The State of Illinois and Medical Home Network partner for improved care coordination

Last week the Illinois Department of Healthcare and Family Services and the Medical Home Network (MHN) announced an innovative partnership that could mean better care and lower cost of care for Medicaid beneficiaries.

MHN is one of the largest collaborations of safety net providers in the country working to deliver better coordinated care to vulnerable populations. Partnership with the State allows MHN to test promising delivery and payment innovations that impact approximately 170,000 Medicaid beneficiaries, who make up just less than 10 percent of the State’s total Primary Care Case Management (PCCM) Medicaid population and 11 percent of PCCM costs. The vast majority of these beneficiaries live on Chicago’s South and Southwest Sides, areas where healthcare is fragmented and health status is generally poor.

In addition to the State, this public-private partnership includes the second largest public health system (Cook County Health and Hospitals System), a renowned academic medical center (Rush University Medical Center), a hospital focused on chronically-ill children (La Rabida Children’s Hospital), three community hospitals, six Federally Qualified Health Centers (FQHCs) and an extensive physician network.

Already, MHN has begun to implement innovative technology called MHNConnect that drives meaningful improvement in care coordination by virtually connecting disparate providers serving the population. MHNConnect, a secure, web-based portal, sends real-time alerts on patient hospital activity to Medical Homes (primary care sites) and makes historical prescription and medical claims data available to providers at the point of care. Doctors’ moments of “if I only knew” are turning into “now I know.”

MHNConnect is an enhanced version of a platform that reduced hospital admissions by 31%, ED use by 34% and increased patients’ visits to their PCP by 29% when applied to an uninsured population in California. The MHN model of care has the potential to deliver better care at a lower cost. MHNConnect and other MHN initiatives are expected to significantly improve critical transitions of care by using real-time information technology to increase the percentage of patients who follow-up with their Medical Home within seven days of a hospital stay or visit to the emergency department (ED). MHN also anticipates reducing the populations’ annual ED visits (approximately 100,000 in a 12-month period) by preventing over 3,000 avoidable visits.

During the first day MHNConnect went live, a MHN Medical Home was able to identify a patient who frequently went to the ED for asthma complications but had not visited his primary care physician or filled a medication that could keep his condition under better control. New information from MHNConnect allowed the Medical Home to identify the patient, contact him to schedule an appointment and begin to manage the patient’s condition at his Medical Home.

Within the first three weeks of using MHNConnect, care coordinators at a second Medical Home were able to successfully schedule timely follow-up appointments after Inpatient Discharges and ED visits for 93% of patients with MHNConnect hospital activity. MHN is encouraged by dramatic results such as these, as well as initial positive feedback from patients and providers.

MHNConnect and other MHN initiatives are designed to improve care coordination, a key to improving quality and reducing cost. MHN expects to reduce total cost of care by 2-4% in year one. If projected savings are realized, the MHN model could serve as a delivery framework to meet the needs of similar communities across the country.

Funded by the Comer Science and Education Foundation, MHN is currently rolling out MHNConnect to additional sites. Read more at http://www.mhnchicago.org/node/21.

Cheryl Lulias
Executive Director, Medical Home Network

                

What does Health Care Reform mean for Small Businesses?

Your Bottom Line: What Healthcare Reform Means for Illinois Small Businesses
March 23, 2012 11:00 AM CDT

This webinar will focus on what the new federal healthcare law, the Affordable Care Act, means for Illinois small businesses. It will include both federal and state provisions to help local small business owners understand how the law will affect them.

We are excited for you to participate because this webinar will have special opening remarks by Marianne Markowitz, Regional Administrator for the U. S. Small Business Administration in Chicago. In addition, valuable information will be provided by ACCION Chicago, the Women's Business Development Center, the Campaign for Better Health Care and the Small Business Majority.

Topics being discussed include:
• Chicago area small business resources
• Small business tax credits— who’s eligible for them and how to claim them
• Illinois health insurance exchange and on going legislation that will directly impact on small businesses access to health insurance
• Prevention and wellness
• Shared responsibility
• Cost containment
• Tools and resources available for small businesses interested in learning more about the law.

Register for the webinar here.
For more information email Joyce Harant or call 309-648-3035.

Three Major Ways the ACA helps Young Adults with Special Health Care Needs

Many children with special health care needs and their families rely on the support of state and federal government programs or benefits to allow them to get the care they need. Without this governmental support, many of these children and young adults would be unable to go to school; their parents would be unable to work, or to live healthy lives. As children transition to adulthood, many of these support systems and benefits fall away. Most of these programs are offered only to children. In order to keep getting the care they rely on, these kids must attempt to find adult programs that offer similar benefits. Due to the differences in programs, as well as differences in eligibility criteria, many of these disabled young adults end up going without much of the care they would need to become healthy, integrated members of society. Needless to say, the process of transitioning from childhood to adulthood is a complicated and confusing one.

How will the ACA change the situation of “transition-age youth”?

1. Dependent Coverage: The ACA mandates that insurance companies must let kids remain covered by their parents’ health insurance up until age 26. For disabled young adults who have insured parents, this is good news. Many children with disabilities receive health care through programs offered only to children, so when those programs come to an end typically at age 19, they lose insurance coverage. Coverage under a parent’s insurance until age 26 would give the family time to secure other insurance options for their disabled child.

2. New Insurance Purchasing Power: Starting in 2014, health insurance companies will no longer be able to deny coverage due to a pre-existing condition, a problem that has caused many issues for transition-age youth with a history of pre-existing conditions looking to purchase insurance.. Additionally, the state health benefits exchanges will begin operations in 2014. These exchanges are predicted to create a consumer-friendly marketplace for individuals and families to purchase insurance options. Tax credits will be offered to citizens between 133-400% of the Federal Poverty Level, in order to offset the costs of plan premiums. So, a transition-age youth or the family of a disabled child looking to purchase insurance will have new consumer powers and protections to aid in doing so.

3. An Expanded Safety Net: The Medicaid expansion will begin January 1, 2014. Under the expansion, all adults with income below 133% of the federal poverty level will become eligible for Medicaid benefits. Often, children who are eligible for Medicaid due to a disability as a child are no longer eligible when judged by the different disability criteria that are applied to adults. The expansion will allow many disabled transition-age youth to keep their Medicaid benefits, regardless of their disability status.

CBHC Statewide Conference Call: Monday, March 12

Please register to join us for the Campaign for Better Health Care's next Statewide Conference Call: "We See What You Are Doing, and We Are Not Pleased: The Right's Attack on Women's Health" on Monday, March 12, 12 pm CST

The right has launched a series of blistering attacks on women's health care: within the past two weeks alone, we've seen their efforts to reduce access to contraception, to mandate unnecessary transvaginal ultrasound procedures for women seeking abortions, to slash funding for reproductive health clinics, and to demonize and defund organizations that provide women's reproductive health services, like Planned Parenthood. These ideological attacks are not just mere politics as usual from the right; they are a means to their true end game, destroying the Affordable Care Act.

On March 26, the Supreme Court will begin hearings on the constitutionality of the personal responsibility clause of the Affordable Care Act. Personal responsibility for the common good means that because everyone has insurance, no one gets to rig the system, everyone has equal skin in the game, and no one rides for free, including the insurance industry. It means that people can't enter the insurance pool only when they become sick, thereby draining the pool of dollars they haven't paid in previously. Making sure everyone pays equally so they can benefit equally is the only way we can keep a system of social insurance going. The opposition's argument against the personal responsibility clause of the Affordable Care Act is their argument against social insurance: how dare anyone force them to pay their fair share and take away their ability to rip the system off and raise costs for everyone else?

The attack on women's rights is not just about addressing health disparities for women, but gives us the opportunity in Illinois to fix racial disparities, income disparities, and other disparities in our current health care system. In building a competitive health care marketplace (insurance exchange) that addresses the disparities, we begin to take the necessary steps to correct them across the board. Women did not want this fight, but it was brought and we will win it by using this opportunity to build a health care system that provides quality, affordable health care for ALL.

Please join us on Monday, March 12 with our special guests Brigid Leahy, Director of Legislative Affairs at Planned Parenthood of Illinois and a spokesperson from the National Women's Law Center, to talk about the recent attacks on women's health and how they fit into the larger strategy of balancing the inequalities in our current system of health care.

Call Agenda
- CBHC Executive Director Jim Duffett updates us on the status of Illinois' Marketplace (the insurance exchange.)
- CBHC Communications Organizer Kathleen Duffy will give an overview of communications plans for the anniversary of the Affordable Care Act on March 23, and for the Supreme Court hearings March 26-28.
- Our guest speakers will discuss the benefits of the Affordable Care Act for women, connect the dots about how attacks on women's health is really an attack on the Affordable Care Act itself, and describe how our efforts to build equity into Illinois' marketplace are good for women, minorities, and everyone.
- And as always, your questions and comments for all our speakers, taken and answered.

The Statewide Conference Call Series is a free resource for advocates presented by the Campaign for Better Health Care. Please visit this link to register and join us on Monday, March 12. Your questions for our speakers can be submitted ahead of time as well!

The Affordable Care Act: Fulfilling Promises, Cutting Costs

Did you know that the Affordable Care Act has alreadyexpanded affordable preventive health coverage to 54 million Americans?

If you’ve been following the Shriver Brief health care blogs, you probably remember reading about the Affordable Care Act mandate that insurance companies provide a specified list ofpreventive health care services to policy holders without charging a co-payment or deductible. Services like screenings for blood pressure and cholesterol; testing for Type 2 diabetes, obesity, and colorectal cancer; and alcohol and tobacco cessation counseling, among others are included in the mandate. Additional preventive health services like childhood immunizations; screenings for hearing, vision, and oral health; as well as testing for autism, HIV, and obesity, among others must be provided free of co-payment for children’s care. And starting in August of this year, insured women will be able to receive a set of women’s preventive health benefits like well-woman visits, FDA-approved contraception, mammograms, breastfeeding support and supplies, and domestic violence screening and counseling, also without cost-sharing. The health reform law requires that all of these free preventive health services are provided by insurance companies for anybody with a new or a so-called “non-grandfathered” insurance plan. And the mostrecent research shows that people—tens of millions of people—are already receiving these preventive services, for free!

According to a study conducted by the Kaiser Family Foundation, “31% of all workers were covered by plans that expanded their list of covered preventive services due to the Affordable Care Act.” Using this data, the Department of Health and Human Services (HHS) was able to calculate just how many people are benefiting from expanded preventive health coverage across the country.HHS estimates that 54 million Americans—and counting—have received one or more of the Affordable Care Act’s mandated preventive health services free of co-payment or cost-sharing. This number breaks down to over 20 million women, 14 million children, and 19.5 million men making use of their increased access to affordable and essential preventive health care. Illinois was among the top five states to benefit the most, with almost 2.4 million Illinois residents receiving free preventive health care services! And this number will only continue to grow as more and more people choose to enroll in new or “non-grandfathered” health plans, and as the health reform lawrolls out its final stages in 2014, adding 16 million individuals to the private health insurance market.

These kinds of meaningful, money-saving provisions in the Health Reform law are making a real impact at a time of need, when many individuals and families affected by the recession have been resorting to cutting back on basic medical care to make ends meet. A Kaiser Family Foundation study conducted in 2009 found that 53 percent of American families were cutting back on medical care because of the cost. In 2010, the Commonwealth Fund reported that 25 percent of Americans were cutting back on recommended tests like blood pressure tests, colonoscopies, mammograms, and other potentially life-saving cancer screenings. And just recently, a study from the University of North Carolina’s medical school found that, during the height of the recession, adults between the ages of 50 and 64 received 500,000 fewer colonoscopies compared to the couple of years before the economy turned, even though the colonoscopies can cut the risk of dying from colon cancer in half. The good news is the Affordable Care Act is increasing access to many of these preventive health tests and screenings at a price Americans can afford.

Households all over the country are pinching pennies trying to stay afloat during hard economic times. Thank you, Affordable Care Act, for working diligently to make sure that nobody’s health is sacrificed because of the cost of care.

Coauthored by Caitlin Padula and Rachel Gielau.
This post was originally published as part of The Shriver Brief's weekly “Did You Know” blog series, which highlights important, but not well known features of the health reform law about prevention, wellness, and personal responsibility for our health.

Using Technology to Connect in New Ways in Illinois

According to the Pew Internet & American Life Project, 85% of all Americans 18 years and older own a cell phone; of these users, nearly a quarter (72%) of them “text”. A July 2011 report shows that nearly one-third of all adults are “smart phone” users.

Given that these statistics are only likely to increase as technology becomes more advanced and allows us to get information in even smaller and more portable devices, it’s important to consider how technology help in efforts to share important and relevant information, as well as connect individuals with services that fit their needs.

For the past two years, Text4baby, the first ever FREE mobile health service, has been using cell phones to share health tips with pregnant women and new moms. Moms sign up by texting BABY to 511411 (or BEBE to 511411 to receive messages in Spanish) to receive helpful messages that are timed to their due date or baby’s first birthday. These messages include reminders about check-ups, immunizations, oral health, and tips for good nutrition.

We here at the Illinois Maternal and Child Health Coalition serve as the statewide coordinator  and have been working with health departments, community clinics, doctors’ offices, as well as local businesses to promote text4baby. To date, we’ve helped enroll nearly 13,000 users into text4baby and have made FREE outreach materials available for order from our website. We’ve heard firsthand from text4baby users about how direct and simple the messages are and how helpful they can be, especially for first-time parents.

Of the many useful messages provided by text4baby, several of them provide users with information about how they can get no-cost or low-cost health insurance for their children by providing them with the toll-free hotline 1-877-KIDS-NOW (1-877-543-7669).

Parents who call the 1-877-KIDS-NOW number in Illinois will be connected with the All Kids program, which provides affordable health insurance to children who live in Illinois and meet income requirements. Parents can request an All Kids paper application to be sent to their address or they can fill out the online application.

Nearly 1.7 million children in Illinois benefit from the All Kids program, which covers doctor visits, prescription drugs, hospital and emergency services, dental and vision care, and more. Some parents may qualify for FamilyCare coverage for themselves and pregnant women may be able to get benefits from the Moms & Babies program.

Even if text4baby or the All Kids or other health insurance programs may not be something that you need, consider sharing these resources on your Facebook page or sending out a Tweet to your followers about the benefits of these programs. With your help, we can ensure that more women, children, and their families have the best opportunity to lead healthy and productive lives.

This post, by Kathy Chan of the Illinois Maternal and Child Health Coalition, was originally posted on the MomsRising,org blog, here. 

The ACA Expands Preventative Care for 2,390,000 Illinoisans

To many, the cornerstone of the Affordable Care Act (ACA) is its  emphasis on providing Americans with access to important preventative care. The benefits of preventative care have been discussed in this blog before, in the context of chronic disease ,  breast cancer and  cervical cancer.

How exactly, then, is the ACA expanding access to preventative health care?

 One instance is a provision under the ACA that requires insurance plans[i] to provide important preventative health procedures to beneficiaries, without any cost-sharing measures (such as co-pays). The U.S. Department of Health and Human Services recently released information on how this provision will benefit Americans.

The list of important preventative health procedures was determined based on guidelines from the U.S. Preventive Services Task Force. Due to the ACA, children have gained access to regular pediatrician visits, immunizations, important vision and hearing screenings and developments assessments, as well as screening for obesity and counseling on how to maintain a healthy weight. Both men and women have gained  access to recommended immunizations and flu shots; cancer screenings (including colonoscopies and, for women, pap smears and mammograms); obesity screening and  healthy diet counseling; screening for high blood pressure and high cholesterol, depression and HIV; and tobacco use counseling. In addition, starting in 2014, women will be covered sexually-transmitted infection screening, and other services specific to women, such as gestational diabetes screening and contraception.

While many people with health insurance were already covered for these preventative health procedures, many were not: 31% of those who had health insurance through their employer have seen an expansion in their benefits—that’s 54 million Americans! In Illinois, the impact is among the biggest: 605,000 children, 898,000 women and 887,000 men have gained new access to expanded preventative health care. That is 2,390,000 Illinoisans, total, who have directly benefitted from the prevention expansions in the ACA!

I am proud to serve on the Administration’s Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, established by the Affordable Care Act, where we will continue to develop policy and program recommendations, and advise the National Prevention Council on lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion

Barbara Otto

Health & Disability Advocates, Chief Executive Officer

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[i] Excluding plans that have Grandfather status