Connecting Kids to Coverage Outreach and Enrollment Grants

By Cindy Mann, Deputy Administrator and Director, Center for Medicaid and CHIP Services

Today, I’m thrilled that we are awarding nearly $32 million to support Connecting Kids to Coverage Outreach and Enrollment Grants.

Our ongoing partnerships with states and communities to connect eligible children to health coverage have taught us valuable lessons about how to conduct effective outreach – outreach that not only raises awareness of health coverage opportunities, but also gets eligible people enrolled.  We are applying these lessons to our work going forward so that Americans can get the health coverage they need.

These successes have also prepared the Centers for Medicaid & Medicaid Services for the historic expansion of coverage set to begin this fall, made possible by the Affordable Care Act.  Working closely with our colleagues in the states and at the federal level, these outreach and enrollment strategies will help us enroll millions of Americans in the Health Insurance Marketplaces and state Medicaid and Children’s Health Insurance Programs.

Today’s grants will build on this progress. Some of our outstanding grantees include:

  • The California Coverage & Health Initiatives will mobilize, coordinate and provide training and will work closely with the Spanish language community to increase health insurance enrollment for kids.
  • The Pima Community Access Program – As a past grantee, this group responded when Arizona reopened enrollment in its KidsCare program by setting up a call center and helped enroll 26,000 children whose families had been waiting to get coverage. This new grant will support their efforts to train over 600 organizations in four counties to help families with the new enrollment process.

Since 2008 children’s health coverage rates have improved dramatically, with millions gaining coverage mainly through Medicaid and CHIP — despite the economic downturn.

For the past four years we have worked tirelessly to reduce the number of insured children in our country. And thanks to these community groups that we partner with, we can see real results.

To view blogs by The California Coverage & Health Initiatives, and The Pima Community Access Program, please visit:

http://blog.cms.gov/

A new opportunity to connect kids to coverage in California

Suzie Shupe, Executive Director, California Coverage & Health Initiatives,

CCII 1

Edgar Aguilar, Program Manager, Children’s Health Initiative of Kern County

CCII 2

California is the most populous state in the union and home to more than 13 percent of the nation’s uninsured children. Since coverage is essential for making sure children reach their full potential, California Coverage & Health Initiatives (CCHI) is honored to receive a $750,900 Connecting Kids to Coverage Outreach and Enrollment Grant that will help us bring more low-income, eligible California children into health coverage.

CCHI has been working for over a decade to ensure children and families have the security of coverage and access to quality care. Our member organizations reach Californians in over 90% of California counties, helping to promote a robust culture of coverage and expand coverage to all children and families in our state. This video highlights who we are and why we are committed to this work.

This new funding will help us focus more of our energy and efforts on counties in California’s Central Valley and Inland Empire regions, where high concentrations of uninsured Latino children and their families live, work and play. CCHI, together with our local member organizations, will work closely with leading Spanish-language media outlets, trusted sources of news and information for Latino communities, to publicize community education and enrollment events. Helping these families learn about their coverage options and how to enroll is crucial to the success of health care reform. We know we can see more children grow up healthy and succeed in life as a result of the opportunities in the Affordable Care Act.

CCHI will also mobilize, coordinate and provide training and “on-the-ground” technical assistance to application assistors in targeted regions with the goal of enrolling tens of thousands of children into Medi-Cal. Collectively we have already covered more than 165,000 previously uninsured children through locally-funded programs and we connect another 125,000 children each year to the Medi-Cal and Healthy Families programs. Our statewide network has firsthand experience enrolling children into public coverage programs and we know that coverage for all children in California is a worthy and achievable goal.

We look forward to leveraging this new opportunity to get Californians the coverage they need, and to new opportunities just over the horizon to connect kids to coverage as a result of the Affordable Care Act. This work promises to move our state toward a brighter and more productive future, and CCHI is proud to be a part of it.

En español

Una nueva oportunidad para vincular a los niños a una cobertura en California
Suzie Shupe, Directora Ejecutiva, Iniciativas de Cobertura y Salud en California
Edgar Aguilar, Gerente de Programas, La Iniciativa de Salud para Niños del Condado de Kern

California es el estado más poblado de la unión y el hogar de más del 13 por ciento de los niños sin seguro médico en la nación. Dado que la cobertura médica es esencial para asegurar que los niños alcancen su máximo potencial, Iniciativas de Cobertura y Salud en California (CCHI por sus siglas en inglés) tiene el honor de haber recibido un subsidio de $750,900 del programa “Conectando niños a una cobertura”.  Estos fondos nos ayudarán a inscribir a más niños de bajos recursos que califican a la cobertura médica en California.

CCHI ha trabajado durante más de una década para que los niños y las familias tengan la seguridad de una cobertura médica y acceso a una atención de salud de calidad. Nuestras organizaciones miembros alcanzan a los californianos en más del 90% de los condados de California, ayudando a promover una cultura sólida de los beneficios de la cobertura médica y expandir la cobertura a todos los niños y familias de nuestro estado.

Estos fondos nos ayudarán a concentrar más de nuestra energía y esfuerzos en los condados de Central Valley de California y las regiones de Inland Empire, donde viven y trabajan muchos niños y familias latinas que no tienen seguro médico. CCHI, junto con nuestras organizaciones miembros locales, trabajarán en estrecha colaboración con los medios de comunicación en español, fuentes confiables de noticias e información para las comunidades latinas, para dar a conocer y anunciar los eventos educativos y de inscripción locales. Ayudar a estas familias a conocer sus opciones de cobertura y cómo inscribirse es crucial para el éxito de la reforma de la salud. Sabemos que podremos ver a más niños crecer sanos y tener éxito en la vida como resultado de las oportunidades en la Ley del Cuidado de Salud a Bajo Precio.

CCHI también va a activar, coordinar y proporcionar capacitación y asistencia técnica personal a las personas entrenadas para ayudar a la gente con sus solicitudes en las regiones especificadas con el objetivo de inscribir a muchos más niños en Medi-Cal. Colectivamente hemos asegurado cobertura para más de 165,000 niños que previamente no tenían seguro médico a través de programas financiados localmente y también vinculamos a otros 125,000 niños cada año a los programas Healthy Families y Medi-Cal. Nuestra red estatal  tiene experiencia de primera mano en inscribir a niños a los programas de cobertura pública y sabemos que la cobertura para todos los niños de California es un objetivo valioso y posible.

Esperamos aprovechar esta nueva oportunidad para que más californianos obtengan la cobertura que necesitan, y para las nuevas oportunidades en el horizonte que vinculan a los niños a la cobertura gracias a la Ley del Cuidado de Salud a Bajo Precio. Este trabajo promete mover nuestro estado hacia un futuro más brillante y más productivo, y CCHI se enorgullece de ser parte de los esfuerzos.

Pima Community Access Program is excited to partner with CMS for the Connecting Kids to Coverage Outreach and Enrollment Grant

Michal Goforth, Executive Director, Pima Community Access Program

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Pima Community Access Program is honored to receive this Connecting Kids to Coverage Outreach and Enrollment Grant.  With nearly $1 million from the grant, made possible by the Affordable Care Act, we will continue our longstanding efforts to ensure that children and families in our communities have access to the health care they need.

We know from experience that application assistance delivered by trusted members of the community is essential.  Working with the Arizona Medicaid agency, we operated a special hotline to help enroll children into Arizona’s Children’s Health Insurance Program (CHIP). Through that collaboration, we were able to access key data systems so we could answer questions, troubleshoot and expedite difficult cases.

As a result, in only 6 months, we were able to help enroll 26,000 children who had been waiting for coverage – and the state’s program will now be enrolling an additional 33,000 children.

This kind of help means the world to families in our community. Our staff recently took a call from a mother whose child had a serious unexpected illness. That child was in need of hospital treatment but was not enrolled in CHIP health coverage, even though the she was eligible.  Because of our direct connections, we were able to help her enroll immediately. Not a second was wasted. 

By preparing community organizations for the significant changes that will be taking place with the application and enrollment process, we are building on these vital lessons.

Under the grant, our organization and our 16 partners will provide in-person and web-based training for trainers who will, work with an array of 600 community organizations, schools, government agencies and faith-based groups. The project will provide tools that organizations can use to motivate Arizona families to enroll and maintain enrollment in the health insurance option that best meets their needs.

We are excited for this new opportunity to help enroll children of Arizona.

 

Administration announces $1 billion initiative to provide better health care and lower costs

By Rick Gilfillan, Director, CMS Innovation Center

Bringing down health care costs is a top priority. That’s why the Affordable Care Act contained an historic set of reforms designed to reward higher quality and lower the cost of care.  And we know that the best way to do that is the same way leading health care organizations do it: by making care better and more efficient.

We also know there are great ideas out there that can help push this work forward and that the kinds of innovative practices that make our health care system work better for everybody can come from any corner of the country. That’s why today we’re launching a $1 billion initiative through a second round of Health Care Innovation Awards.

These Innovation Awards will be given to organizations whose creative solutions to our most pressing health care challenges have the potential to serve as models for improving care and lowering costs across the country.

In November of 2011, we launched our first round of Health Care Innovation Awards by issuing a challenge to America’s health care providers, businesses, universities, and community groups.  We asked them to submit their proposals for how to get the most out of our health care dollars by delivering better care. That challenge resulted in more than 3,000 applications, from which a team of independent experts and HHS officials selected 107 promising innovations with the strongest likelihood of creating larger-scale, sustainable results.

And as we kick off round two of the Innovation Awards today, we’re already seeing encouraging results from a number of our round one recipients. The University of Miami, for example, is transforming school-based health clinics into medical homes to serve vulnerable children. These medical homes are connected to community health care providers and these children are already receiving tele-health consults for dermatology, psychiatry, and nutrition along with dental care.

Another recipient, Christiana Care Health Services, has used advanced data analytics to improve preventive care for patients with heart disease. Their comprehensive electronic registry allows providers to more quickly and accurately assess patients’ symptoms and needs based on similar occurrences in the past. This smarter preventive care doesn’t just prevent tragedies before they happen—it also saves money on hospital visits.

As with last year’s awards, we’re seeking out innovative practices that have a high likelihood of delivering better care and lower costs on a national scale.  The last few years have seen us make tremendous strides towards keeping health care spending in check, and a lot of that is thanks to innovations that have helped improve the quality and efficiency of care delivery and payment systems.

Across the country, private and public sector innovators are developing even more great ideas to improve our health care system.  And today’s announcement will allow us to take some of the most promising innovations and put them into action for the benefit of all Americans.  That’s good news for patients, for providers, for our economy, and for the future of American health care.

More information is available at: http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Round-2.

Learn more about the key features of the Affordable Care Act.

Continuing to work with states to build new systems of health coverage

By Cindy Mann CMS Deputy Administrator and Director, Center for Medicaid and CHIP Services

CMS is committed to working in partnership with states in administering their Medicaid and Children’s Health Insurance Programs (CHIP) and to providing flexibility in pursuit of our shared goals.

Premium assistance has been a longstanding option in both Medicaid and CHIP and is one way to accomplish those shared goals.  CMS provided guidance in December of last year on how states might use these options to develop state-based solutions that meet both the state’s unique needs and requirements of the programs

In response to some questions that have been raised by states, today we are issuing some clarifying guidance.   Today’s Frequently Asked Questions explain the basic requirements that apply when a state chooses the premium assistance option and the guidelines we would apply when a state requests a waiver to implement premium assistance.  Under both approaches, individuals remain Medicaid beneficiaries and continue to be eligible for benefits and cost-sharing protections established by law.

As we review waiver proposals, HHS will consider factors that will impact cost effectiveness, such as those introduced by the creation of Health Insurance Marketplaces.

We remain committed to working with states and providing them with the flexibility and resources they need to build new systems of health coverage.  Premium assistance is simply one option, and we will continue to work with states on solutions that work best to meet shared goals.  We encourage states to come to us with their delivery system ideas, and look forward to continuing to work with states on these and other innovative approaches.

Premium Assistance FAQ

eHealth: Aligning Quality Measurement at CMS

By Patrick Conway, MD, MSc

Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs

The next step on the path of meaningful adoption of health information technology (HIT) for providers—will launch later this year for hospitals and next year for eligible professionals. How will this next phase improve health care and reduce the burden on providers?

Achieves Electronic Data Reporting

With the increase in adoption of EHRs, we are moving away from technology as an end goal and towards the use of technology as a key tool in health care quality improvement. The next phase of the EHR Incentive Programs will encourage the adoption of broad scale electronic reporting of quality data.

Aligns of Quality Measurement

One of the foremost goals of Stage 2 is the alignment of quality measure reporting across CMS programs. CMS has worked with partners and representatives from industry to identify and finalize a set of unified quality measures which meet the requirements of multiple programs, such as the Physician Quality Reporting System (PQRS) and Physician Value-Based Modifier, in addition to meeting EHR Incentive Programs requirements.  Accountable Care Organizations can also report quality measures from their EHRs to meet reporting requirements for participating eligible professionals.

The quality measure set—released by CMS last October—includes only measures that have been field tested, meet validation standards, and align with the National Quality Strategy, which outlines improvement goals for health care.

How Providers Benefit

For providers, program alignment means:

  •  Using a single submission method to report on a unified set of quality measures
  •  Choosing the submission method most suited to their unique needs

For example, eligible professionals may submit through a data-submission vendor or submit reports generated from their certified EHR technology directly to CMS.

As we look toward full implementation of meaningful use Stage 2 in 2014, CMS is committed to continuing to improve processes, support program alignment, facilitate interoperability and feedback to providers, and focus on the strategic use of health IT to drive quality improvement in our health care system and better outcomes for patients.

Learn more at HIMSS

We encourage you to learn more about CMS’ efforts during the CMS Quality Measurement Session at HIMSS13 today.

Administrative Simplification and ICD-10: Streamlining Health Care Operations

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services

Did you know that the United States spends more than $150 billion annually on health care administration, and for the average physician, two-thirds of a full time employee is needed to carry out billing and insurance related tasks?

To ease these financial and administrative burdens, the Health Insurance Portability and Accountability Act (HIPAA) and the Patient Protection and Affordable Care Act (Affordable Care Act) established administrative simplification requirements. These requirements are in place to lower costs, create uniform electronic standards, and streamline exchanges between health care providers and payers.

We at the Centers for Medicare & Medicaid Services (CMS) are charged with carrying out and enforcing the administrative simplification requirements for HIPAA-covered entities, which include health care providers that conduct certain transactions in electronic form, health care clearinghouses, and health plans.

The administrative simplification mandates require the adoption of operating rules for each of the HIPAA Administrative transactions; a unique, standard Health Plan Identifier (HPID); and standards and operating rules for electronic funds transfers (EFT) and claims attachments.

Two key components of administrative simplification are Version 5010 and ICD-10. Version 5010 modified standards for electronic transactions and created the platform to support the expanded ICD-10 code sets. The ICD-10 code sets convey clinical advances in health care and current medical protocols in the administrative transactions.

If you are attending the HIMSS13 conference and would like to hear more about these initiatives, be sure to catch our ICD-10 and Administrative Simplification session (Education Session 131) on March 6, 2013, 8:30 – 9:30 am. And please stop by our booth (#2868) in the exhibit hall.

We also have helpful resources to help you stay up to date on ICD-10 and other administrative simplification initiatives.

Visit our ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, deadline. And be sure to check out the ACA website and sign up for Administrative Simplification Updates.

Lastly, follow us on Twitter @CMSGov using #ICD10 and #CMSeHealth. You can also use the official HIMSS hashtag #HIMSS13 to join in on all conference related topics.

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