Posts Tagged ‘poverty’
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
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?
Momentum Must Not Waver
Author : Toni Bigby
Jan 26th, 2010 | by
There’s really only one thing that worries me about the Massachusetts election. I’m not troubled by the fact that the Democrats lost filibuster-proof control of the Senate. Control shifts back and forth as often as who is going to host the Tonight Show on NBC.
It doesn’t worry me that Senator Elect Scott Brown will try to block any potential of health care reform. We’ve come too far over the past year…really over the past half century…to turn back now.
I’m also not concerned that the Democrats will try to force through a health care reform policy -just to get it done. Forcing through policy doesn’t always go over well to voters in an election year – especially those with long-term memories. However, a recent poll by the Kaiser Foundation indicates the American public, including skeptics, become more supportive of health care reform after being told about many of the major provisions in the bills.
But what is worrisome…troubling…concerning to me is that momentum will waver, and the true ideals of health care reform will be lost. We must be sure the following elements of health care reform stay in place:
- Increase Medicaid eligibility – whether its 133% or 150% (which I would prefer), we need to make sure reform protects our most vulnerable citizens
- Protect our children – CHIP programs work…that’s why so many of our policy-makers rose to the occasion to protect in the current bills – Sen. Casey, Sen. Rockefeller, Sen. Reid, etc.
- Affordable Coverage for All – Don’t let purchasing health insurance be burdensome to the majority – continue with plans to provide government assistance through subsidies to those under 400% of the national poverty level
- Use of a state based health care exchange to act as a transparent clearinghouse for consumers to purchase coverage
- Cost containment to bend the unsustainable curve of health care costs
- Medicare & Medicaid benefit integration and financing for dual eligibles within a managed care model to rebalance the long-term care system to increase use of home and community based support services. Shifting more of this high-need population into coordinated managed care arrangements could produce significant savings while ensuring options for consumers where they desire to reside.
Sure, CareSource is a non-profit health plan that believes there is always room for improvement, but we support health care reform. Give non-profits wider opportunities to control costs, enable insurance companies to accept anyone with pre-existing conditions, include an individual mandate so that we all pay our fair share and, reimburse for positive outcomes, etc.
So to do my part in making sure Congress knows that I don’t want the momentum to subside in Washington, I used this source to send Congress – and my local newspapers – a letter:
http://www.progressohio.org/page/speakout/deliverchange
This one is for Ohio citizens…but if you live outside of Ohio, you can go to FamiliesUSA to send your own letter to Congress.
Please let Congress know that we cannot afford to take our eye off the goal just because of one election. We must move forward with health care reform. Our country deserves it.
Article Tags
Affordable Health Coverage • Children’s Health Insurance Program (CHIP) • congress • exchange • health care reform • Health Coverage • Kaiser Foundation • Massachusetts Miracle • Medicaid • Medicare • poverty • Scott Brown • Senator Scott Brown • Senator-elect Scott Brown • support health care reform
The Holidays are a Time for Reflection
Author : Toni Bigby
Nov 24th, 2009 | by
The holiday season is now upon us. And while this time of year is supposed to be a joyous time spent with family and friends, I find myself reflecting on the lives of people that find the holiday season to be just another reminder of their economic circumstance. The underserved – particularly those at or below the poverty level – will experience the holidays in a much different way. With more and more families facing job loss as a result of the recession, many will not have Thanksgiving feasts…many will be struggling to find ways to “make the season bright” for their children. Many are turning to the social services available within their community just to make it through another month.
Throughout my time at CareSource and with Ohio’s Medicaid program, I’ve learned to have a deep appreciation for the challenges faced by the underserved. Sure, we can try to conceptualize what a day in the life of someone living in poverty is like, but CareSource has exposed me to a much more profound way to think about the priorities of the underserved…and they did this by proactively organizing an interactive event for CareSource employees called the “Poverty Simulator.”
Because our company prides itself on helping the underserved better their lives by improving their health care, our organization does some pretty unique things to help us appreciate the challenges our members face each day – and how they prioritize getting their most basic needs met. This Poverty Simulator – organized by Think Tank, a non-profit organization that strives to build communities where all people can thrive – does just that…it allowed us to put ourselves in the shoes of our members through role-play, to gain a fuller appreciation of barriers that often preclude them from accessing health care services responsibly. It’s all done in an effort to teach us why our members make the decisions they make; ask the question they ask; need the support services they need; and where their health care fits in to the grand scheme of things they consider vital… Why? All so we can better serve them.
We’ve held this event four times this year for our employees who have described the event as “heart-wrenching,” “mind-blowing” and “eye-opening.” The simulator has been so enlightening that we included it as part of an event we hosted on Capitol Hill that allowed health care experts and interested parties to experience it firsthand. The purpose was for those following and influencing the health care debate to gain a better understanding of how poverty impacts the way people prioritize and access health care – even if it is made available to them at no cost.
It’s so easy to make general assumptions about why people make the decisions they make. But quite frankly, until you actually walk in the shoes of the underserved, it is very difficult to appreciate the complexities of living in poverty. Please take a few minutes to see what the Poverty Simulator is all about. I think you’ll find it offers a unique and profound approach for helping organizations understand the needs of its customers, and how CareSource excels at building a culture of compassion, dignity and excellence.
Article Tags
benefit bank • CareSource • giving back • Governor Strickland • health care • health care reform • medicaid program • Ohio • Ohio medicaid • poverty • role-play • social services • Thanksgiving • Think Tank • underserved • underserved Americans
Can We Wait Until 2014?
Author : Chris Whistler
Oct 14th, 2009 | by
The US Senate Finance Committee just approved a health care plan that includes a provision that would significantly expand Medicaid. This is great on so many levels. However, it has one flaw. That being, the full expansion wouldn’t actually start until 2014. Is it just me, or does that seem to contradict the whole idea of protecting the most vulnerable first?
Yes, it’s true that we’ve been trying to fix the health care system since at least 1948. So from one point of view, spending another few years trying to get it right doesn’t seem out of line. But imagine if all you hear around you is that health care reform is going to make a difference in the lives of the 47 million uninsured Americans right now, but then you find out that you have to wait longer than everybody else. Then, to make matters worse, your income is among the lowest in America and is the primary reason you are uninsured in the first place.
The unfortunate truth about this health care plan is that once again, those who are most in need are expected to wait longer than the rest of us. This includes hard working people with low incomes who just don’t happen to have dependent children – the current ticket for most people to qualify for Medicaid. And parents who are doing all they can to make ends meet for their children who are blocked from Medicaid coverage because their very limited income is deemed too high for them to qualify. The list goes on.
Where’s the justice in waiting to expand Medicaid until 2014? Or, maybe more pragmatically, where is the preventive care and coordination that is going to enable the right care at the right time in the right setting – you know, rather than causing the first stop to be in an emergency room after waiting until the cancer spreads, the diabetes worsens, or the heart attack occurs.
Doesn’t it make sense to have health care coverage for those that need it most first?
Ask your health care reform questions here
Article Tags
2014 • cancer • care source • diabetes • health care plan • health care reform • health care system • heart disease • Medicaid • poverty • Preventive Care • Senate Finance Committee • underserved
CQ Roll Call Group Forum: Expanding Health Care Coverage to all Americans
Author : Janet Grant
Oct 13th, 2009 | by
CareSource is the exclusive host of the CQ/Roll Call group event on Capitol Hill titled “CQ Roll Call Group Forum: Expanding Health Care Coverage to all Americans.”
Keynote Speaker (confirmed): Senator Jay Rockefeller
Panel Moderator: Morton Kondracke, Executive Editor for Roll Call/CQ
This forum will examine how poverty impacts the way people access health care –and how providing coverage is only the first step to promoting healthy outcomes. The Roll Call Group forum will include a keynote speaker (Sen. Jay Rockefeller), a panel discussion with industry leaders, public interest groups, and leading experts on health care reform.
After the keynote address, we will be conducting an experiential learning session where attendees will participate in a “poverty simulation” which will offer a glimpse of the daily realities faced by low-income families.
Title: CQ Roll Call Group Forum: Expanding Health Care Coverage to all Americans
Place: Hyatt Regency on Capitol Hill
Description: This forum will examine how poverty impacts the way people access health care –and how providing coverage is only the first step to promoting healthy outcomes.
Date: October 26, 2009
Time: 8:00a – 11:00a
Ask your health care reform questions here
Article Tags
Congressional Quarterly • CQ • CQ Roll Call • CQ Roll Call Group • health care coverage • health care reform • Hyatt Regency • Mort Kondracke • poverty • Roll Call • Senator Jay Rockefeller • Washington DC
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.
