Michigan s Role in Realizing the Health Equity Promise of the ACA

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Kellie Todd
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1 Michigan s Role in Realizing the Health Equity Promise of the ACA QUYNH CHI NGUYEN PROGRAM & POLICY ASSOCIATE STAFF LEAD, HEALTH EQUITY 2014 Consumer Assistance Conference Lansing, Michigan September 29,

ASSOCIATE STAFF LEAD, HEALTH EQUITY 2014 Consumer

2 Community Catalyst Non-profit health care advocacy organization Work to promote health equity Network of advocates in 40+ states Build advocacy infrastructure Lead broad-based issue campaigns

of advocates in 40+ states Build advocacy

3 Health Disparities Prior to the Affordable Care Act (ACA) The uninsured rate peaked at 18.0% in the third quarter of 2013 (Source: Gallup Poll)

4 AFFORDABLE CARE ACT A STEP TOWARD HEALTH EQUITY STRONG PROTECTIONS AGAINST DISCRIMINATION IN HEALTH CARE PROGRAMS (ACA 1557) 2014

5 Key ACA Provisions to Advance Health Equity Non-discrimination provision (ACA 1557) Coverage expansion Better access to care Better quality and integrated care Community benefits 2014

6 Coverage Expansion Expansion of Medicaid eligibility Subsidies for private insurance in marketplaces Nationally, 12 million people are newly insured since October 2013 Source: US Department of Health and Human Services Marketplace and Medicaid Summary Enrollment Reports, May 1,

newly insured since October 2013 Source: US Department of Health and

7 Michigan: Coverage Expansion Medicaid expansion Starting April 1, 2014: An estimated 300,000 to 500,000 adults with income up to 138% of FPL covered through Medicaid program Private insurance through Federal facilitated marketplace 272,539 newly insured as of end of March percent are African American 1.6 percent are Latino 3 percent are Asian Source: Source: US Department of Health and Human Services Marketplace and Medicaid Summary Enrollment Reports, May 1,

272,539 newly insured as of end of March 2014 8 percent are African American 1.

8 ROLE OF CONSUMER ADVOCATES TO ASSIST PEOPLE CHOOSE THE RIGHT HEALTH CARE OPTION FOR THEMSELVES AND THEIR FAMILIES 2014

9 OEE Strategies to Hard-to Reach Populations Health insurance literacy strategies (trusted messengers such as promotoras, faith leaders, etc.) Getting the word out (local media outlets, word of mouth, etc.) In person assistance (CBOs, community health centers, etc.) 2014

10 Moving from Coverage Care

11 Better Access to Care Network adequacy standards with Essential Community Provider (ECP) inclusion Expansion of community health centers Support for school-based health centers 2014

12 Engagement Opportunities Improving network adequacy standards Collect stories how are these issues affecting people? Identify allies and build common ground Identify advocacy actions

13 Better Quality and Integrated Care Dual demonstration projects aim to improve care for approximately 10 million dual eligibles addressing health disparities and reducing cost 2014

14 The Opportunities of the Dual Demonstration Projects Fewer hospital readmissions Integration of long-term services and supports Better overall function Greater autonomy, dignity and independence Reduce health disparities Smart cost containment 2014

supports Better overall function Greater autonomy, dignity

15 Michigan s Dual Project: MI Health Link Starting January 2015 Approximately 104,000 dual eligibles in 4 regions Entire Upper Peninsula, Southwest Michigan (Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph and Van Buren counties), Wayne county, Macomb county Uses a care bridge to coordinate services between integrated care organization (medical and LTSS) and Prepaid Inpatient Health Plan (behavioral health)

Joseph and Van Buren counties), Wayne county, Macomb county Uses a care bridge to coordinate services

16 Engagement Opportunities Why is it important? Improves communication Expands promising practices Corrects potential, costly problems How to engage? Join MI Voices for Better Health Coalition Attend state regional forums to receive updates on the implementation (i.e. enrollment process)

COMMUNITY-IDENTIFIED NEED, PLACING PARTICULAR FOCUS

17 HOSPITAL COMMUNITY BENEFIT IMPROVE ACCESS TO HEALTH CARE AND/OR COMMUNITY HEALTH RESPOND TO A COMMUNITY-IDENTIFIED NEED, PLACING PARTICULAR FOCUS ON THE VOICES AND ISSUES FACING THE UNDERSERVED COMMUNITIES 2014

18 Community Health Needs Assessment Gather information about the community s health Define the community Involve the community and public health Implement programs and report yearly on progress Choose what needs to address; publish assessment

and public health Implement programs and report yearly on

19 Why Is It Worth the Effort? Community involvement can lead to a more effective program. Official stats alone don t tell the community s story Shifts community mindset from consumers of services to active agents for change Culturally appropriate programs and messaging Community leaders become ambassadors = more buy-in 2014

Official stats alone don t tell the community s story Shifts community mindset

20 2014

21 Recommendations Make health equity a priority Establish equity task force Build coalitions Develop shared equity policy agenda Forster meaningful engagement

22 Fostering Meaningful Engagement Process matters Connect to existing concerns and priorities Start at the beginning Resources and support Focus on concrete areas

23 Strengthening Partnerships Connect specific constituencies around the issues they most care about Policy makers Office Of Minority Health Health plans and providers Minority small business groups Faith based organizations and churches Immigrant groups

24 Thank You! QUYNH CHI NGUYEN:

How To Understand Why The Health Care Act Matters

How To Understand Why The Health Care Act Matters Why the Affordable Care Act Matters Mindy Owen RN, CRRN, CCM Phoenix HealthCare Assoc. LLC Coral Springs Florida Objectives The participant will be able to define the relationship between the ACA and the