| The latest news from and for state health care advocates |
February 2011 |
|
|
|
In each edition, we'll feature an action, victory, campaign, or interesting tactic shared by a state advocate. Send us your updates. |
|
|
In This Issue:
Buzz around the States
HHS awarded seven early innovator exchange grants to Kansas, Maryland, New York, Oklahoma, Oregon, Wisconsin, and a multi-state consortium in New England led by the University of Massachusetts Medical School. Read more here.
In Missouri, supporters of the Affordable Care Act outnumbered opponents at a hearing on “Obamacare.”
Illinois’s Campaign for Better Health Care gears up for a month full of action as they prepare for March, Health Care Justice Month.
In Vermont, Governor Shumlin introduced health care legislation that goes beyond a robust exchange.
[Return to top]
States in Focus
|
If your state Medicaid office holds public meetings, encourage coalition partners and beneficiaries to attend and share their comments and concerns. Like in Oklahoma, it may be a great opportunity to make suggestions and share information on what other states are doing to upgrade technology systems. You may also want to make sure that your state is aware of federal funds that are available to upgrade systems, including CHIPRA outreach grants and the 90/10 enhanced federal match.
|
Oklahoma Paves the Way for Real-Time Online Enrollment in the Exchange
Two weeks ago, 20 inches of snow left Oklahomans stranded and stuck in their homes. During that time, 780 Oklahomans enrolled in the state’s Medicaid and CHIP programs. Mike Fogarty, chief executive officer of the Oklahoma Health Care Authority, credits the achievement to Oklahoma’s new real-time online enrollment system. Mike observed, “Under the old legacy system, it would have been unheard of to see that level activity when nearly all state agencies and outreach offices were closed.”
Since its launch in September 2010, SoonerEnroll has helped expand access and retention and ease the workload of county-level outreach workers. With this new system, Oklahomans don’t have to miss a day of work, and they have the freedom to enroll from the comfort of their home. During the first four months of the new system, 39 percent of enrollees joined online, 14 percent enrolled through the state-run helpline, and 41 percent enrolled at a local outreach office.
 |
For more information on how “SoonerEnroll” works, check out this informational video.
In Oklahoma, enrollment challenges were raised initially by consumer advocates during public meetings regarding Medicaid. The state addressed these concerns by upgrading the enrollment system over three years. During this period, the Oklahoma Health Care Authority engaged outreach workers, numerous state agencies, and consumer advocates to achieve buy-in from various stakeholders. It has been six months since the launch of SoonerEnroll, and beneficiaries as well as advocates are impressed with the process. Local outreach workers, who were previously skeptical, are also particularly pleased because they have more time to do direct outreach in the community and enroll the people most in need at local offices.
For states considering making similar upgrades to prepare for coordination of public programs and the exchange in 2014, Mike Fogarty advises: “Do it now. And when you do, make sure all stakeholders are involved from the beginning and use federal dollars to help supplement the cost.”
|
By providing support to legislators who have little to no staff, Iowa advocates became an integral part of the legislative process. The process also sparked a relationship with the advocacy community and the Insurance Commissioner, who had been opposed to the legislation. Now, advocates meet monthly with the Insurance Commissioner to discuss rate review and other needed consumer protections.
|
Public Hearings Give Iowans a Big Win
Last year, Iowa State Representative Janet Petersen approached advocates to discuss what she could do about constituent complaints regarding health insurance rate increases. Carrie Fitzgerald, senior policy associate with the Child and Family Policy Center, and other Iowa advocates recommended that Petersen pursue rate review legislation. The legislation would create a transparent process requiring a series of public hearings before any rate increase could be approved.
Representative Petersen proposed an amendment to the Insurance Commissioner’s annual spending bill to create the new rate review rules. In small states like Iowa, legislators don’t have staff, so the advocates’ support in moving the process forward behind the scenes was essential. Advocates garnered support among Democratic and Republican legislators with a simple message: This bill is about transparency and accountability. They made the case that the legislation would give the members something they could do to help their constituents. Insurers still would be allowed to raise rates, but they would have to go through a more transparent and public process.
That message worked and despite insurance company opposition, the bill passed unanimously and was signed into law in spring 2010. Later that year, the first test of the new law came about. Wellmark, Iowa’s largest insurer and the bill’s most outspoken opponent, wanted to raise rates an astounding 18 percent. Two public hearings were scheduled, and Iowans from all over the state came to testify. People with heart-wrenching stories of high co-pays and unaffordable coverage moved those in attendance, including Commissioner Voss, who presided over the hearings. In addition to testifying, Carrie organized people to call their legislators and share their stories. Finally, Commissioner Voss approved an 8.5 percent hike, much lower than the initial increase. The Commissioner stated that the stories shared at the public hearings influenced her decision. Since the rate review law has been in place, it has prevented at least two more insurers from raising rates last year.
[Return to top]
|
Amid efforts to trim state budgets, state-based advocates have opportunities to improve access to quality health care and cut excess costs within the health care system. These solutions are sometimes challenging to come by, but evidence-based prescribing provides a new option that could save money.
|
Maine Promotes a Safer, More Affordable Option to Address State Budget Crisis
Many states are still facing major budget crises. It’s a struggle to find cuts that save money, but don’t hurt the consumer. Thankfully, there are opportunities in evidence-based prescribing to both save money and provide quality, affordable care to consumers. Ann Woloson, executive director of Prescription Policy Choices, actively promotes a more cost-effective health care system through encouraging evidence-based prescribing and purchasing of prescription drugs. Ann advocates for evidence-based strategies that include academic detailing (prescriber education) through Consumer Reports Health Best Buy Drugs™ and the Drug Effectiveness Review Project, which provide prescribers, consumers, and health plans with unbiased information on the effectiveness, safety, and affordability of prescription drugs.
Evidence-based prescribing shows promise in improving health care while also containing rising prescription drug costs. This could be especially important to government programs, such as Medicare and Medicaid, which are taking on an increasingly larger share of these costs. Ann points to a recent Lewin Group study, Potential Federal and State-by-State Savings if Medicaid Pharmacy Programs Were Optimally Managed, which estimates that the United States could save $30 billion if states managed pharmacy benefits through managed care strategies, including increased use of recommended prescription drugs. States may also find evidence-based prescriptions to be an asset when they set up their state exchanges, which will include prescription drugs as an essential health benefit.
There are resources available to help stakeholders understand and benefit from evidence-based prescribing. Several states engage in prescriber education, which involves having trusted messengers, including health care providers who have studied the research, provide concise scientific information about the effectiveness and safety of prescription drugs to prescribers. The National Resource for Academic Detailing helps states develop credible prescriber education programs that promote the use of evidence-based medicine. Consumer Reports Health Best Buy Drugs™ (CRHBBDrugs™) provides consumers with easy to understand information on certain classes of prescription drugs to help consumers make good choices about the medication they need. Finally, the Drug Effectiveness Review Program (DERP) works strategically with states to provide information about the effectiveness of drugs and therapies used in treating specific illnesses.
Beat of the Month
John Legend knows, Everybody Knows, nobody has it easy--especially during the legislative session.
[Return to top]
March 23 marks the one-year anniversary of the Affordable Care Act. Take advantage of this special date to bring attention to the many provisions of the law that took affect in the past year and brought real benefits to American families. To find out how you can get involved in national and state efforts around this anniversary, contact us at stateinfo@familiesusa.org.
|
|
New Resources from Families USA and Stand Up for Health Care
[Return to top]
