Patient Navigator 2019 Launch Press Release
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Memo to the Biden Administration Transition Team
Memo to the Biden Administration Transition Team From: Trish Riley, National Academy for State Health Policy Executive Director Re: State-based marketplace strategies for insurance market stabilization and improvement Nov. 20, 2020 The National Academy for State Health Policy (NASHP), in close consultation with executives from state-based health insurance marketplaces (SBMs), has developed a list of priority actions that may: ● Lower costs and bring stability to individual and small group health insurance markets; ● Improve access to health insurance coverage; and/or ● Improve consumer experience when purchasing small group or individual market coverage. NASHP is home to the State Health Exchange Leadership Network, a consortium of state leaders and staff dedicated to operation of the SBMs. This list draws upon the experience of SBM leaders who have spent the past decade building and operating successful platforms for the procurement of health insurance coverage. These recommendations reflect NASHP’s collective discussions with SBM leaders, but do not reflect consensus across all SBMs. States value flexibility to design their programs to meet local needs and circumstances. For additional information specific to each state, please see Appendix A, which includes references to comments submitted by SBMs in response to various policy changes. We have also included the contact information for SBM executives who can provide additional information specific to their states. NASHP is ready to provide any additional information that may be helpful as you deliberate critically important issues related to health care coverage. Thank you for your time and consideration. Sincerely, Trish Riley Executive Director National Academy for State Health Policy 2 Monument Square, Suite 910, Portland ME 04101 1233 20th St NW, Suite 303, Washington, DC 20036 Phone: (207) 837-4815 State-Based Marketplace Recommended Areas for Priority Administrative Action in 2021 I. -
Implementing an Integrated Healthcare System in Kentucky
Implementing an Integrated Healthcare System in Kentucky Kentucky Public Health Leadership Institute Scholars: Leslie Aitken; BBA, CPA Director of Administrative Services; Clark County Health Department Anne Hatton; RN Clinic Nurse Administrator; Clark County Health Department Olivia Whitman; MPH Community Health Development Coordinator; Clark County Health Department Mentor(s): April Harris; M.P.H., CHES Deputy Director/Accreditation and QI Coordinator; Three Rivers District Health Department EXECUTIVE SUMMARY: Currently, the U.S. is ranked 1st in healthcare spending and 26th in life expectancy among OECD countries and life expectancy in Kentucky is below the U.S. national average.1 The Affordable Care Act (ACA), which was signed into law in March of 2010, included comprehensive health insurance reforms aimed at increasing the quality of healthcare services provided and decreasing the cost of healthcare.2,3 In 2014 the rollout of Kynect, Kentucky’s official marketplace for insurance under ACA, resulted in the second largest decrease in the uninsured rate in the country.3 To-date approximately only 11% of Kentuckians are uninsured yet, Kentucky still ranks 44th in the nation in terms of health outcomes.4 The following paper reviews the potential barriers to receiving healthcare, along with the five model types of integrated healthcare systems and the features of each that could alleviate some of those barriers. INTRODUCTION/BACKGROUND: In the United States 17.5% of the Gross Domestic Product (GDP) is spent on healthcare, which is about $3.0 trillion dollars as a nation, and $9,523 per person.5 However, the current life expectancy of an American is, only, approximately 76 years of age for males and 81 years of age for females.1 Currently, the U.S. -
236Th & 237Th Legislative Health Committee Report
THE NEW YORK STATE SENATE STANDING COMMITTEE ON HEALTH 236TH-237TH LEGISLATIVE SESSION REPORT _________________________________ SENATOR KEMP HANNON CHAIRMAN REPORT OF THE NEW YORK STATE SENATE STANDING COMMITTEE ON HEALTH 236th & 237th LEGISLATIVE SESSION Senator Kemp Hannon, Chairman Senator Gustavo Rivera, Ranking Member Committee Members Senator Greg Ball Senator Velmanette Montogmery Senator Hugh T. Farley Senator Ted O’ Brien Senator Simcha Felder Senator Jose Peralta Senator Martin J. Golden Senator Diane J. Savino Senator Ruth Hassell- Thompson Senator Jose M. Serrano Senator Brad Hoylman Senator James L. Seward Senator William J. Larkin, Jr. Senator Catharine M. Young Senator Jack M. Martins Committee Staff Kristin Sinclair, Committee Director Alison Kane, Counsel to the Chairman Beth Kempter, Committee Clerk Room 420 New York State Capitol Albany, NY 12247 TABLE OF CONTENTS Executive Summary .........................................................................................................................1 Health Chapters ................................................................................................................................2 Patient Safety & Rights ........................................................................................................2 Health Care Facilities..........................................................................................................3 Health Care Professionals ...................................................................................................6 -
Emerging Field of Patient Navigation By: Brian E
Emerging Field of Patient Navigation By: Brian E. Daly, EdD Welcome to the Patient Navigation World Patient Navigation is a challenging healthcare career path. Recently, I experienced this role as my injured spouse dealt with a broken wrist and foot, limited mobility, denial of services from an insurance company, excessive prescription costs, and conflicting treatment plans (we had to go two different physicians for treatment of the wrist and foot). Although I have had many experiences working healthcare issues with friends and family, these recent challenges made me think – “I wish I had a competent patient navigator to help with this morass.” Healthcare is moving to a patient-centered, evidence-based approach but it will need the help of patient navigators, advocates, and community health workers to get there. A disjointed medical care system desperately needs the skills of these navigation professionals. Defining Patient Navigation Simply put, patient navigation is having a “mom.” As a patient, I am in a poor position to handle all the challenges that arise during my treatment. I just can’t take in all the noise and only hear part of the message. I am directed to do things to improve my health status but I don’t hear the whole message. I am too busy sorting out what I know and what I imagine. Despite being focused on improving my health, there are too many distractions. My emotional state confuses my rational state. In season one of the TV series “Breaking Bad” a high school chemistry teacher is diagnosed by his physician as having cancer. -
What Explains 2018'S Marketplace Enrollment Rates?
U.S. Health Reform—Monitoring and Impact What Explains 2018’s Marketplace Enrollment Rates? June 2018 By Rachel A. Burton, Rebecca A. Peters, Erik Wengle, Caroline Elmendorf, and Joshua Aarons Support for this research was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation. With support from the Robert Wood Johnson Foundation (RWJF), the Urban Institute is undertaking a comprehensive monitoring and tracking project to examine the implementation and effects of health reform. The project began in May 2011 and will take place over several years. The Urban Institute will document changes to the implementation of national health reform to help states, researchers and policymakers learn from the process as it unfolds. Reports that have been prepared as part of this ongoing project can be found at www.rwjf.org and www.healthpolicycenter.org. SUMMARY In the months leading up to the 2018 open enrollment kept grandmothered off-marketplace plans because period for health insurance marketplaces, members of premiums for these plans have grown at slower rates Congress made several efforts to repeal and replace the than marketplace premiums have. Affordable Care Act (ACA). Also, the federal government stopped reimbursing insurers for cost-sharing reductions The size of premium tax credits. Rhode Island, (CSRs) for eligible marketplace enrollees with incomes below Washington, and Louisiana maximized their premium 250 percent of the federal poverty level (FPL); cut funding tax credits by “silver-loading”—that is, directing insurers for enrollment assisters and marketplace advertising; to only increase silver plan premiums to account for and shortened the default open enrollment period for the cancelation of federal CSR payments. -
Safety-Net Hospital Systems Transformations in the Era of Health
Safety-Net Hospital Systems Transformation in the Era of Health Care Reform Experiences, Lessons, and Perspectives from 13 Safety-Net Systems Across the Nation February 2015 D EVELOPED BY T E X A S H E A L T H I N S T I T U T E S U P P O R T E D B Y B L U E S H I E L D O F C A L I F O R N I A F OUNDATION Project Support Provided by: Blue Shield of California Foundation Project Team at Texas Health Institute: Dennis P. Andrulis, PhD, MPH, Senior Research Scientist Nadia J. Siddiqui, MPH, Senior Health Policy Analyst Swapna Reddy, JD, MPH, Health Policy Analyst Lauren R. Jahnke, MPAff, Health Policy Consultant Maria R. Cooper, MA, Health Policy Analyst Acknowledgements: We thank the many hospital executives at the following systems who generously shared their time, candid perspectives, and resources to inform this project: Boston Medical Center Elmhurst Hospital Center (NYCHCC) Cambridge Health Alliance UK HealthCare Hospital System Cook County Health & Hospitals System UW Harborview Medical Center Hennepin County Medical Center Clinica Family Health Services Maricopa Integrated Health System Maui Memorial Hospital MetroHealth System Yuma District Hospital Mount Sinai Hospital of Chicago We also thank Rachel Wick, Program Officer, Blue Shield of California Foundation, for her guidance and feedback throughout this project. Finally, we thank Anna Schellhase, THI Policy Intern, for her research assistance and support. Texas Health Institute 8501 North Mopac Expressway, Suite 170 Austin, Texas 77584 (512) 279-3910 http://www.texashealthinstitute.org/health-care-reform.html Safety-Net Hospital Systems Transformation in the Era of Health Care Reform 2 Table of Contents Introduction....................................................................................................................... -
Minnesota Action Plan to Improve Health Literacy
Minnesota Action Plan to Improve Health Literacy March 2016 Foreword With more and more people accessing health insurance in Minnesota, it is important to equip them with the information needed to navigate the health care system and take action to maintain and improve their health. Health literacy – skills necessary for an individual to participate in the health care system and maintain good health1 – has become increasingly concerning. Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in our health care facilities, retail outlets, media, and communities.2 Over the past several years, the health care system has experienced an unprecedented level of change, which has compounded this problem. Our responsibility as a health care community is to communicate clearly. Without clear communication, we cannot expect people to adopt healthy behaviors, follow medical advice, or understand their health insurance plans. When people receive accurate, easy-to-understand information about a health issue, they are better able to take action to protect and improve their health and wellness. For this reason, health equity has become a critical topic for health professionals and community organizations. Health equity aims to ensure that every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of his or her social position or other socially determined circumstances.3 Health equity implies that health should not be compromised or disadvantaged because of an individual or population group’s race, ethnicity, gender, income, sexual orientation, neighborhood or other social condition.4 To build a healthier society, it is important that organizations work together to improve health equity. -
Social Work's Contribution to Patient Navigation Patricia Louise
Promoting Socially Just Healthcare Systems: Social Work’s Contribution to Patient Navigation Patricia Louise Desrosiers Gayle Mallinger Tonya Bragg-Underwood Abstract: Patient navigation is an emerging area of healthcare practice that uses an interdisciplinary and integrated care model designed to reduce health disparities and improve health outcomes. The authors define patient navigation, delineate the alignment of social work competencies with patient navigator requirements, and argue for a clear social work role and presence as patient navigators in interdisciplinary healthcare delivery. Social workers are well-equipped to carry out a variety of patient navigator responsibilities due to their unique skill of social justice advocacy as a macro-level intervention. Through involvement in patient navigation, social work leaders can promote the development of socially just healthcare systems that respect the dignity and worth of all patients. Keywords: Patient navigation; health disparities; social work roles; interdisciplinary teams Patient navigation is an emerging area of healthcare practice designed to assist patients in negotiating complicated healthcare systems. This patient-centered approach promotes improved health outcomes and diminished health disparities. Specifically, patient navigators (PNs) assist medically needy individuals to overcome barriers to treatment. Thus, navigators are charged with coordinating services, organizing transportation, and arranging for translation and financial support. In addition, the navigator provides emotional support and patient education. Complex patients, including those with multiple diagnoses, diverse cultural backgrounds, or special needs, such as hearing or vision impairments, are often inundated with a variety of helpers. Navigators aim to reduce confusion and frustration for patients. Consider the fictitious case of Sally, a 70-year-old African American female with high blood pressure who is not having success following her doctor’s orders. -
August 25, 2021 NEW YORK FORWARD/REOPENING
September 24, 2021 NEW YORK FORWARD/REOPENING GUIDANCE & INFORMATIONi FEDERAL UPDATES: • On August 3, 2021, the Centers for Disease Control and Prevention (CDC) issued an extension of the nationwide residential eviction pause in areas experiencing substantial and high levels of community transmission levels of SARS-CoV-2, which is aligned with the mask order. The moratorium order, that expires on October 3, 2021, allows additional time for rent relief to reach renters and to further increase vaccination rates. See: Press Release ; Signed Order • On July 27, 2021, the Centers for Disease Control and Prevention (CDC) updated its guidance for mask wearing in public indoor settings for fully vaccinated people in areas where coronavirus transmission is high, in response to the spread of the Delta Variant. The CDC also included a recommendation for fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result. Further, the CDC recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status See: https://www.cdc.gov/coronavirus/2019- ncov/vaccines/fully-vaccinated-guidance.html • The CDC on Thursday, June 24, 2021 announced a one-month extension to its nationwide pause on evictions that was executed in response to the pandemic. The moratorium that was scheduled to expire on June 30, 2021 is now extended through July 31, 2021 and this is intended to be the final extension of the moratorium. -
Unlocking the Complexity of the Health Care System: Kentucky’S Health Navigators
Unlocking the Complexity of the Health Care System: Kentucky’s Health Navigators Unlocking the Complexity of the Health Care System: Kentucky’s Health Navigators BY Michael T. Childress RESEARCH SUPPORTED BY The Foundation for a Healthy Kentucky OCTOBER 2012 College of Communication and Information 308B Lucille Caudill Little Fine Arts Library University of Kentucky Lexington, KY 40506‐0224 Center for Business and Economic Research 335AV Gatton College of Business and Economics University of Kentucky Lexington, KY 40506‐0034 859.257.2912 office 859.257.7671 fax [email protected] Page | i Page | ii PREFACE ealth navigation comes in many forms. Sometimes it takes the form of helping an individual find the treat‐ ment, medication, or health services they need. Other times navigation takes the form of helping a patient H overcome barriers of child care, finances, or transportation so they can see a doctor. In other cases naviga‐ tion means working with patients to enhance health literacy so they comply with medical instructions and are not readmitted to a hospital. And sometimes health navigation entails lending an empathetic hand to patients under‐ going the rigors of cancer treatment. Here we adopt a fairly broad definition of what constitutes “health navigation.” We include individuals, groups, and agencies that most would agree are health navigators. At the same time, in the course of this research we came across many individuals who view themselves as health navigators—even if the purists do not. In general we err on the side of inclusion and encourage readers to make their own judgments. We also estimate the under‐ lying demand for navigation services across Kentucky and conclude that the need for navigation is likely greater than the existing capacity. -
Coronavirus Resource Guide for Residents and Businesses
Coronavirus Resource Guide For Residents & Businesses Compliments of: The Office of Suffolk County Legislator William R. Spencer, MD 18th District 224 Wall Street, Suite 303 Huntington, NY 11743 (631) 854-4500 Updated: 4/14/2021 2 Message from Legislator Spencer… Dear Neighbor, The COVID-19 pandemic has turned our lives upside down and the greater effects of this crisis have impacted all of us in numerous ways - emotionally, physically and economically. As we emerge from this crisis after more than a year of facing a pandemic, we see that the collective efforts and sacrifices made by many have led to a flattening of the curve, and now, with vaccination efforts ramping up across the country there is hope that we will one day return to a semblance of normalcy. Many Suffolk residents and businesses will be coping with the effects of COVID-19 for the foreseeable future. In an effort to help constituents navigate the ever-changing landscape and the numerous support services available across multiple levels of government, my office has put together the enclosed resource guide. It is my hope that this comprehensive list can help point you in the right direction during this difficult time. Please continue practicing social distancing and following all of the CDC recommended precautionary measures to prevent the spread of the virus. Check up on your family, friends, and neighbors, and remember to thank our health care workers, first responders, and essential employees on the frontlines. If you know of someone in need of support, feel free to refer him or her to my office, we are here to provide assistance. -
Consumer Decisionmaking in the Health Care Marketplace
Research Report Consumer Decisionmaking in the Health Care Marketplace Erin Audrey Taylor, Katherine Grace Carman, Andrea Lopez, Ashley N. Muchow, Parisa Roshan, Christine Eibner C O R P O R A T I O N For more information on this publication, visit www.rand.org/t/rr1567 Library of Congress Cataloging-in-Publication Data is available for this publication. ISBN: 978-0-8330-9505-3 Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2016 RAND Corporation R® is a registered trademark. Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Preface For this report, researchers conducted a literature review to better understand how consumers make choices about health insurance enrollment and to assess how website design can influence choice when consumers select plans online.