The document summarizes findings from a 2012 survey of enrollees in Minnesota's high risk health insurance pool, the Minnesota Comprehensive Health Association (MCHA), regarding their potential transition to other coverage options under the Affordable Care Act in 2014. Key findings include that the majority of MCHA enrollees will likely not qualify for financial assistance to purchase coverage, many are unfamiliar with the ACA's changes and worried about costs increasing, and mail is the preferred method of receiving information about coverage options. Outreach efforts will need to address concerns over affordability and promote new protections to encourage enrollment in appropriate plans.
The 10th Annual Utah Health Services Research Conference: Clinical and Economic Impact of a Pharmacist-Led Diabetes Collaborative Drug Therapy Management Program in a Medicaid ACO Setting. By: Eman Biltaji; C McAdam Marx; M. Yoo; B. Jennings; J. Leiser - University of Utah College of Pharmacy
Health Services Research Conference: March 16, 2015
Patient Centered Research Methods Core, University of Utah, CCTS
Privacy and Security: Challenges and Opportunities in Healthcare IdentityPaul Brian Contino
Paul Brian Contino
Corporate Chief Technology Officer
New York City Health & Hospitals Corporation
HIMSS14 Annual Conference & Exhibition, Orlando Florida
CLOSING KEYNOTE: Best Practices - Panel Of end Users
February 23, 2014 3:00-4:15pm
Patient Access Network Foundation - PV ReporterDavid Wallace
The Patient Access Network Foundation (PAN) offers help and hope to people with chronic or life-threatening illnesses for whom cost limits access to breakthrough medical treatments. Myeloproliferative Neoplasms (MPNs) are a covered illness.
The 10th Annual Utah Health Services Research Conference: Clinical and Economic Impact of a Pharmacist-Led Diabetes Collaborative Drug Therapy Management Program in a Medicaid ACO Setting. By: Eman Biltaji; C McAdam Marx; M. Yoo; B. Jennings; J. Leiser - University of Utah College of Pharmacy
Health Services Research Conference: March 16, 2015
Patient Centered Research Methods Core, University of Utah, CCTS
Privacy and Security: Challenges and Opportunities in Healthcare IdentityPaul Brian Contino
Paul Brian Contino
Corporate Chief Technology Officer
New York City Health & Hospitals Corporation
HIMSS14 Annual Conference & Exhibition, Orlando Florida
CLOSING KEYNOTE: Best Practices - Panel Of end Users
February 23, 2014 3:00-4:15pm
Patient Access Network Foundation - PV ReporterDavid Wallace
The Patient Access Network Foundation (PAN) offers help and hope to people with chronic or life-threatening illnesses for whom cost limits access to breakthrough medical treatments. Myeloproliferative Neoplasms (MPNs) are a covered illness.
The Canadian Cancer Survivor Network (CCSN) conducted a survey in April 2013 the discover the impact that being involved in volunteer advocacy and/or the development of public policy has on cancer patients, survivors, caregivers and family members. 51 people completed the survey. Findings were that patient advocacy generally has a positive impact on the self-image of those doing it, that many volunteer advocates felt better, prouder, more useful, more hopeful, more effective and more powerful. Still others felt less angry, less anxious, and less sad. But some survey respondents did feel sadder, angrier, less hopeful and less content. CCSN recommends that organizations ensure that cancer patients involved in advocacy activities receive skills to help them and support to deal with the often slow-moving and sometimes frustrating healthcare, cancer care and government systems in Canada.
Aetna Presentation Social Determinants of Latino HealthDanny Santibanez
Social Determinants of Hispanic/Latino Health
Daniel Santibanez, MPH, RD, University of North Florida
September 23, 2005 - UNF Hispanic Health Issues Seminars
This is part 8 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of the Duval County Health Department.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
On the Substance-Related Treatment Gap in Medicare-Only CoverageElspeth Slayter
This presentation details a policy analysis related to the gap in health insurance coverage for adults with Medicare-only coverage who have substance-related disorders in need of treatment. Adults with Medicare-only coverage are rarely addressed as compared to elders or people who are dually-eligible for Medicaid and Medicare. And further, people don't like to think about substance-related disorders…I propose a state-specific plan to address coverage for such conditions for a potentially needy population in a way that promotes long-term cost-savings.
The Evolution of Consumer Driven Health PlansPaladina Health
The Evolution of Consumer Driven Health Plans White Paper will prepare you for the following regarding the shift to true healthcare consumerism:
- What types of employer-sponsored health plans exist and what employers should consider
- The impact of consumer driven health plans (CDHPs) and high deductible health plans (HDHPs) in controlling healthcare costs
- What models challenge the fee-for-service delivery system and why employers need to explore them
Blazing New Trails: Shifting the Focus on Alcohol and Drugsnashp
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Authors: Barbara Cimaglio, Sally Fogerty, BSN, M.Ed., John C. Higgins-Biddle, Ph.D.
In this presentation, Alan Birch discussed the role of an Oncology Drug Access Navigator as well as how the role fits into the healthcare team and what they help patients with. He gave a brief overview and history of the role as well as discussing challenges faced by patients and how National Pharmacare may impact it all.
The webinar was followed by an interactive question & answer session.
About the presenter:
Alan Birch is an Oncology Drug Access Navigator at North York General Hospital. He is a member of ODANO, the oncology drug access navigators of Ontario and has been in the role for the last 5 years. Alan is a registered pharmacy technician by background and is also a member of the Ontario College of Pharmacists and Ontario Pharmacist's Association.
David Prior: driving improvements in the quality of care across the systemThe King's Fund
David Prior, Chair, Care Quality Commission, explains how clinicians, providers, commissioners and service users all have a role in regulation. He highlights the new responsibilities of the CQC and how they can help to support integrated care in England.
The Canadian Cancer Survivor Network (CCSN) conducted a survey in April 2013 the discover the impact that being involved in volunteer advocacy and/or the development of public policy has on cancer patients, survivors, caregivers and family members. 51 people completed the survey. Findings were that patient advocacy generally has a positive impact on the self-image of those doing it, that many volunteer advocates felt better, prouder, more useful, more hopeful, more effective and more powerful. Still others felt less angry, less anxious, and less sad. But some survey respondents did feel sadder, angrier, less hopeful and less content. CCSN recommends that organizations ensure that cancer patients involved in advocacy activities receive skills to help them and support to deal with the often slow-moving and sometimes frustrating healthcare, cancer care and government systems in Canada.
Aetna Presentation Social Determinants of Latino HealthDanny Santibanez
Social Determinants of Hispanic/Latino Health
Daniel Santibanez, MPH, RD, University of North Florida
September 23, 2005 - UNF Hispanic Health Issues Seminars
This is part 8 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of the Duval County Health Department.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
On the Substance-Related Treatment Gap in Medicare-Only CoverageElspeth Slayter
This presentation details a policy analysis related to the gap in health insurance coverage for adults with Medicare-only coverage who have substance-related disorders in need of treatment. Adults with Medicare-only coverage are rarely addressed as compared to elders or people who are dually-eligible for Medicaid and Medicare. And further, people don't like to think about substance-related disorders…I propose a state-specific plan to address coverage for such conditions for a potentially needy population in a way that promotes long-term cost-savings.
The Evolution of Consumer Driven Health PlansPaladina Health
The Evolution of Consumer Driven Health Plans White Paper will prepare you for the following regarding the shift to true healthcare consumerism:
- What types of employer-sponsored health plans exist and what employers should consider
- The impact of consumer driven health plans (CDHPs) and high deductible health plans (HDHPs) in controlling healthcare costs
- What models challenge the fee-for-service delivery system and why employers need to explore them
Blazing New Trails: Shifting the Focus on Alcohol and Drugsnashp
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Authors: Barbara Cimaglio, Sally Fogerty, BSN, M.Ed., John C. Higgins-Biddle, Ph.D.
In this presentation, Alan Birch discussed the role of an Oncology Drug Access Navigator as well as how the role fits into the healthcare team and what they help patients with. He gave a brief overview and history of the role as well as discussing challenges faced by patients and how National Pharmacare may impact it all.
The webinar was followed by an interactive question & answer session.
About the presenter:
Alan Birch is an Oncology Drug Access Navigator at North York General Hospital. He is a member of ODANO, the oncology drug access navigators of Ontario and has been in the role for the last 5 years. Alan is a registered pharmacy technician by background and is also a member of the Ontario College of Pharmacists and Ontario Pharmacist's Association.
David Prior: driving improvements in the quality of care across the systemThe King's Fund
David Prior, Chair, Care Quality Commission, explains how clinicians, providers, commissioners and service users all have a role in regulation. He highlights the new responsibilities of the CQC and how they can help to support integrated care in England.
Explore how the Affordable Care Act and creation of state level and national exchanges has impacted member risk profiles and demand for small-group and individual health plans.
The healthcare transformation from fee for service to fee for outcomes just got an adrenaline shot in the arm April 27th when the Department of Health and Human Services surprised many in the market by announcing a Quality Payment Program, a proposed set of new rules to take effect in 2019 based on key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
mHealth Israel_US Health Insurance Overview- An Insider's PerspectiveLevi Shapiro
Presentation about the US Health Insurance Sector by Lori Rund, VP, Product Management and Market Intelligence at Health Alliance Plan, a managed care organization owned by the Henry Ford Health System, with 650,000 lives. Lori is responsible for the identification, concept building, researching and business case developments for new products, services and markets. She develops and leads comprehensive market intelligence functions to help the organization better understand industry trends and identify business opportunities.
Prior to joining Health Alliance Plan, Lori was Director of Product Development and Market Intelligence at Health Alliance Medical Plans in Illinois and Director of Market Research and Strategy at Carle Clinic Association, also in Illinois.
Reducing Health Disparities: The Journey of Brightpoint HealthBrightpoint Health
Brightpoint Health's CEO and President, Paul Vitale and Chief Clinical Officer, Dr. Barbara Zeller, share Brightpoint's journey, strategies and best practices to reduce health disparities in New York City's high-need neighborhoods.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This presentation shows providers how to verify a patient's Medicaid eligibility before providing services to them as part of the Managed Medical Assistance program.
The pending Healthy Ohio 1115 Medicaid waiver would require nearly all non-disabled adults on Ohio Medicaid to pay premiums. If approved by the federal government, the waiver would result in a greater number of uninsured Ohioans as well as increased Medicaid administrative costs and complexity.
Speakers include:
* Tara Britton, Public Policy Fellow, The Center for Community Solutions
* Nita Carter, Project Director, UHCAN Ohio
Similar to Risky Business: The Transition of High Risk Pool Enrollees to Other Coverage in 2014 (20)
Exploring Disparities Using New and Updated MEasures on SHADAC's State Health...soder145
Slides from webinar webinar introducing two new measures of health outcomes and social determinants of health on SHADAC’s State Health Compare—Unhealthy Days and Unaffordable Rents. This presentation, hosted by SHADAC researchers Brett Fried and Robert Hest, examine these new measures and highlight how the estimates can be used to explore disparities between states and among sub-populations.
Leveraging 1332 State Innovation Waivers to Stabilize Individual Health Insur...soder145
Presentation by SHADAC Senior Research Fellow Emily Zylla at the 2018 Association for Public Policy Analysis & Management (APPAM) Fall Research Meeting in Washington, DC.
Modeling State-based Reinsurance: One Option for Stabilization of the Individ...soder145
Presentation by SHADAC Director Lynn Blewett at the 2018 Association for Public Policy Analysis and Management (APPAM) Fall Research Conference in Washington, DC.
2017 Health Insurance Coverage Estimates: SHADAC Webinar Featuring U.S. Censu...soder145
Join us for an overview of the 2017 health insurance coverage estimates from two key, large-scale federal data sources: The American Community Survey (ACS) and the Current Population Survey (CPS).
This webinar will examine the new estimates with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers.
Attendees will learn about:
The new 2017 national and state coverage estimates
When to use which estimates from which survey
How to access the estimates via Census reports and American FactFinder
How to access state-level estimates from the ACS using SHADAC tables
SHADAC researchers and Census experts will answer questions from attendees after the presentation.
Exploring the New State-Level Opioid Data On SHADAC's State Health Comparesoder145
Between 2000 and 2016, the annual number of drug overdose deaths in the United States more than tripled, from 17,500 to 63,500, and most of these deaths involved opioids. Despite widespread increases in overdose death rates from natural and semi-synthetic opioids, synthetic opioids, and heroin, individual states’ death rates varied widely. For example, in 2016, Nebraska’s rate of 1.2 deaths per 100,000 people was the lowest in the U.S. for natural and semi-synthetic opioids, while West Virginia’s rate (the highest) was more than 15 times larger, at 18.5 deaths. These deaths are the most glaring indication of the growing crisis of opioid abuse and addiction that has been spreading unevenly throughout the country over the past two decades.
On this SHADAC webinar, Research Fellow Colin Planalp will examine the United States opioid epidemic at the state level, analyzing trends in overdose deaths from heroin and other opioids, such as prescription painkillers. Using data available through SHADAC’s State Health Compare, he will look at which states have the highest rates of opioid-related deaths and which have experienced the largest increases in death rates.
Mr. Planalp will be joined by SHADAC Research Fellow Robert Hest, who will discuss the data on opioid-related overdose deaths from the U.S. Centers from Disease Control and Prevention (CDC) that are available on SHADAC’s State Health Compare. He will also discuss State Health Compare data from the U.S. Drug Enforcement Administration (DEA) on sales of common prescription opioid painkillers. Mr. Hest will show users how to access and use the data for state-level analyses.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Risky Business: The Transition of High Risk Pool Enrollees to Other Coverage in 2014
1. Funded by a grant from the RobertWood Johnson Foundation
Risky Business – The Transition of High Risk Pool
Enrollees to Other Coverage in 2014
Findings from the 2012 Minnesota Comprehensive Health
Association (MCHA) Enrollee Survey
Elizabeth Lukanen, MPH
SHADAC, University of Minnesota
State Health Research and Policy Interest Group Meeting
AcademyHealth
Baltimore, Maryland
June 22, 2013
2. Acknowledgements
• SHADAC
– Lynn Blewett, SHADAC Director and Professor
– Kathleen Call, Professor
– Heather Dahlen, PhD Student and Research Assistant
– Karen Turner, Senior Program Analyst
• MCHA
– Peggy Zimmerman-Belbeck , Director of Operations
– Kirby Erickson, Executive Director
• Medica
– Kris Messner, Strategic Account Manager
– Anton Dmytrenko, Strategic Account Executive
• Support for this work was provided by a grant from the Robert Wood
Johnson Foundation’s State Health Reform Assistance Network
2
3. Presentation Overview
• High risk pools and the Affordable Care Act
(ACA)
• 2012 MCHA Enrollee Survey
• Survey Results
• Implications for Outreach
3
4. State High Risk Pools
• Established to provide coverage to the
“uninsurable”
• Financed through assessments on fully-insured
health plans, state general fund revenue, and
enrollee premiums
• Stabilize risk in the individual market by spreading
costs associated with individuals with high-cost
health care needs
• Coverage is similar to underwritten plans offered
in individual market and they do have similar
rating practices
• Premiums are capped between 125% and 250%
• As of 2011, there were 35 states with high risk
pools, covering approximately 227,000, with over
$2.5 billion in paid claims
4
5. The Affordable Care Act (ACA) and
Individuals with Preexisting Conditions
• Prohibits pre-existing condition exclusions
• Introduces premium rate restrictions in individual
and small group markets
• Prohibits lifetime or annual limits
• 100% coverage for preventive care
• Provides new subsidized coverage options
– Medicaid (income ≤ 138% FPL)
– Premium and cost sharing subsidies
through the exchange (income 139 to 400% FPL)
• Temporary national HRP (enrollment of 107,000
in January 2012)
5
6. Transition of High Risk Pool Enrollees
• Three programs to encourage gradual
transition, spread risk and minimize
adverse selection in exchange
– Temporary reinsurance and risk
adjustment from 2014 to 2016 and
permanent risk corridors
• Guidance in December, 2012
stipulated that high risk pools were
not eligible for reinsurance money
• Incentive for states to transition high
risk pool enrollees quickly
6
7. Minnesota Comprehensive Health
Association
• Five Eligibility Avenues:
– Loss of group coverage
– Medicare ineligibility
– Health-related rejection
– Presumptive condition(s)
– Health Coverage Tax Credit (HCTC) program
• Among the longest-running and largest state high risk
pools in the country
– Currently, 26,000 enrollees
• Premiums capped at 125% of individual market
• Lifetime maximum benefit of $5,000,000
• Administered by Medica Health Plan
7
8. 2012 MCHA Survey: Objectives
• Provide information to MCHA to help transition
enrollees into new ACA coverage options
– Assess potential eligibility for Medicaid and exchange
– Gauge enrollee familiarity with ACA changes
– Collect information to inform outreach and
communication strategies
• Gain knowledge of how MCHA enrollees might
impact risk pools
– Collect information on health status, pent-up
demand
8
9. Methodology
• Mail survey of 5,200 MCHA enrollees
– Policy holders enrolled for 12 months
– Excluded children and those with Ryan White and HCTC
eligibility
• $2 incentive payment with survey mailing
• Oversampling of low-income enrollees (used receipt of
low income subsidy as proxy) and those in rural areas
• Survey response rate was 50.2%
• Weighting adjustments were
conducted
• Income imputed for 6% of cases
9
10. Enrollee General Demographics
• Mean age is 52 years
• Slightly more females than males (53%)
• Almost 60% live in an urban area
• A quarter have less than a high school education
• 70% are employed or self-employed
• Majority report incomes above 400% FPG
• Most enrollees (82%) have total family assets
that exceed $20,000
10
11. Enrollee Health Characteristics
11
• MCHA enrollees report
good health, only 15%
report fair or poor
health
• 92% of enrollees report
having at least one
chronic condition
• The most common
chronic conditions:
• high blood pressure
• weight condition
• high cholesterol
• allergies
• arthritis/osteoporosis
8%
18%
21%
18%
35%
Number of Chronic Conditions
0
1
2
3
4 or more
12. Enrollee Experience with MCHA
• More than two-thirds have been in MCHA
for more than 4 years
• Almost a quarter have been in MCHA for
10 years or more
• Rural enrollees are more likely to have
been on the program for 10 years or more
(26% vs. 20%)
• More than one third of enrollees have high
deductible plans ($5,000 and $10,000)
• 81% report being somewhat/very
satisfied with their MCHA insurance
coverage
12
13. Features of MCHA Coverage that are
Important to Enrollees
13
73%
66%
62%
38%
17%16%
13%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Rated "Extremely Important"
Rx coverage
Ability to see a
specific provider
Cost of premium
Ability to go to the
Mayo Clinic
Low income
subsidy program
HSA option
Coverage for a
specific service
1. Routine/annual exams
2. Preventive services
and screenings
3. Chiropractic services
4. Mental
health/Chemical
dependency
5. Chronic conditions
14. Primary Reasons Enrollees Would Leave MCHA
14
27%
23%20%
10%
10%
10%
Can no longer afford premium
New job with Insurance offer
Nothing would make me leave
My health improves and I can get in
private market
Turning 65
Other
Of the enrollees that responded, “nothing would make me leave”:
• 29% are unaware of other health insurance options
• 19% report that other companies will not cover me/my family due to
preexisting conditions
• 14% report that MCHA is the only coverage that offers Mayo clinic
• 13% report other plans will not cover me/my family
15. MCHA Enrollees Potential Eligibility for
New Coverage Options in 2014
• The majority of enrollees will likely get no federal
financial support for their health insurance coverage
15
Income as % FPG % MCHA Enrollees
Eligibility for Financial
Support
Less than or equal to138%
FPG
9% Medicaid
139-400% FPG 37%
Premium and cost-sharing
subsidies through the
exchange
Above 400% FPG 55% None
16. Enrollee Familiarity with Health Reform
39%
59%
24%
24%
31%
15%
5% 1%1% 1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
General familiarity with
health reform
Familiarity with potential
coverage changes
No answer
Very familiar
Somewhat familiar
Somewhat unfamiliar
Very unfamiliar
16
17. Enrollees Worries About Changes Under
Health Care Reform
17
Self Report of Worried/Very Worried % Enrollees
Having to pay more for premiums 92%
Having to pay more for deductibles and coinsurance 91%
Not being able to afford the health care services you think you need 86%
Not being able to afford the prescription drugs you need 79%
The quality of health care services you receive getting worse
74%
Having to change doctors 73%
Not being able to get the health care services you need for reasons
other than money
73%
Having to change health plans 69%
18. Willingness to Enroll in a Public Program
18
49%51%
If you learned you were eligible for a public program
at no cost, would you enroll?
Yes
No
19. Possible Outreach Methods
19
72%
16%
4%
3% 2% 2% 1%
How would you most like to receive information
about coverage changes?
Mail
Website
One-on-One meetings
Phone number to call with
questions
Don't want to receive
information
Group meetings
20. Implications for Marketing and Outreach
• The “selling” of the new coverage
options needs to start now in a variety
of formats
• Messaging should include:
– No exclusion based on pre-existing
conditions
– First dollar coverage for preventive
services
– No lifetime limits
– Financial support (for those that qualify)
– Information about finding insurance that
covers preferred doctors and Rx
20
21. Implications for Outreach
• Messaging and outreach may need to differ by:
– Rural vs. urban
– Eligibility type (Medicaid vs. exchange)
• Outreach will need to address expectations about the
cost of new coverage options (very difficult!)
• Messaging needs to combat the negative image of
“public programs”
• Ideally, assistance should be specialized for this
population (e.g., special training for in person assisters)
21
22. Sign up to receive our newsletter and updates at
www.shadac.org
@shadac
Contact Information
Elizabeth Lukanen
Senior Research Fellow
elukanen@umn.edu
612.626.1537