Tag Archive for benefits

Veterans Access Federal Benefits, Save States Millions

One man’s effort in Washington state to help veterans find federal benefits has grown into independent efforts by dozens of states. Repurposing an existing reporting tool, states are not only connecting veterans to better benefits, but also saving millions in Medicaid costs. 

Washington state’s Public Assistance Reporting Information System (PARIS) allowed them to identify war veterans who were enrolled in Medicaid but not taking advantage of federal veterans’ benefits. The state then notified them of the benefits to which they were entitled, and moved them off of state Medicaid and onto federal program.

Since 2004, Washington state has saved more than $30 million using this system, while helping veterans get access to more comprehensive care.

History of PARIS

PARIS, a 20-year-old system operated by the U.S. Department of Health and Human Services’ Administration for Children and Families, was originally intended to help states identify Medicaid recipients who were cheating the system by applying for benefits in multiple states.

In 2002, Bill Allman, then an employee of the Washington Department of Social and Health Services, began looking for a way to see if the veterans he was helping were eligible for federal veterans’ benefits.

The information he was looking for was in PARIS. Using the system in a way no one had thought to try before, Allman, now the president of PARIS, realized savings for his state and greater benefits for the veterans he was helping. Allman launched the Veterans Benefit Enhancement Project, now a core component of PARIS. He now advises more than 30 states looking to realize the same savings he found for the state of Washington.

“Medicaid dollars, particularly long-term medicaid dollars, are going up at the rate of 200 to 250 percent,” Allman said. “By 2015, it will go up by 300 percent.”

As Medicaid costs rise and an increasing number of veterans are unable to pay back their long-term care Medicaid loans, the state is often forced to put liens on veterans’ homes. There’s no reason for veterans to be put in a position like that, Allman said, especially when they may not need to be on Medicaid in the first place. “When we tell them about the benefits they’re entitled to, they always say the same thing,” Allman said. “They say, ‘Why did no one tell me about this before?'”

Following the PARIS mandate

All states are now required to participate in PARIS, per a 2010 mandate from the Centers for Medicare and Medicaid Services. Naturally, states want to get the most out of the system they are required to use, by following Allman’s lead. “I want every state to do this,” Allman said. With the Affordable Care Act, Allman pointed out, states will need to offer health care options to all citizens anyway, so it would be in the states’ best interest to shift some of the support to the federal level.

Officials in more than 30 states are now in various stages of implementing the Veterans Benefit Enhancement Project.

California ran a pilot program from 2009 to 2011. Limited to a handful of counties, the pilot  focused on veterans classified as 100 percent disabled, saving the state $1.6 million. A report on the pilot deemed the program cost-efficient and suggested that it be expanded.

One of the biggest challenges in California was dealing with large sets of overlapping data. While more than 16,000 matches were initially identified as potentially eligible to be moved to federal benefits, duplicates and other complications reduced that number to just 4,000. Of those, just 990 veterans were contacted to gather further information on their eligibility. In the end, just 24 veterans were taken off Medi-Cal and moved to federal benefits. The savings to the state were significant, however, and the veterans also benefitted as they could now pay living expenses with VA benefits, which never need to be repaid.

The program continues to be effective in California, but Manuel Urbina of the California Department of Health and Human Services Medi-Cal Eligibility Division said the state needs dedicated personnel in order to expand implementation. “For this to be successful,” Urbina said, “the state experience has been that you need people to do dedicated case management. … The return on investment equation is there. We didn’t invest hardly anything, and we got this large return, so the potential is there.”

Additional outreach needed

What the Veterans Benefit Enhancement Project does is very basic, Allman said. The program is simply identifying veterans who would benefit from federal funding and then educating them. The problem for states is identifying who those veterans are. A report by the U.S. Government Accountability Office (GAO) found that 62 percent of veterans may be eligible for enhanced monthly VA benefits, but only 22 percent of veterans receive those benefits. The GAO recommended that the VA conduct more focused outreach to educate veterans in order to address the disparity.

“It bothers me that states don’t do outreach on their own or that the VA doesn’t do some kind of national campaign to help veterans understand what the benefits are,” Allman said. “So I think it’s up to the states to do the outreach for the VA.” Being a veteran himself, and passionate about helping people, Allman said that the money states can save through this program has always been a secondary consideration to him. He concedes, however, that the potential savings is compelling motivation for states to educate their veterans and consider adopting his system.

You may use or reference this story with attribution and a link to
http://www.govtech.com/Veterans-Access-Federal-Benefits-Save-States-Millions.html

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Health Insurance Exchanges: Benefits, Challenges, Lessons

On Thursday, Jan. 10, Government Technology hosted its first TweetChat: Innovation in Focus – States and Health Insurance Exchanges.

The chat, held on Twitter using the hashtag #GTonHIX, included industry experts John Sweeney, IBM’s senior product manager for the Curam solution, and Dan Schuyler, director for Leavitt Partners’ health insurance exchange practice, to answer questions about state health insurance exchanges (HIX).

An HIX is a government-regulated, standardized marketplace for the purchase of health insurance, and the Obama administration mandates that each state have one. States may choose to create and run their own HIX, or they can opt out and have the federal government create their exchange for them.

States had to declare whether they were running their own exchange by Dec. 14, 2012. And according to the National Conference of State Legislatures, as of Jan. 4, 2013, 19 states, including the District of Columbia, submitted blueprints for HIXs to the U.S. Department of Health and Human Services, which must approve the plans. Under the mandate, all insurance exchanges must be fully operational by Jan. 1, 2014. 

As the deadline looms, states may have pressing questions about what needs to happen by 2014. Here are some of the discussion highlights:

1.    What are the benefits for both states and their citizens in building these exchanges?

2.    Are there any lessons learned from states that have implemented or are in the process of implementing an exchange?

3.    What are the technical challenges the states face in implementing HIXs?

4.    How different will the HIXs be across states?

5.    How can states maximize the cost benefits of implementing these HIXs?

Photo from Shutterstock 

You may use or reference this story with attribution and a link to
http://www.govtech.com/health/Health-Insurance-Exchanges-Benefits-Challenges-Lessons.html

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As Obama goes so go many groundbreaking ACA benefits

The presidential election holds potential to alter the Patient Protection and Affordable Care Act’s (ACA) fate.

For most of the ACA’s impactful benefits to be realized, President Barack Obama must be re-elected, because GOP nominee Mitt Romney has spent many months campaigning on the promise that he will repeal the ACA on his first day in office.

Acknowledging that the health reform law “is not the end of efforts to improve healthcare,” the Democratic Party National Platform lays out the vision to “continue to fight for a strong health care workforce” by “emphasizing primary care,” and “eliminating disparities in health” as well as strengthening Medicaid.
That last phrase also shows up in the Republican’s National Party Platform, which lists ‘Strengthening Medicaid in the states’ as one of its top two tenets; the other is ‘Saving Medicare for future generations.’

[One-liner: Health IT in the Democratic platform. And Don’t blink: What health IT means to the GOP.]

Both platforms are indicative of parties looking toward the future. Indeed, the health reform law will become more popular over time as it is put in place and people use its benefits, according to an advisor for the Obama campaign. “People get used to the law, and they become dependent upon it. And it becomes very hard to repeal it,” said Chris Jennings, who is also president of Jennings Policy Strategies Inc. and former senior healthcare advisor to former President Bill Clinton, at a recent conference sponsored by the Bipartisan Policy Center. Historically, the initial response to Social Security and Medicare were similar.

Individuals and families are already taking advantage of ACA benefits, namely young adults staying on their parents’ plans until they are 26; insurers unable to refuse to cover children with pre-existing conditions; and seniors able to close the funding gap known as the “donut hole” for prescription drugs.

The 2012 Democratic National Platform, released Sept. 4, also highlighted provisions, such as preventive screenings for women and contraception with no out-of-pocket costs; small businesses receiving tax credits to help them cover their workers, and insurers paying rebates to businesses and families when they are overcharged based on the ratio of medical-to-administrative costs.

As more elements of the health reform law take effect, insurers will no longer be able to deny coverage based on pre-existing conditions; Medicaid will cover more working households; and those who don’t get insurance through an employer will shop for coverage on exchanges and may be eligible for tax credits to help afford it.
The re-election of Obama will offer more certainty that those elements will be realized.

Whereas the Democratic platform views health care as a linchpin for economic prosperity and security “so people, business and government are not constrained by rising costs,” the Republicans offer stark contrast.
Romney pledged in his speech in accepting the GOP nomination to repeal and replace the Affordable Care Act, which the Supreme Court recently upheld for the most part. In addition to repealing the law, Romney has indirectly supported strong cuts for Medicaid through calling for its conversion to a block grant program, Jennings said.

[Survey analysis: Romneycare vs. Obamacare, do Americans care?]

Not only would the millions of citizen who stand to gain coverage under the ACA lose it, but many who are currently covered could see reduction or elimination of such coverage.

“It means a shifting of cost and burden to people and to states and fundamentally undermining the insurance market and making it even worse than what we already have,” Jennings said (pictured at right).

For Republicans, however, the effect of the Supreme Court decision on health reform feeds into the GOP view that the elections will be about choosing “big government or not so big government,” said Tom Scully, general partner, Welsh Carson Anderson & Stowe, senior counsel, Alston & Bird; and a Romney campaign designee. He was also an administrator of the Centers for Medicare and Medicaid Services under former President George W. Bush.

Scully doesn’t anticipate hearing a lot of details revealed about health care between now and the election. The perception of the health reform law is more about “taking on a massive entitlement expansion and massive growth of the federal government.”

“Doing massive entitlement expansion, even though it may be something you morally believe in, is not responsible,” Scully said, with debt and entitlement spending at unsustainable levels.
“Someone has to take leadership in fixing our national problems,” he added. “You can’t punt everything forever.”

For the Republican view, reining in healthcare costs is about state-based and market incentives.

“Money is getting tighter across the board. Even with Democratic governors, the world is moving to capitation and Medicaid managed care,” Scully said. It makes sense shifting to a third party contractor and reducing risk, referring to them as “private managed care bundlers.”

Scully knows about entitlement expansion. As CMS administrator, he was instrumental in shepherding the Medicare modernization law and the prescription drug plan, which favored using the market to provide services.

[Related: Political strategists on how candidates should shape healthcare messages in the election.]

“In Part D, once you came up with the money, and if the structure can work and provide the services they predict that they can manage and market, they will show up,” Scully said.

For the Obama administration, it was important to have broad healthcare industry and consumer support for the health reform legislation to make the market work, Jennings said.

“Coverage is a moral imperative, but that really wasn’t their driver. Theirs was to make sure people were in the system so you can have plans compete on cost and quality and not on their ability to avoid certain people, which creates all sorts of strange and warped incentives,” Jennings said. “We can have a discussion of allocation of resources and making it work, but the fundamentals of coverage, exchanges, insurance reform, tax credits are all pillars to make the system work.”

And a number of those pillars will likely die or survive depending on the outcome of Tuesday, November 6, 2012.

View the original article here

As Obama goes so go many groundbreaking ACA benefits

The presidential election holds potential to alter the Patient Protection and Affordable Care Act’s (ACA) fate.

For most of the ACA’s impactful benefits to be realized, President Barack Obama must be re-elected, because GOP nominee Mitt Romney has spent many months campaigning on the promise that he will repeal the ACA on his first day in office.

Acknowledging that the health reform law “is not the end of efforts to improve healthcare,” the Democratic Party National Platform lays out the vision to “continue to fight for a strong health care workforce” by “emphasizing primary care,” and “eliminating disparities in health” as well as strengthening Medicaid.
That last phrase also shows up in the Republican’s National Party Platform, which lists ‘Strengthening Medicaid in the states’ as one of its top two tenets; the other is ‘Saving Medicare for future generations.’

[One-liner: Health IT in the Democratic platform. And Don’t blink: What health IT means to the GOP.]

Both platforms are indicative of parties looking toward the future. Indeed, the health reform law will become more popular over time as it is put in place and people use its benefits, according to an advisor for the Obama campaign. “People get used to the law, and they become dependent upon it. And it becomes very hard to repeal it,” said Chris Jennings, who is also president of Jennings Policy Strategies Inc. and former senior healthcare advisor to former President Bill Clinton, at a recent conference sponsored by the Bipartisan Policy Center. Historically, the initial response to Social Security and Medicare were similar.

Individuals and families are already taking advantage of ACA benefits, namely young adults staying on their parents’ plans until they are 26; insurers unable to refuse to cover children with pre-existing conditions; and seniors able to close the funding gap known as the “donut hole” for prescription drugs.

The 2012 Democratic National Platform, released Sept. 4, also highlighted provisions, such as preventive screenings for women and contraception with no out-of-pocket costs; small businesses receiving tax credits to help them cover their workers, and insurers paying rebates to businesses and families when they are overcharged based on the ratio of medical-to-administrative costs.

As more elements of the health reform law take effect, insurers will no longer be able to deny coverage based on pre-existing conditions; Medicaid will cover more working households; and those who don’t get insurance through an employer will shop for coverage on exchanges and may be eligible for tax credits to help afford it.
The re-election of Obama will offer more certainty that those elements will be realized.

Whereas the Democratic platform views health care as a linchpin for economic prosperity and security “so people, business and government are not constrained by rising costs,” the Republicans offer stark contrast.
Romney pledged in his speech in accepting the GOP nomination to repeal and replace the Affordable Care Act, which the Supreme Court recently upheld for the most part. In addition to repealing the law, Romney has indirectly supported strong cuts for Medicaid through calling for its conversion to a block grant program, Jennings said.

[Survey analysis: Romneycare vs. Obamacare, do Americans care?]

Not only would the millions of citizen who stand to gain coverage under the ACA lose it, but many who are currently covered could see reduction or elimination of such coverage.

“It means a shifting of cost and burden to people and to states and fundamentally undermining the insurance market and making it even worse than what we already have,” Jennings said (pictured at right).

For Republicans, however, the effect of the Supreme Court decision on health reform feeds into the GOP view that the elections will be about choosing “big government or not so big government,” said Tom Scully, general partner, Welsh Carson Anderson & Stowe, senior counsel, Alston & Bird; and a Romney campaign designee. He was also an administrator of the Centers for Medicare and Medicaid Services under former President George W. Bush.

Scully doesn’t anticipate hearing a lot of details revealed about health care between now and the election. The perception of the health reform law is more about “taking on a massive entitlement expansion and massive growth of the federal government.”

“Doing massive entitlement expansion, even though it may be something you morally believe in, is not responsible,” Scully said, with debt and entitlement spending at unsustainable levels.
“Someone has to take leadership in fixing our national problems,” he added. “You can’t punt everything forever.”

For the Republican view, reining in healthcare costs is about state-based and market incentives.

“Money is getting tighter across the board. Even with Democratic governors, the world is moving to capitation and Medicaid managed care,” Scully said. It makes sense shifting to a third party contractor and reducing risk, referring to them as “private managed care bundlers.”

Scully knows about entitlement expansion. As CMS administrator, he was instrumental in shepherding the Medicare modernization law and the prescription drug plan, which favored using the market to provide services.

[Related: Political strategists on how candidates should shape healthcare messages in the election.]

“In Part D, once you came up with the money, and if the structure can work and provide the services they predict that they can manage and market, they will show up,” Scully said.

For the Obama administration, it was important to have broad healthcare industry and consumer support for the health reform legislation to make the market work, Jennings said.

“Coverage is a moral imperative, but that really wasn’t their driver. Theirs was to make sure people were in the system so you can have plans compete on cost and quality and not on their ability to avoid certain people, which creates all sorts of strange and warped incentives,” Jennings said. “We can have a discussion of allocation of resources and making it work, but the fundamentals of coverage, exchanges, insurance reform, tax credits are all pillars to make the system work.”

And a number of those pillars will likely die or survive depending on the outcome of Tuesday, November 6, 2012.

View the original article here

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