Archive
The Rituals of Back to School
Author : OurHealthCareSource.com
Sep 1st, 2010 | by
Where did summer go? It’s back to school time once again. The “Back to School” season has almost become a holiday. There are so many rituals associated with back to school:
Buying new school supplies like pencils, notepads, crayons, calendars, folders…maybe a new backpack?
Examining the clothing situation–new shirts, pants, socks…perhaps replacing those shoes that were outgrown during the summer?
Checking your schedule twice to make sure you’re ready to adapt to a new normal for the next nine months!?!?!?
How about getting that doctor’s appointment for an annual check-up?
Unfortunately, this ritual doesn’t always seem to make the list, which is why we partnered with our state-level association, Ohio Association of Health Plans, to launch a statewide campaign called “Get Your Well On.”
The goals of the “Get Your Well On” campaign are simply stated:
- Promote the importance of having a consistent relationship with your primary doctor
- Encourage responsible health care engagement and healthy living
Simply stated…but profoundly inspiring. Frankly, it’s our responsibility as Medicaid Care Coordination plans to forever promote the benefits of good health to our members. But this partnership with our industry in Ohio has been an inspirational experience.
Our organization – OAHP – has partnered with associations and communities across the state to bring this message to the urban, suburban and rural. Organizations like the Ohio PTA, Ohio Benefit Bank, Ohio Association of Second Harvest Food Banks, Ohio Child Care Resource & Referral Association, Ohio Council of Churches, Special Olympics Ohio, Family Children First Councils, Ohio After School Network, and many, many more have been instrumental in championing our cause.
We are meeting at a true grassroots level with people that are touching the lives of hundreds of thousands of Ohioans. And they are so appreciative of the materials we are giving to them:
We’ve been organizing events in Columbus, Cleveland, Dayton, Toledo, Akron and more…inviting the passionate agencies at the community level to hear our message. We’ve partnered with large conferences to voice our point of view to hundreds at a time.
The basic comment we get most often as we engage with communities—
“This information can never be promoted enough. Thank you for giving me the tools to help promote this to the people I work with.”
Medicaid Care Coordination plans are forever promoting healthy living and prevention to our members. It’s the philosophy of this type of health care delivery. Our “Get Your Well On” campaign is casting a larger net across Ohio, touching lives beyond the underserved.
So maybe a new back-to-school ritual for all of us should be a reflection on our health in general…and then the drive to take action. Our Governor made it official this week with his proclamation. Now we all have a friendly reminder to “Get Our Well On.”
Article Tags
Akron • Back-to-school • Cleveland • Columbus • Dayton • Family Children First Councils • Medicaid Care Coordination • Ohio After School Network • Ohio Association of Second Harvest Food Banks • Ohio Benefit Bank • Ohio Child Care Resource & Referral Association • Ohio Council of Churches • Ohio PTA • Special Olympics Ohio • Toledo
Moving Hope To Reality
Author : OurHealthCareSource.com
Jul 22nd, 2010 | by
Dear President Obama,
Thank you…thank you for the release of the Patient’s Bill of Rights. This public proclamation that describes how patients will be protected by the rising costs and complexities of the health care system is exactly what this country needs. It is fundamentally consistent with the philosophies of our nation. The Patient’s Bill of Rights builds a foundation that allows opportunities to exist, opportunities open to all, and most notably our country’s underserved population.
Underserved people continue to suffer in our country. And one of the most profound challenges to this demographic is having the forum to voice opinion. Underserved communities struggle to be heard…struggle to tell their stories…struggle to instill empathy in those most able to be helpful.
The Patient’s Bill of Rights gives the underserved a voice. It protects them from elements that have been traditionally uncontrollable. It protects our children, it protects those with pre-existing conditions, and it protects women. But most importantly, it protects the integrity of our country and the goodwill we extend to our citizenship.
So thank you, Mr. President, for embracing our country’s underserved, and moving hope to what is tangible. And we’re happy to answer your request and spread the word about the new Patient Bill of Rights.
The Patient’s Bill of Rights
“Starting in September, some of the worst abuses will be banned forever. No more discriminating against children with pre-existing conditions. No more retroactively dropping somebody’s policy when they get sick if they made an unintentional mistake on an application. No more lifetime limits or restrictive annual limits on coverage. Those days are over.” – PRESIDENT BARACK OBAMA
President Obama announced a Patient’s Bill of Rights made possible under health reform—a basic set of consumer protections.
The Patient’s Bill of Rights:
- Prevents insurance companies from canceling your policy if you get sick. Right now, insurance companies can retroactively cancel your policy when you become sick if you or your employer made an unintentional mistake on your paperwork.
- Stops insurance companies from denying coverage to children with pre-existing conditions. Beginning in September, discrimination against children with pre-existing conditions will be banned—a protection that will be extended to all Americans in 2014.
- Prohibits setting lifetime limits on insurance policies issued or renewed after Sept. 23, 2010. No longer will insurance companies be able to take away coverage at the very moment when patients need it most. More than 100 million Americans have health coverage that imposes lifetime limits on care.
- Phases out annual dollar limits on coverage over the next three years. Even more aggressive than lifetime limits are annual dollar limits on what an insurance company will pay for your health care. For the people with medical costs that hit these limits, the consequences can be devastating.
- Allows you to designate any available participating primary care doctor as your provider. You’ll be able to keep the primary care doctor or pediatrician you choose, and see an OB-GYN without referral.
- Removes insurance company barriers to receiving emergency care and prevents them from charging you more because you’re out of network. You’ll be able to get emergency care at a hospital outside of your plan’s network without facing higher co-pays or deductibles or having to fight to get approval first.
Article Tags
Health Coverage • health insurance • Hospital • Medicaid • OB-GYN • Patient Bill of Rights • poverty • President Obama • underserved
The 2010 Census – It’s easy. It’s important. It’s safe.
Author : OurHealthCareSource.com
Apr 1st, 2010 | by
It’s that time of year again. Census time. Yes, this year we have to take 10 minutes out of our busy schedules and answer 10 easy questions… and we’re done – for 10 years! Simple questions that determine how $400 Billion – yes, that’s BILLION -get distributed to each state.
During the 2000 Census collection, over 70% of Americans sent their surveys back as instructed. But many surveys had to be completed with the help of U.S. Census workers who traveled door to door canvassing the streets to find individuals who just couldn’t find the time to make this a priority. And why shouldn’t they just wait for a knock on the door?
Get this: For each percentage point we can raise the response rate, the feds reportedly will save about $85 million on door-to-door workers. Isn’t that reason enough?
But the population that traditionally struggles to complete their Census forms is the people we serve each day here at CareSource. Why? Because this population tends to be transient – not typically staying at one residence for any prolonged period of time. They also may not have an official address, or they may be homeless, or they live in a communal living situation. Whatever the case, during this census period, it’s extremely important that we get the people in our underserved communities counted.
That’s why CareSource is joining the national effort to reach out to our members to reinforce the importance of completing their census form. Our 820,000+ members qualify for Medicaid coverage and have income below 200 percent of the poverty level. Because the deadline is quickly approaching, we are posting information to our Web site as a reminder for both members and our vast provider network (22,000+ providers, 210 hospitals). We’re also adding a hold message on our customer service line (pending state approval) to encourage our members to “Be Counted” and why it’s so important.
But we didn’t stop there. As a large employer, we have also encouraged our 900 employees to complete their census forms and have reiterated why it’s so important for a publicly funded, not-for-profit company like CareSource to support this national endeavor. Recurring messages will be sent to employees to provide constant reminders prior to the April 15th deadline.
According the NAACP and the federal government, here is why it is so important to get everyone counted – especially families struggling with poverty:
- Federal Funds: For each 100 people not counted, a community risks losing an estimated $1.2 million over the next decade for federally funded programs including: Medicaid, public housing assistance, child health programs, Head Start, transit programs, and more.
- Political Representation: States use census numbers to redraw all political boundaries and determine which states gain or lose representation, including Congressional Districts, state house and senate districts for city councils, school committees and county board.
- Public Infrastructure: All levels of government rely on census numbers to locate vital public works like schools, health centers, public transportation, highways, and affordable housing.
- Private Investment: Businesses large and small use census numbers to identify new markets, select sites for operations, make investment decisions and determine the goods and services offered.
When families do not participate in the census, it means their communities lose access to money, resources and power. On behalf of our country’s underserved communities, please encourage the families and organizations you interact with to complete and return their census form. It’s easier than ever. The 2010 Census form asks 10 questions and takes about 10 minutes to complete. But the key is – IT MUST BE MAILED BACK TO BE COUNTED. Simply mail it back using the postage-paid return envelope by April 15, 2010. Telephone assistance in filling out the form is also available by simply calling 1-866-872-6868.
For those who do not respond, census workers will visit households that do not return forms to take the count in person. But don’t forget – the higher the participation rate, the cheaper the census will cost taxpayers. Just think – if we increase the rate of response from 70 to 80 percent, that’s an estimated $850 million in savings!
It’s easy. It’s important. It’s safe. For more information about the 2010 Census and the “Take 10″ initiative, visit www.2010census.gov.
Article Tags
2010 Census • 2010 Census Collection • Census • Census forms • Census help • Medicaid • Public Infrastructure • taxpayers • underserved • what is the Census
A Commitment To Our Children
Author : OurHealthCareSource.com
Mar 16th, 2010 | by
Ohio’s underserved population got a positive boost this past week from our Federal government and Governor Ted Strickland. The first was Ohio receiving over $700-million in federal assistance for Medicaid. The second is our Governor’s commitment to U.S. Health and Human Services Secretary Kathleen Sebelius’ challenge to get all eligible children enrolled in Medicaid/State Children’s Health Insurance Program (SCHIP) and keep them covered longer. These are tremendous strides that our Federal and State governments have taken to further its commitment to America’s children.
In Ohio, where we have an unemployment rate of 10.8% and a multi-million budget gap, we are seeing more and more people needing the many social services that help keep our Ohio families afloat. Medicaid is one program in particular that has experienced a surge in enrollment. So receiving more federal assistance is extremely helpful in keeping Medicaid enrollees covered and making sure they are accessing the health care system responsibly.
Next, our Governor’s commitment to making sure every child eligible for Medicaid/SCHIP is enrolled is also greatly needed. There are 77,000 children in Ohio that are currently uninsured but actually eligible for Medicaid/SCHIP today. The income limit for children to receive health care through Medicaid/SCHIP is currently capped at 200% of the poverty level (or a little over $44,000 for a family of four). So we stand equally committed to finding these children, and making sure they all get access to primary and preventative health care.
But finding all children eligible to be enrolled with Medicaid/SCHIP is a little trickier than you might think. In addition to concentrated grassroots outreach, we need Ohio’s Medicaid program to implement new strategies that lessen the barriers to entry. Here are three strategies to consider:
- Express Lane Eligibility – Essentially, this will help get children covered when their families opt to receive assistance through other public programs like school lunch or food stamps. States can use the relevant findings from these other public programs to determine their eligibility for Medicaid/SCHIP without requiring the family to resubmit and/or re-verify their personal information.
- 12-month Continuous Coverage – In Ohio, families with children receiving Medicaid/SCHIP need to re-apply every 12 months to maintain their coverage. During this 12 month period, a child can become ineligible for Medicaid/SCHIP for a variety of reasons. Most notably, is not keeping their redetermination appointment for other public assistance programs (e.g., cash assistance or food stamps). This causes children to inappropriately lose their coverage. By guaranteeing 12 months of coverage to children, we ensure our eligible kids don’t lose coverage while ultimately improving overall health outcomes.
- Presumptive Eligibility – Allows trained qualified entities to screen a child or pregnant woman’s eligibility for Medicaid/SCHIP. If presumed eligible, a child or pregnant woman can receive all health services covered under Medicaid until a final determination is made. Presumptive eligibility would allow uninsured children and pregnant women to begin the Medicaid application process, obtain needed medical services while also ensuring the health care provider is reimbursed for services rendered.
It’s clear that needless administrative barriers are simply making health care access harder and harder for underserved populations. These three strategies are common sense approaches that will ensure the nation’s underserved get the coverage they need – when they need it.
Questions for our readers – What do you think of the Federal and state measures described above? Is it a good use of federal dollars to help states with their Medicaid programs? Are these suggestions for CHIP enrollment enough to capture all the children eligible for the program?
Health Reform is a Civil Rights Issue
Author : Toni Bigby
Jan 18th, 2010 | by
Martin Luther King, if he had been given the time, must eventually have tackled the health care issue as an essential civil right. As a nation, we’ve focused so much on the tactics and details—public options, mandates, “Cadillac plans” and so on—that we may be forgetting why increasing health care accessibility is important to us as a nation.
So this is just a reminder for all of us: without health care, personal growth and success are limited indeed. Children with sensory or behavioral problems are not treated, or whose simple illnesses are not cared for, cannot learn. Adults with a chronic disease (like diabetes or asthma) can earn a living—but only if they have the care and medications they need. Families that lose a parent to a disease that could have been cured if caught earlier, suffer consequences that can hardly be measured – stability, opportunity, potential.
If we are serious about equal opportunity, education, stable families, social justice at any level, we must embrace health care accessibility as an essential civil right.
Article Tags
asthma • Cadillac Plan • chronic disease • civil rights • diabetes • health care issue • health care issues • health care reform • individual mandate • mandates • Martin Luther King • medications • MLK • Public Option
The Really Important Thing is Health Care for All
Author : Janet Grant
Oct 1st, 2009 | by
Last week, I sat down with the anchors at WDTN-TV, Dayton, OH. The topic of our discussion was around health care reform and how it will affect the underserved population that currently access public programs, like Medicaid.
In the TV interview, I also discussed the broad questions people have regarding health care reform. People want to know, “What does health care reform mean for me?” Will I be able to keep the coverage I have?
For health care reform to be effective, it must cover all individuals and provide those faced with poverty the supports they need to access care appropriately. Giving someone a health insurance card is only one part of the equation – albeit a considerable part. However, getting them to their regular provider on a regular basis is the essential factor for ensuring the outcomes health care reform promises.
There are still many people that do not qualify for Medicaid, and would benefit tremendously from having access to ongoing health coverage. It’s great that we are covering our children through Medicaid (one out of every five), but that coverage needs to extend to the parents and childless individuals as well.
What do you think are the biggest opportunities for health care reform? Who needs to benefit most? How do you think Americans in poverty could benefit most from health care reform?
Article Tags
health care for all • health care plan • health care reform • health insurance card • Medicaid • public-sector • underserved • underserved population • WDTN-TV
Put Your Money Where Your Mouth Is
Author : Cathy Ponitz
Aug 19th, 2009 | by
“Giving back to the community” is a pretty standard element of corporate strategy. And if it’s your mission to sell a product or service, it’s just practical to make that giving highly visible to as many people as possible.
However, when your business is to help people with poverty issues that deeply affect their lives and well-being, and your ability to serve them is challenged by the circumstances of their lives and communities, marketing is not the first consideration. You are compelled to go beyond business strategy to actually change those conditions directly. To put your money where your mouth is.
That’s the essential logic behind the CareSource Foundation.
Changing the Health Care Landscape
Our goal is to change the health care landscape for those who have the greatest challenges and the fewest resources. We know that diabetes, childhood obesity and asthma are rampant and costly…so we support programs that educate children and families on managing those conditions. We know that domestic violence and destructive behavior by young people are health issues as well as criminal issues, so we support innovative solutions for at-risk youth and help for domestic violence victims.
Mobile health and prescription access. Emergency shelters. Screenings, prenatal health, senior health, behavioral health. Investment in the health of every county in Ohio and the counties we serve in Michigan. Wherever we find an effective program that helps vulnerable populations with important health related issues, we look for ways to partner with them to find solutions.
Perhaps the greatest challenge in health care is its absence. Sadly, even with Medicaid and Medicare, about 11% of our state’s population has no health coverage at all. Although CareSource provides coverage for 765,000 Medicaid enrollees and the CareSource Foundation has invested more than $1.5 million in programs that stem the tide on significant health issues, more still needs to be done.
Taking Foundations to Another Level and Beyond
As we enter our third year as a foundation, we’ve decided that we can and should do more to support families as the nation recovers from this economic downturn. This year, we’ve developed a brand new concept called “Signature Grants” which are fundamentally inline with the programs we currently support but we’ve taken them to the next level. These large-scale grants will have numerous regional, state and/or national partners all focused on creating sustainable, high-impact change in one of two key areas: childhood obesity and/or the uninsured.
Unlike responsive grants, we actually solicit proposals that are geared toward making improvements in these predefined categories, thus offering yet another way for CareSource to impact change in the communities we serve. We believe this “outside of the box” thinking will encourage communities to work in tandem to focus on key issues that continually perpetuate the escalating costs of health care.
What We Suggest
What if all health care plans serving the underserved focused their “giving back” on the health of their own communities? Providing coverage, care and education, supporting innovations that make a difference in individual lives? What if they looked at issues that continually consume the increasingly scarce health care dollar and focus profits on impacting change?
It wouldn’t solve the structural dysfunctions in the health care system today…that’s the job of health care reform. But caring, compassionate help that empowers consumers to stay healthier and use resources well is not only the right thing to do. Long term, it will reduce costs and improve the quality of American lives. And that’s a benefit for everyone.
Article Tags
domestic violence • effects of poverty • health care landscape • health care plan • health care reform • Medicaid • philanthropy • poverty • poverty issues • senior health
People On Public Health Plans Don’t Care About Prevention
Author : Dave Mezzanotte
Author : Pam Tropiano
Aug 18th, 2009 | by
…At least that’s what some providers think. And I guess their perception is warranted given the historical challenges providers have with patients on public health programs. But the truth is that the underserved aren’t purposely making it harder for a provider to deliver preventive care. It’s just that members of public health plans often aren’t empowered to be engaged in their health care experience. The underserved simply experience the same kinds of frustrations from the health care community that they experience from many other aspects of their lives.
At CareSource, where we deal with this dynamic set of members on public health programs, we are recognizing the impact we can make when we create an environment where our members are empowered to be engaged in the health care system.
Empowerment leads to healthy lifestyles
We have learned that if we educate, create the right kinds of tools, and establish an environment where engagement and two-way decision making is encouraged, we can move our members to participate in healthy living – and that leads to lower healthcare costs.
The first step is through education
CareSource’s in-house nurses, case managers and social workers work with members to help them be empathetic to the patient-provider relationship. We help them understand the impact they have on a provider’s office when they don’t show up to a scheduled appointment. We help them see the strain they put on the system when they choose to use expensive health care means – like emergency rooms for flu symptoms. We educate them about how living a healthier lifestyle will impact their well being, and the well being of their families.
Developing tools to facilitate empowerment
Next, we are developing a number of tools to help our members be empowered. For example, we are exploring the creation of checklists and sets of questions for members to bring into their primary care physicians’ offices when they visit for an annual exam. We are in the process of developing a “pact” agreement between the patient and provider so the patient feels they have “skin in the game” relative to the provider-patient relationship ( See Dr. Craig’s blog entry about the Health Care Home pilot program ). We plan to craft materials and tools for patients with chronic care needs that make it easier for those patients to maintain an active role in their care. These tools – once rolled out – will empower our members to engage in the system in a responsible manner, and take charge of their own health.
Recognition pays off more than incentives
Lastly, CareSource is organizing a program to recognize our members for appropriate use of the system. We have tested the waters of incentive programs – discounts on services or discounts on health-related products – but have found that these programs have done little to move the needle. However, what we have learned is that our members appreciate public recognition for their efforts – a certificate of achievement for losing weight, a letter to an employer promoting a patient’s ability to quit smoking, a recipe book for a patient that has taken control of her diabetes, and elected to change their nutritional intake. We have found that actions like these do more to promote healthy lifestyle because it shows compassion, respect and dignity to our members. So we are in the process institutionalizing a recognition program the delivers on our promise to make a difference in the lives of the underserved.
There’s no doubt that a shift to healthy living will help lower the cost of health care. But the ability to make this shift lies as much in the hands of the health care user as it does with the providers. And we see our role is in helping to encourage empowerment in our members.
