Tag Archive for public

Can Sports Teams Help Inform the Public About Health Exchanges?

It’s a Wednesday night in Boston, and Amy O’Leary is out at Fenway enjoying a Red Sox game and hoping for another year like 2007. That’s when the team won the World Series, sweeping the Colorado Rockies in four games.

It’s also the year that Massachusetts started requiring nearly all residents to have health insurance — and the Red Sox helped to get the word out about it. They let the state set up booths at games to explain the new law to fans, and the Massachusetts Health Connector ran ads on Red Sox broadcast networks.

O’Leary remembers it well. “I think it made sense. People feel like they know the players,” she says. “I think that sports teams in general can be messengers of good information to a wide variety of people.”

Now that other states are opening health insurance marketplaces, they’re trying the same strategy. Myung Kim is outreach director for Colorado’s new health insurance marketplace, Connect for Health Colorado.

“People who care about being healthy, our young adult population, are big watchers of the sports shows, and we know are going to be an important population for us to reach,” Kim says.

Colorado is targeting young people — many of whom are uninsured — to help balance the insurance pool under the Affordable Care Act. Young people generally use fewer health services so their premiums will help the insurance companies cover the medical needs of older, sicker beneficiaries.

So the state is running television ads during Rockies baseball games that show people buying a health policy and then celebrating as if they’d just won sporting event. The voiceover in the ads says, “Connect for Health Colorado, because when health insurance companies compete, there’s only one winner: You.”

But while Colorado follows Massachusetts’ lead on advertising its new insurance marketplace, it is one of only 15 states independently setting up its own exchange. The federal government is fully or partially at the helm of the insurance exchanges in all the other states.

Mandy Cohen, with the federal Department of Health and Human Services, says it can be tough to reach young people who may not currently value having health insurance.

“We also know that they’re most heavily marketed to, so it’s really hard to break through to this group,” Cohen says. “We know we had to put an extra emphasis on the 18-to-35 year old cohort.”

But when the White House reached out to pro baseball, NASCAR and other sports organizations to discuss marketing partnerships, some Republicans called a foul. Senate Minority Leader Mitch McConnell sent the leagues a letter saying they, “risk damaging (their) inclusive and apolitical brand(s)” by promoting the federal health care law.

That didn’t happen in Boston, says Red Sox Vice President Charles Steinberg.

“We didn’t have negative feedback,” says Steinberg. “In American democracy we debate issues and we come to resolution and we pass laws. And those laws are designed to benefit the people. So when you can be a communicator of the laws of the land, you believe that you’re helping people.”

Still, the White House as of now has cancelled at least some of its meetings with sports leagues about potential partnerships.

In Colorado, the ads running during Rockies TV broadcasts haven’t stirred up any controversy. But they might not be home runs either.

The same night O’Leary was in Boston, Joan Ringel was at the Rockies game. She’s seen the ads on TV and says it’s kind of hard to even tell what they are selling.

“You wouldn’t know that that is Colorado’s exchange for the Affordable [Care] Act,” Ringel says. “I didn’t think they explained clearly that people need to pay attention to the exchange when it’s time to sign up.”

Open enrollment for Obamacare insurance starts in October — World Series time. The White House is hoping sports fans will also think of it as a chance to benefit from the Affordable Care Act.

This story was originally published by Kaiser Health News.

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Florida, LexisNexis Partner to Combat Public Assistance Fraud

Florida, the state with the highest per capita identity theft complaints, is experimenting with a new way to weed out potential fraudsters in its public assistance programs. If the federal government concludes that the program meets a civil rights review, then the model could spread to other states soon.

Florida is working with LexisNexis, a private company known for its digital archives of newspaper articles and legal documents, to pilot an automatic online identity authentication system for three types of public assistance: Medicaid, Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP).

The Florida Department of Children and Families (DCF) currently receives 90 percent of public assistance applications online, which entails a manual review of applicants’ self-reported information across multiple databases and a follow-up phone call. The LexisNexis model functions more like online financial services in the private sector, where software verifies a person’s identity based on a few items of personal information.

LexisNexis, which won the three-year, $2.9 million contract from Florida, uses a database it’s compiled of 500 million unique American identities to vet applicants. The company cross references a range of biographical information, including social security numbers, residential addresses, incarceration records and death certificates. The screening is automatic and based on four multiple choice questions (randomly selected from a pool of 35 possible questions). If a person fails the test, he or she can apply again through the manual online process, by mail or in person.

“What we’re trying to determine is that the person does exist, that it’s not a made-up identity and that they’re who they say they are,” said Susan Vitale, deputy secretary for DCF.

Last year, Florida recorded 69,795 identity theft complaints, equal to 361.3 complaints per 100,000 state residents, according to a February report from the Federal Trade Commission. About 1.6 percent of nationwide identity theft complaints, the report said, involved government benefits applications.

So far, the Florida pilot program is on pace to save the state of Florida close to $80 million, which is $50 million more than originally projected. If successful, the pilot would mark an important turning point for the detection of waste, fraud and abuse within public assistance. Rather than recouping money from someone already exploiting the system, this would stop it “upfront, at the door and not [let] them in,” Vitale said. “That is a very big paradigm shift.”

The pilot started in seven counties in Central Florida in March, and will go statewide in June. Florida had to request a waiver from the U.S. Department of Agriculture (USDA) to use the automatic online software to screen for identity theft in federal food stamp applications. Federal evaluators are monitoring the pilot to make sure that protected groups under civil rights law, such as minorities, the disabled and people with limited English skills, are not intimidated or discouraged by the automatic online screening. Florida is required to report back to the USDA on the pilot’s impact on protected groups through customer surveys, the tracking of complaints, community feedback and changes to the total number of SNAP participation.

Identity fraud in public assistance is “certainly something that you would want to prevent [and] to the extent that you can make online applications more secure, it’s a good thing,” said Elizabeth Lower-Basch, a policy coordinator and senior analyst with the Center for Law and Social Policy. “You just need to make sure that it doesn’t create burdens for people.”

Because the LexisNexis identity screening technology is so new in the world of public assistance, policymakers aren’t sure how it will impact participation rates just yet. Many of the factors that determine whether someone participates in public assistance are related to state economic conditions and the profile of the applicant, such as a person’s age, gender, level of income and education.

But governments can also affect someone’s likelihood of seeking public assistance. Past studies of SNAP by Mathematica Policy Research have demonstrated that people enter SNAP at higher rates if state governments perform outreach, expand their eligibility definitions or ease income reporting requirements. Last year, Gov. Andrew Cuomo singled out fingerprinting in his State of the State address as a screening method that he believes discourages participation in New York City’s food stamps program. (Mayor Michael Bloomberg defended the program, arguing it’s the best way to cut down on fraud.) Whatever the reason, analysis from the Food Research and Action Center suggests that many families living in poverty in urban areas qualify for food stamps, but don’t take advantage of the benefits.

Vitale insists that Florida’s program won’t hamper people trying to access benefits. “The idea here is to detect the fraud upfront,” she said, “but it is not to prevent people from applying.” For her part, Vitale suggested the convenience of applying online and the prospect of shorter processing times might increase participation.

If Florida’s experiment appears to reduce fraud without turning away people who are actually eligible, then other states might copy the program. Vitale said she’s heard from state officials in Wisconsin, Michigan, Texas and Pennsylvania that are all interested getting the same waiver to try out identity authentication. “We’re happy to lead the way,” she said, “and hope that other states will follow.”

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Kyle Janek Receives Bob Bullock Public Service Award

Kyle Janek, executive commissioner of the Texas Health and Human Services Commission, was awarded the 16th annual Bob Bullock Award for Outstanding Public Stewardship at the GTC Southwest conference on Tuesday, June 4, in Austin, Texas.

The Bob Bullock Award is presented each year to a Texas state executive or elected official for outstanding leadership, innovation and a career that demonstrates dedication to serving Texas citizens. Bob Bullock was a former Texas politician who during his career served as the state’s comptroller, lieutenant governor and secretary of state.

“[Bob Bullock] is a legend in Texas politics and he had a profound impact on the way policy is created and carried out,” Janek said. “It’s an honor to be thought of this way and receive an award named for such an iconic Texan.”

Janek was appointed Texas health and human services executive commissioner last September by Gov. Rick Perry. As head of the Health and Human Services Commission, he oversees five health and human services agencies, with more than 56,000 employees total and annual budgets of $30 billion, all while serving more than 4 million Texans, according to the commission.

Roughly a decade prior to taking his position as executive commissioner, Health and Human Services programs were distributed among various agencies and essentially siloed from Medicaid. After a major cross-agency consolidation, the programs were brought together under a single enterprise made up of multiple agencies and departments. As executive commissioner, Janek is tasked with overseeing the enterprise.

A practicing anesthesiologist since 1986, Janek’s career in public service began when he was elected to the Texas House of Representatives, where he took office in 1995 and served for eight years. He was elected to the Texas Senate in 2003 where he served for more than five years. According to Janek, since he was the only physician in Texas’ part-time Legislature at the time, he absorbed many health-care related duties, and served on the committee for public health. Janek remains a board-certified anesthesiologist today.

Janek said his experience in the medical field has helped shape the way he carries out operations in state government. Since he was formerly a Medicaid provider, he sees training and work experience from a provider’s perspective and understands how doctors think.

But by entering into government, he began to look at challenges from other angles and consider budgetary factors not solely from a medical perspective.

So what has been Janek’s strategy for success in the public sector?

Janek said he first ran for public office because he wanted to contribute his own ideas to government rather than hearing about decisions made after the fact.

“I was driven by the job and the opportunity to do things that actually had an impact when I was dissatisfied with the way government was performing,” Janek said. “So whether it was in the public sector or private sector, I enjoyed having a job that made a difference.”

AP Photo/Harry Cabluck

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Opinion: Can Google Analytics Replace Public Health Workers?

As big data becomes more sophisticated, the question about whether analytics tools — like those developed by Google — could someday replace data compiled by federal agencies.

A case in point is the Google Flu Trends website, which could someday become a suitable replacement for much of the work now performed by the Center for Disease Control (CDC).

That day, however, is not likely to come for a least a few years, according to a recent opinion article in the National Journal, although many agree there is great potential in such technology if it can be honed.

A comparison of Google’s flu trend graph and the CDC’s data shows a discrepancy in findings:

Google Flu Trends map
Google Flu Trends chart



CDC flu trends chart

While Google shows the current flu outbreak as being the worst of the past six years, the Center for Disease Control shows that the current outbreak is bad, but not as bad as outbreaks of at least two years past. Furthermore, the CDC graph shows that the outbreak is already on the decline. The discrepancy can be accounted for if one looks at the simplistic nature of Google’s data, according to the article.

The CDC uses a combination of data: reports of sickness across many disease control centers along with tweaks made by public health experts with years of experience. Google’s data is based off of search results that do their best to filter out search noise, but with limited success. The things that’s missing, according to the article? The human factor. And Google admits the tool is still in an early phase of development; it has a ways to go before it can compete with human data analysis.

“We intend to update our model each year with the latest sentinel provider [influenza-like illness] data, obtaining a better fit and adjusting as online health-seeking behavior evolves over time,” Matt Mohebbi, a Google software engineer recently wrote for Forbes. “With respect to the current flu season, it’s still too early to tell how the model is performing.”

But in the future, we could see a combination of the two, said Lynnette Brammer, a flu epidemiologist with the CDC. While there may never be a substitute for human decision-making, technology could save public heath workers a lot of time, she said. “We want the data transmission to be as easy for the people providing it to us as possible,” she said. “But the thing we don’t want is to lose the connection we have with those people. Even if you have really good data coming in, you’re always going to have questions about what it means.”

When comparing the two systems, one primarily run by people and the other by a machine, it comes down to understanding complexity. “It’s really hard, certainly for us at CDC, to understand what’s causing that change,” Brammer said. “They’re seeing pretty much record levels of influenza-like illness. And while ours are high, they’re not at historical limits by any means. We just have a lot more flexibility and ability to track down and ask additional questions and find the answers to those questions.”

Main photo courtesy of Shutterstock

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Virginia Launches Online Public Assistance System

Virginians in need of public assistance can now file for benefits online from the comfort and privacy of home.

The state launched CommonHelp, a self-service website that allows residents to apply for benefits, check on the status of applications or renew for assistance electronically. The system saves them the hassle of having to travel to a social services branch office to do paperwork and speeds the process of eligibility determination.

Developed in tandem by Deloitte and Virginia technology and social services staff, the site went live earlier this month. CommonHelp took approximately 18 months to build and can be used by citizens to apply for the Temporary Assistance for Needy Families program, child-care services, energy assistance, food assistance and some medical assistance.

“Virginians can now apply for our services 24 hours a day, seven days a week, from their homes, libraries, schools or anywhere the Internet is available to them,” said Virginia Department of Social Services Commissioner Martin D. Brown in a statement. “For some of our most vulnerable citizens, including the disabled and seniors, online services will make it easier to screen and apply for assistance.”

In an interview with Government Technology, Virginia Secretary of Health and Human Resources William A. Hazel said the change was necessary due to aging back-end processing systems and a huge uptick in the number of people applying for benefits the past few years. 

Hazel explained that three years ago, approximately 600,000 people were enrolled in Medicaid. But with the difficulties brought on by the recession, that number is now roughly 960,000. In addition, eligibility determinations have skyrocketed, with more than 1.2 million being done last year for Medicaid and another 1.1 million for the state’s Supplemental Nutrition Assistance Program (SNAP).

But as the applications have increased, the budget for staffing, benefit eligibility determinations and other related tasks has not. Hazel said the situation has increased the amount of time customers have to wait for their eligibility to be verified and a backlog of work on staff that turns into error rates on applications.

In 2009, the percentage of errors on a Medicaid eligibility application was 16 percent — pieces of information were missing, applications were incomplete, etc. That drove the decision to create CommonHelp.

“We were faced with the thought that we had to have a more permanent solution to provide better access to citizens and reduce the eligibility application [error] rates,” Hazel said.

“This ultimately is not simply about eligibility determinations,” he added. “It’s about better case management and providing a higher quality service and being able to measure the results of the services we provide.”

Deloitte’s involvement in the project began years ago. The company was originally brought on by the Virginia Department of Social Services to build a website so that residents could apply online for child-care benefits.

But as the Department of Health and Human Resources decided to integrate its siloed systems and transition to service-oriented architecture — a collection of Web services and technology components that can help connect disparate systems — the initial child-care project was expanded.

Deloitte used the original technology it developed for a similar project in Michigan and adapted it to fit Virginia’s needs.

Virginia staff was also a big part of the portal’s development. The language used on the website was vetted through test audiences to ensure words were understandable, and social service workers were consulted so that the system was intuitive even to users not familiar with computers.

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