| | Quote of the Week: "The sense of danger must not disappear: The way is certainly both short and steep, However gradual it looks from here; Look if you like, but you will have to leap."
- From W.H. Auden's poem Leap Before You Look |
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In This Issue |
News Items By Susan Jaffe Kaiser Health News February 9, 2012 Thanks to a provision in the Affordable Care Act (ACA), the days of wading through the fine print in a document the size of the Manhattan phone book to try to figure out your private insurance benefits are almost over. As of September 23, 2012, the Obama administration will require all insurers and employers that offer health insurance to provide a new "Summary of Benefits and Coverage." These summaries, which must use standardized language to provide the same details for every policy to make it easier for purchasers to compare plans, must be consumer friendly and written in simple English. Fine print is not allowed, and examples of coverage in the form of consumer insurance labels (modeled after the nutritional labels found on most packaged foods) must be included. The prices of policies will not be part of the descriptions. The final regulations governing the "Summary of Benefits and Coverage" were released on February 14, 2012.
It's noteworthy that the November 2011 Kaiser Health Tracking Poll reports this is the most popular provision of the ACA. By Alison A. Galbraith, Stephen B. Soumerai, Dennis Ross-Degnan, Meredith B. Rosenthal, Charlene Gay, and Tracy A. Lieu Journal of General Internal Medicine January 18, 2012 Employers offer high-deductible health plans as a way to control their health insurance costs. For employees, their health insurance premiums are lower but they will incur higher out-of-pocket costs, typically $1,000 - $6,000, before the health plan contributes towards the costs of health care. Researchers at Harvard Medical School and Harvard Pilgrim Health Care Institute, Harvard School of Public Health, and Children's Hospital Boston investigated the effect of high-deductible health plans on families who have members with chronic conditions to see if enrollment in these plans meant they delayed care or went without needed health care. They surveyed families with adults or children with chronic illnesses enrolled in high-deductible and traditional health plans and found several associations. Overall, families enrolled in high-deductible plans were about three times more likely to delay or forgo care as families enrolled in traditional health plans. Families in high-deductible plans whose income was less than 400% of the federal poverty level (less than $92,200 for a family of four) delayed or went without care for family members with chronic illnesses 40% of the time, compared to 16% for families in traditional plans. Families with income more than 400% of the federal poverty level delayed or went without care 16% of the time, compared to 4.8% of families in traditional plans. |
Resources By Howard K. Koh, Donald M. Berwick, Carolyn M. Clancy, Cynthia Baur, Cindy Brach, Linda M. Harris and Eileen G. Zerhusen Health Affairs January, 2012 Health literacy is the ability to understand and appropriately make decisions based on health care information. According to the U.S. Department of Health and Human Services (HHS), 35% of adults have basic or below basic health literacy skills. Improving health literacy not only ensures that individuals have the knowledge and skills to make informed decisions and enjoy better health outcomes, but also ensures the health care system is more efficient and cost-effective due to increased preventive care, fewer medication errors, and less use of emergency care. The authors emphasize that improving health literacy is not just an issue of concern to patients. Health information and health systems are complex; they need to implement system-level changes that contribute to efforts to improve health literacy. The Affordable Care Act (ACA), the National Action Plan to Improve Health Literacy, and the Plain Writing Act of 2010 focus on improving health literacy as a way to help break the cycle of "crisis care" by improving access, quality, and cost of care by making written materials easier to read, improving the way providers communicate with patients, and helping patients develop skills to manage chronic conditions. By Kathryn L. Santoro, Claire Speedling, Julie Schoenman, and Carolyn Myers, under the direction of Nancy Chockley National Institute for Health Care Management (NIHCM) October 2011 Adolescence is a time of major developmental growth, during which one important task is learning to make independent decisions that support health and wellness into adulthood. Getting, understanding and using accurate health information (also known as health literacy) is key to achieving this developmental milestone. This brief reports on the consequences of a lack of health literacy among adolescents and describes the increasing impact of health disparities on adolescents as this population has become more racially and ethnically diverse than the general population. The authors include an overview of two federal initiatives, the National Stakeholder Strategy for Achieving Health Equity by the National Partnership for Action to End Health Disparities and the National Action Plan to Improve Health Literacy by the U.S. Department of Health and Human Services, that help promote health literacy. They also include examples of ways health plans and foundations are collaborating in these initiatives to develop and fund strategies targeted for improving the health literacy of teens. These include development of online health literacy tools, use of social media, teen-specific newsletters, and information to educate providers about ways to ensure adolescents understand health information. By Cindy Brach, Benard Dreyer, Paul Schyve, Lyla M. Hernandez, Cynthia Baur, Andrew J. Lemerise, Ruth Parker Institute of Medicine (IOM) January 27, 2012 A health literate organization is designed to help the public better understand, access, and use the services provided by the health care system. This discussion paper from the IOM presents ten attributes of effective health literate organizations, along with specific examples. It is targeted at a broad array of stakeholder organizations, including primary and specialty care providers, hospitals, and public and private payers. It also offers an extensive list of resources to support increasing health literacy in organizations. By Ashweeta Patnaik, Timothy R. Elliott, Darcy M. Moudouni, Constance J. Fournier, Emily Naiser, Thomas R. Miller, James A. Dyer, Catherine Hawes, and Charles D. Phillips Rehabilitation Psychology November 2011 Researchers at Texas A&M University knew that families were often unhappy about the amount of Personal Care Services (PCS) hours their Medicaid-enrolled children with intellectual disabilities (ID) received, because it did not match their reported need. Additionally, throughout the state there was significant variation in how children with ID were evaluated for PCS hours, despite a known relationship between the level of severity of ID and limitations in activities of daily living (ADLs) as an accurate predictor for the number of PCS hours needed. They developed an assessment tool that, for the first time, took into account the family's report of their child's needs and behaviors, including tendencies for verbal abuse, aggression, and bullying. For four months, Medicaid case managers used the tool to evaluate 2,694 Texas children for PCS. Data analysis showed that the assessment of caregivers' and children's strengths and limitations are necessary to interpret the number of PCS hours needed for each family, more so than the level of intellectual disability. The researchers also found that variability in the number of PCS hours depended, in part, on the differences in practice among case managers, and on the interaction between the family and the case manager. |
Events and Announcements The Catalyst Center and the National Academy for State Health Policy (NASHP) have pooled their expertise to create a user-friendly tutorial, specially written for Title V staff, family leaders, public health/maternal and child health students, and interested others. Go through each section sequentially, assessing your knowledge by taking a quiz at the end of each section, or focus on specific areas of interest such as partnerships between Title V and Medicaid staff, pathways to coverage, financing, service delivery models, quality measurement and improvement, or eligibility changes under the Affordable Care Act. You can test your newfound proficiency by playing a game of Medicaid/CHIP Jeopardy or completing the "Alphabet Soup" crossword puzzle. It's all available at Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and The Children's Health Insurance Program (CHIP). Health care transition doesn't just happen at home. Schools, where adolescents spend a majority of the day, can be an important partner in helping students prepare and plan for transition. Tune in to hear Eileen Forlenza, Family and Medical Home Director at the Colorado Department of Public Health and Environment and Cabinet Member for the National Health Care Transition Center, and Mallory Cyr, Got Transition? National Youth Coordinator, discuss how to use a student's IEP to help address health goals and keep transition student-centered. Register for this radio show. Listen to past Got Transition? broadcasts. |
News You Can Use from Our Partners RFP for Action Learning Collaborative (ALC) from AMCHP and the National Center for Ease of Use of Community-based Services AMCHP (the Association of Maternal and Child Health Programs) and the National Center for Ease of Use of Community-Based Services have issued a Request for Proposals (RFP) for an Action Learning Collaborative (ALC) to promote ease of use of community-based services for Latino families raising children and youth with special health care needs. The ALC is designed to: - Increase awareness and knowledge of the ease of use of services for Latino families and the essential role the Title V CYSHCN community plays in implementation;
- Build collaboration between state health, parent, and education agencies to strengthen ease of use for Latino families;
- Build the capacity of state health agencies to integrate efforts to make services easier to navigate for Latino families;
- Provide capacity building assistance to states to enable them to more effectively address the ease of use of services for Latino families;
- Facilitate change in knowledge, attitudes, practices, and policies;
- Provide "lessons learned" for other states interested in taking this approach.
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In case you missed it...here is the most popular news item from our last issue of the Week In Review Medicaid.gov Keeping American Healthy The Centers for Medicare and Medicaid Services (CMS) is funding five Medicaid and CHIP (Children's Health Insurance Program) Learning Collaboratives. Selected states will work with CMS to improve the design and operations of their Medicaid programs. The learning collaborative focus areas will address: - Expanding Medicaid eligibility and enrollment under the Affordable Care Act (ACA);
- Early innovators in information technology infrastructure to ensure ease of use for the health exchanges;
- Use of data to evaluate program performance;
- Information technology; and
- Value-based purchasing.
Learn more about each collaborative and see the lists of participating states.
To view more articles from past issues of the Week In Review, visit the Catalyst Center website. If you have suggestions for news items related to coverage and financing of care for CYSHCN please email Week In Review editor and Catalyst Center Assistant Director Beth Dworetzky by 12 pm EST on Friday at [log in to unmask]. Back to Top |
The Catalyst Center is a national center dedicated to improving health care insurance and financing for Children and Youth with Special Health Care Needs (CYSHCN). For more information please visit us at www.catalystctr.org or contact Meg Comeau, Program Director at [log in to unmask]. The Catalyst Center Health & Disability Working Group Boston University School of Public Health 715 Albany Street Boston, MA 02118-2526
The Catalyst Center is funded under grant #U41MC13618 from the Maternal and Child Health Bureau, Health Resources and Services Administration U.S. Department of Health and Human Services. |
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