Consumer Health Assistance Programs: Resources for States and Advocates who are Establishing Programs
A consumer health assistance program provides valuable services to people who have questions about health insurance (such as Medicaid or private insurance) or who are having trouble getting access to health care. The resources below are particularly helpful when thinking about establishing a program in your state. You can also talk to your state legislator and other local policymakers about the need for such a program and let them know that this web site provides several publications on key elements in structuring a program. Contact Families USA for further information.
General Consumer Health Assistance Programs
Designing a Consumer Health Assistance Program (Families USA, June 2001)
Consumer Health Assistance Programs: A Model Act for Legislators and Advocates (Health Assistance Partnership, April 2005)
Assistance for Health Care Consumers: Key Provisions of State Laws (a companion piece to the model law, Health Assistance Partnership, April 2005)
Consumer Health Assistance Programs: Report on a National Survey (Families USA, June 2001)
Consumer Health Assistance Programs: Bridging Gaps in the Health Care System (Health Assistance Partnership, June 2005)
From Concept to Operation: A Guide to Developing Assistance Programs for Health Care Consumers (Center for Health Care Rights, January 2003)
Collecting and Using Data: How Consumer Health Assistance Programs Report on Their Work (Health Assistance Partnership, July 2005)
Medicaid Consumer Assistance Programs
Many Medicaid health assistance programs were originally established to assist consumers in navigating managed care, although some have since responded to needs of the fee-for-service Medicaid population as well. They assist consumers in establishing or maintaining Medicaid eligibility and in resolving problems with access to care. They counsel individual consumers; educate consumers and providers; and collect data about consumer concerns problems that can be helpful to policymakers, Medicaid agencies, and health plans. Program roles can range from coaching and educating consumers to investigating complaints and mediating solutions to actually representing consumers in grievances and fair hearings. In addition to general Medicaid health assistance programs, some states have established specialized programs to assist mental health consumers or other people with special health care needs.
Click the titles below to see more information about programs serving Medicaid beneficiaries.
Do You Need Help Meeting Quality Assurance Standards? A Health Assistance Program Can Be Part of Your Strategy (Health Assistance Partnership, 2002)
Table Describing Medicaid Consumer Health Assistance Programs (Health Assistance Partnership, November 2003)
Profiles of Medicaid Consumer Health Assistance Programs (Health Assistance Partnership, 2002)
Health Assistance Programs Roles in Grievances, Appeals and Hearings for Medicaid and SCHIP Beneficiaries (Health Assistance Partnership, 2002)
