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New Report: 4 in 10 QHP Issuers Operate a Medicaid Plan in the Same State

A new ACAP analysis finds that of the 335 Qualified Health Plan issuers offering Marketplace plans in 2016, 137—or just over 40%—offer Medicaid managed care coverage in the same state. A closer analysis of the results, however, suggests that many individuals – even those residing in states with large numbers of overlap issuers – have limited access to plans that operate in both Medicaid and the Marketplace, as many overlap issuer plans are only offered regionally. 

Read the report >   Spreadsheet of QHP Issuers (Excel) >   Press release >

ACAP Applauds Preservation of Risk-Adjustment Fixes in Medicare Advantage Final Call Letter

ACAP CEO Margaret A. Murray made the following statement about the 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter recently issued by the Centers for Medicare & Medicaid Services (CMS):

“With this final notice, CMS has addressed the flaw in its risk adjustment system that had led to systemic underpayments for health plans serving full-benefit dual eligibles—who are among the poorest, sickest, and most vulnerable Medicare beneficiaries.

“This fix will help Safety Net Health Plans and others to continue their mission to bring integrated services to full-benefit dual eligibles through coordinated, accessible, high-quality care—as is the intent of the Dual Eligible Special Needs Plan program as originally passed in the Medicare Modernization Act." Full statement >

ACAP Marks Six Years of the Affordable Care Act

On the six-year anniversary of the enactment of the Affordable Care Act, ACAP CEO Margaret A. Murray issued a statement that read in part:

"At the time President Obama signed [the ACA] into law, about 1 in 6 Americans lacked access to health coverage--despite the fact that America spends far more on health care than any other country in the world. Thanks to the expansion of Medicaid programs in states around the country and subsidized coverage through Marketplaces, the proportion of uninsured is now more like 1 in 10 – and dropping. That’s an overdue step in the right direction.

“However, improving our health care system is a continuous process, not a one-and-done proposition. Working with its 56 member Safety Net Health Plans – including seventeen offering coverage as Qualified Health Plans through Marketplaces – ACAP has developed a number of specific proposals that can further improve health coverage and consumer choice." Read the proposals > 

39 Organizations Voice Support for 12-Month Continuous Enrollment in Medicaid, CHIP

Thirty-nine allied health organizations recently submitted a letter to leaders in the House and Senate urging them to pass legislation that would provide for 12 months’ continuous eligibility for Americans in the Medicaid and Children’s Health Insurance Programs (CHIP). 

The legislation – H.R. 700 in the House, introduced by Reps. Gene Green (D-Texas) and Joe Barton (R-Texas), and S. 428, introduced by Sen. Sherrod Brown (D-Ohio) – addresses “churn,” a phenomenon where people with Medicaid and CHIP coverage lose their eligibility because of bureaucratic paperwork issues or short-term changes in income. Read the letter > | Press release > 

Medicaid Managed Care Is Accountable Care:
Reporting Prevalence by Program Type

Source: CMS Medicaid Managed Care Enrollment Reports, 2013 | see more >

Charles King of Housing Works Wins 2016 ACAP Leadership in Advocacy Award

The Association for Community Affiliated Plans (ACAP) today named Charles King, President and Chief Executive Officer of Housing Works, Inc., the winner of its Leadership in Advocacy Award. Housing Works is an organization dedicated to ending the dual crises of homelessness and AIDS through relentless advocacy, the provision of lifesaving services, and entrepreneurial businesses that sustain its efforts. Mr. King co-founded Housing Works in 1990 to serve the thousands of homeless people in New York City who were living with HIV/AIDS at the time. Since it was founded, Housing Works has served more than 20,000 homeless and low-income New Yorkers living with HIV/AIDS and currently serves over 5,000 people each year. Read more >

ACAP Lauds Introduction of S. 2438, The Medicaid and CHIP Quality Improvement Act of 2016

In a recent statement, ACAP CEO Margaret A. Murray applauded the recent introduction of S. 2438, the Medicaid and CHIP Quality Improvement Act of 2016:

“Safety Net Health Plans are strongly supportive of Senator Brown’s introduction of legislation that will establish a nationwide system of quality measurement, reporting, and improvement across all Medicaid program delivery systems, including managed care, fee-for-service, and primary care case management.  

“The benefits of this legislation are readily apparent: greater visibility into the quality of the Medicaid program will help us to get the most benefit out of the federalized nature of the program – because Medicaid is different in all 50 states, a richer set of quality data will give us a better idea of what’s working well, and what needs improvement... We are grateful to Senator Brown for his considerable leadership in introducing this bill, and urge his fellow Senators to support it as well." Full statement >

Outdated Privacy Regulations Impede Care Coordination for People with Substance Use Disorder

A new ACAP report examines how Federal regulations interact with health plan efforts to coordinate care for their members with substance use disorder, or SUD. Among the Federal regulations relevant to health plans seeking to deliver coordinated care to their members are those found in Title 42, Part 2 of the Code of Federal Regulations—42 CFR Part 2, or “Part 2”. These regulations are intended to safeguard the confidentiality of patient records concerning alcohol and substance abuse treatment records. 

Read the report >
     Strategies to Reduce Prescription Drug Abuse >