Health Care Reform – Public health organizations collaborate to prepare providers for Medicaid expansion


There have been announcements by three leading public health organizations that they have plans to collaborate in a project with the primary aim of helping nation’s healthcare providers prepare for the 2014 Medicaid coverage expansion under the Patient Protection and Affordable Act.

The organizations collaboration are the National Assosciation of Community Health Centers, George Washington University School of Public Health Services and America’s Essential Hospitals. It is a three year collaboration and around $1.8 million dollar has been funded by the Kaiser Permanente. Their task is to examine and assess areas where local hospitals, clinics and health providers can also collaborate to meet the challenges which would rise as millions of Americans would become newly eligible for Medicaid.

Bruce Siegel, President and CEO of AEH said that this collaboration was a great achievement as they were not getting together around the people they care for and that too in a very formal way. This would deliver a message that health centres and safety net hospitals will be working together from now on.

He added further that the main goal of this initiative is to lay the foundation for the creation of a partnership model that can be viewed by healthcare providers throughout the country as a framework to build local collaborations of their own.

This trio will assess and identify five states or regions which are in desperate for targeted assistance and create a stakeholder support network which would act as a model for other areas. The preparedness of the safety net providers for the expected rise in the population of the newly insured patients would be assessed; evidence-based tools, reports and any technical assistance required would also be provided; and finally evaluation of the overall project would also be a part of the goals that have been set.

One of the most important goal would be to identify the collaborations that are successful in integrating care to ensure unhindered transition from enrolment to participate in medical homes and referrals to other safety institutions.

It is expected that by August 31 the five states or regions would have been identified. The selection would be based on a number of criteria which include status of state exchanges and Medicaid expansion and the number of uninsured affected in each potential state.

In Massachusetts, due to the unwillingness of some insurers to participate in the program, a plan which insures disables adults younger than 65 years and dually eligible for Medicare and Medicaid had to be scaled down.

According to a report by the Boston Globe, almost fifty percent of the insurers who had said that they would participate in the voluntary One Care program have opted out. This program was intended to manage care of the state’s low income and disable people between the ages of 21 to 64. HealthCare bills of these people are covered by Medicare and Medicaid.

States largest Insurer Blue Cross and Blue Shield, and even the Boston Medical Centre HealthNet Plan and Neighbourhood Health Plan have decided not to participate in the programme as they speculate losses from participating in these programs.

A survey conducted by the National Council on Aging, United Healthcare and USA Today showed that 3 out of 4 low-income seniors suffering from any chronic illness have difficulties in managing their health due to lack of money and energy.