul><ul><li>Introduction to Medicaid </li></ul><ul><li>Health Care Reform and Implications for Ending Chronic Homelessness </li></ul><ul><li>Getting Involved in Implementation </li></ul><ul><li>Next Steps </li></ul>
  4. 4. Medicaid Essentials <ul><li>Medicaid populations – Children and parents, pregnant women, elderly, people with disabilities, adults as states permit </li></ul><ul><li>Subject to financial qualifications </li></ul><ul><li>State-federal partnership </li></ul><ul><li>Federal matching funds </li></ul><ul><li>State flexibility </li></ul><ul><li>Health care services and long-term supports </li></ul><ul><li>More info about Medicaid, including state-specific data: The Kaiser Family Foundation, www.kff.org/medicaid </li></ul>
  5. 5. Medicaid Essentials <ul><li>Medicaid Today </li></ul><ul><li>62 million enrollees </li></ul><ul><ul><li>Around 50% are children </li></ul></ul><ul><ul><li>25% elderly and disabled (14-15 million) </li></ul></ul><ul><li>$338 billion federal and state expenditures </li></ul><ul><ul><li>$17 billion to hospitals for otherwise uncompensated care </li></ul></ul><ul><ul><ul><li>To compare, combined budget for SAMHSA and HRSA is around $11 billion </li></ul></ul></ul><ul><li>Medicaid is always a work in progress, always changing. </li></ul><ul><li>For states, Medicaid a major budget item but also a considerable part of their economies. </li></ul>MACPAC. “Report to the Congress on Medicaid and CHIP.” March 2011. http://www.macpac.gov/reports Kaiser Family Foundation- State health facts. “Distribution of Medicaid Spending by Servce, FY 2009.” Accessed on May 2, 2011. http:// www.statehealthfacts.org/comparetable.jsp?typ =2&ind=178&cat=4&sub=47
  6. 6. Medicaid Essentials <ul><li>Medicaid Managed Care </li></ul><ul><li>70% of Medicaid enrollees, around 36 million nationally ,are in managed care </li></ul><ul><li>75% of all child CHIP enrollees are in comprehensive managed care plans </li></ul><ul><li>Some states enroll all Medicaid participants in managed care while other states do not contract with plans at all. </li></ul>MACPAC. “Report to the Congress on Medicaid and CHIP.” March 2011. http://www.macpac.gov/reports CMS. “Medicaid Managed Care Enrollment as of June 30, 2009.” June 2009. https://www.cms.gov/MedicaidDataSourcesGenInfo/downloads /09June30f.pdf
  7. 7. Medicaid Populations MACPAC. “Report to the Congress on Medicaid and CHIP.” March 2011. http://www.macpac.gov/reports For more information about Chronic Homelessness policy solutions, find our policy brief at http://www.endhomelessness.org/content/general/detail/2685
  8. 8. Chronically Homeless Adults <ul><li>110,000 chronically homeless adults in 2010 </li></ul><ul><li>Frequent system users: hospitals, jails, mental health, prison </li></ul><ul><li>Serious mental illness, substance use, poor physical health, co-occurring conditions </li></ul><ul><li>Permanent supportive housing is effective </li></ul><ul><ul><li>Housing stability </li></ul></ul><ul><ul><li>Health services utilization </li></ul></ul>
  9. 9. How Medicaid Helps <ul><li>Medical </li></ul><ul><li>Screening, prevention </li></ul><ul><li>Mental health and rehabilitation </li></ul><ul><li>Long-term services & supports </li></ul>
  10. 10. Talking the Affordable Care Act <ul><li>1. Essential Health Benefits – Coming in 2014 </li></ul><ul><li>Medicaid for new group: adult citizens up to 133% of federal poverty level </li></ul><ul><li>Basic coverage subject to federal and state definitions, under development </li></ul><ul><li>Mental health coverage is required </li></ul><ul><li>Additional Medicaid coverage subject to implementation </li></ul>
  11. 11. Talking the Affordable Care Act <ul><li>2. Delivery System Changes </li></ul><ul><li>More options for states to provide home and community-based services </li></ul><ul><li>Quality improvements in primary care delivery – health homes, care coordination </li></ul><ul><li>Opportunities for future state Medicaid reforms to incorporate best practices for PSH in benefits and program designs. </li></ul>
  12. 12. Talking the Affordable Care Act <ul><li>Federal Incentives </li></ul><ul><li>Basic health care benefits for newly-eligible enrollees </li></ul><ul><ul><li>Very significant federal commitment – enhanced match rate </li></ul></ul><ul><li>Needs-based home and community-based services for all enrollees </li></ul><ul><ul><li>Significantly more dependent on state priorities – usual match </li></ul></ul>
  13. 13. Implications for Housing Solutions <ul><li>Medicaid Changes – New Tools to End Homelessness </li></ul><ul><li>Potential to boost supportive housing as strategy to end homelessness, especially for individuals with multiple co-occurring conditions </li></ul><ul><li>It is up to homelessness advocates to drive these policy changes and shape effective systems </li></ul><ul><li>Together we can end homelessness </li></ul>
  14. 14. <ul><li>Action Steps </li></ul><ul><li>Assign a health care “lead” in your organization or network </li></ul><ul><li>Tell your story, share your vision – concrete, visible, and compelling </li></ul><ul><li>Know your audience </li></ul>An Initial Agenda for Engagement
  15. 15. An Initial Agenda for Engagement <ul><li>Action Steps, cont’d </li></ul><ul><li>Know your audience: </li></ul><ul><ul><li>Mainstream housing (for-profit developers, PHAs) </li></ul></ul><ul><ul><li>Healthcare partners (local reform coalitions, nonprofit hospitals, clinics) </li></ul></ul><ul><ul><li>Public agencies (health, housing, social services) </li></ul></ul><ul><ul><li>Safety net advocates and providers </li></ul></ul><ul><ul><li>Local and state legislators </li></ul></ul><ul><li>Add your voice to support Medicaid funding </li></ul>
  16. 16. An Initial Agenda for Engagement <ul><li>Talking Points </li></ul><ul><li>Medicaid helps end homelessness by providing access to primary care and coordinating key services </li></ul><ul><li>PSH + Medicaid can be cost-effective for communities </li></ul><ul><li>Housing and health pieces can fit together to improve lives and make a stronger safety net </li></ul>
  17. 17. Conclusion <ul><li>Summary </li></ul><ul><li>Additional resources www.endhomelessness.org </li></ul><ul><li>Slides and other materials will be available </li></ul><ul><li>www.endhomelessness.org/section/issues/mental_physical_health/medicaid </li></ul><ul><li>Questions? </li></ul><ul><li>Contact us – lstand@naeh.org </li></ul>
  18. 18. Bonus Points – Medicaid & Budgets Kaiser Family Foundation – Commission on Medicaid and the Uninsured. “Top 5 Things To Know About Medicaid.” February 25, 2011. http://www.kff.org/medicaid/8162.cfm

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