Transcript HealthCare Access Maryland

HealthCare Access Maryland
Central Region Connector
Sheila Mackertich
VP of Health Reform Initiatives
Facebook: /HealthCareAccessMaryland
Twitter: @hcamaryland
Website: www.hcamaryland.org
About HCAM
• Non-profit agency
created in 1997
• Today: 19
programs/30 grants
• Formerly Baltimore
HealthCare Access
• Areas of expertise:
– Renamed to reflect
expanded reach & focus
• Originally two core
programs:
– Eligibility
– Care Coordination
– Eligibility & enrollment
– Navigation of health
care system
– Care Coordination
– Education & Advocacy
• Diverse and culturally
competent staff
HCAM -- Central Region Connector
Central Region
• Baltimore City
• Baltimore County
• Anne Arundel County
• 17 Partners/
Subcontractors
• Local Health
Departments
• Department of Social
Services
Central Region
Partners/SubContractors
•
Anne Arundel Medical Center
•
Maryland Medical Society
(MedChi)
•
Baltimore City Health Department
•
Baltimore Healthy Start, Inc.
•
Mental Health Association of
Maryland (MHAMD)
•
Baltimore Medical Systems
•
Mercy Hospital
•
Charm City Clinic
•
Mosaic Community Services
•
Chase Brexton Health Services
•
•
Chatman, LLC
Park Heights Community Health
Alliance
•
Coordinating Center
•
Planned Parenthood of Maryland
•
Healthcare for the Homeless
•
•
Independent Marylanders
Achieving Growth Through
Empowerment Inc. (IMAGE)
St. Stephens African Methodist
Church/ Office Management
&Technology (OMT/SSAME)
Central Region Connector
• HCAM and our 17 partners will employ 107
certified Navigators & trained Assisters to:
– provide outreach and education
– eligibility determinations
– facilitate enrollment of the 217,000 uninsured
central region residents into Medicaid, MCHP &
subsidized/unsubsidized qualified health plans
Responsibilities
• Navigators will:
• Assisters will:
– Conduct public education and
outreach as required by the
Affordable Care Act
– Conduct public education and
outreach
– Facilitate enrollment in Medicaid
– Distribute fair and impartial
information
– Provide information in a culturally
and linguistically appropriate
manner
– Facilitate enrollment in health plans
– Provide referrals for grievances,
complaints and questions
– Maintain expertise in eligibility,
enrollment and program
specifications
– Provide information in a culturally
and linguistically appropriate manner
– Refer insured small groups and
individuals back to producers
– Maintain expertise in eligibility,
enrollment and program
specifications
– Refer insured small groups and
individuals back to producers
•
Both navigators and assisters will
receive training through MHBE
Application Counselors
• The Maryland Health Progress Act:
– Application Counselor Sponsoring Entities:
• MHBE may designate community-based organization, health care provider,
unit of State or local government, or other entities as ACSEs.
– Certified Application Counselors: MHBE may certify individuals as
application counselors who:
• Are employed by or volunteer with a sponsoring entity;
• Are subject to the same requirements, restrictions, conflict of interest rules,
and oversight applicable to navigators;
• Are not compensated by the MHBE, carriers, producers, or TPAs for
consumer assistance services;
• Do not impose fees for consumer assistance services;
• Must disclose conflicts-of-interest; and
• Must act in the best interest of the consumer.
Application Counselors
•
Application Counselor Training & Certification Standards:
– Certified Application Counselor may:
• Provide information to consumers about the full range of QHP and QDP
options and IAPs;
• Assist consumers with the application process for determining eligibility for
IAPs;
• Facilitate plan selection and enrollment of eligible individuals in QHPs,
QDPs, and access to APTCs; and
• Provide to consumers uniform, factual, and unbiased information approved
by the Maryland Medical Assistance Program about all participating MCOs
and participating providers.
–
Certified Application Counselors may not:
• Express a personal or professional assessment about, select or counsel an
applicant about an MCO; or
• Hold an Individual Exchange Navigator certification or be an Assister.
Central Region Connector
Outreach/Education/Enrollment
• Health Departments/Social Services
• Faith-based organizations
• Community based organizations: clinics,
food banks, libraries, supermarkets
• Civic Associations, clubs
• Health fairs, festivals
Central Region Connector: Where
We Are
http://www.healthcareaccessmaryland.org/healthcare-reform/
Snapshot: First Two Weeks
Statewide stats (10/1-10/17)*
• Unique website visitors: 261,139
• Calls to call center: 25,149
• Accounts created with verified identity: 34,862
• Eligibility determinations completed: 23,141
• Enrollment into a plan: 2,393
* Source MHBE
Consumer Assistance
• Online at
www.MarylandHealthConnection.gov
– Shop
– Compare
– Enroll
• In-person Assistance
– Navigators (Certified)
– Assisters (Non-Certified)
– Insurance Producers
(Authorized)
– Captive Producers
– Application Counselors
• Consolidated Services
Call Center
– 855-642-8572
– 855-642-8573 – TTY
– Customer Service
– Application and enrollment
assistance
– Language line/ translation
services
– TTY for the hearing
impaired
• HCAM Call Center
– 877-223-5201
Sheila Mackertich
Vice President of Health Reform Initiatives
410.649.0516
[email protected]
www.healthcareaccessmaryland.org