Posts Tagged ‘ohio medicaid providers’
Aug 2nd, 2010 | by
In this tumultuous and uncertain political year, some things are very clear. State budgets are facing serious deficits. For millions of Americans, the Great Recession is not over. We see it firsthand here at CareSource. In fact, as the nation’s second largest Medicaid health plan, we know there are 844,000 CareSource members who are faced with the realities of the economic downturn each day. Subsequently, this has increased the demand for Medicaid and other important services families need to survive. Simply put, Washington must do more to address the devastating impact of these tough economic times.
Every day, we see the consequences of high unemployment in our states. With more people out of work, more families are relying on Medicaid to provide essential medical care. Any delays may force families who are already struggling to maintain basic necessities to forgo the health care coverage they fundamentally deserve and more importantly – the coverage they desperately need.
Yet efforts in Congress to approve a six-month extension of higher federal Medicaid assistance to the states are being blocked. Instead of voting as if the economy is strong, Congress should take the pressure off states by passing this temporary extension now. Otherwise we could see drastic cuts in health care for the most vulnerable, education, and other critical services. These cuts will only delay the day that we will see the economy actually recover.
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.
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?
Article TagsExpress Lane Eligibility • Federal Government • Governor Strickland • Kathleen Sebelius • Medicaid • medicaid ohio eligibility • Ohio medicaid • ohio medicaid eligibility • Ohio medicaid program • ohio medicaid providers • poverty • Presumptive Eligibility • SCHIP • State Children’s Health Insurance Program • U.S. Health and Human Services • underserved • underserved population • Unemployment
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 Tagsasthma • Cadillac Plan • chronic disease • civil rights • diabetes • health care issue • health care issues • health care reform • individual mandate • mandates • Martin Luther King • medications • michigan medicaid • MLK • Ohio medicaid • Ohio medicaid program • ohio medicaid providers • Public Option
Dec 10th, 2009 | by
Whenever a new concept is proposed, those at the deliberation table automatically ask “what would happen if?” before they decide to act. With health care reform for example, the driving questions are more like: “Are the changes going to result in more Americans getting coverage? Are the proposed changes budget neutral?” Given the broad scope of the proposed health care legislation, it’s easy to see how details can get overlooked. And when time is ticking, unintended consequences have a higher chance at prevailing.
One concern that should be brought to light is the $6.7B annual fee proposed on insurers. While conceptually this might make sense given the number of Americans who will be required to obtain coverage and the new revenue that insurers stand to gain, a portion of this fee would not be limited exclusively to commercial health insurance companies. Health plans that contract with federal and state governments to serve Medicaid, Medicare, and beneficiaries of the Children’s Health Insurance Plan (also known as CHIP) would also get taxed too.
Well, the challenge is that a significant portion of this fee will fall on state budgets because of the way states are required to reimburse health plans that serve its most vulnerable residents. The new fee will unintentionally require states and the federal government to ultimately come up with additional public dollars to pay for this added fee.
Also, this fee would unfortunately raise the overall costs of these government programs and place additional strains on programs that are already in extreme financial distress. For example, Ohio’s Medicaid program would have to potentially come up with an estimated $65 million annually. Subsequently, the burden of this fee will be paid for by taxpayer-funded government programs and beneficiaries that use these health plans.
Easy solution to the problem? Just exempt health plans administering government entitlement programs from the application of this fee. Problem solved; Unintentional consequence diverted.