This Week in Healthcare: Open Enrollment Round 2

NEWSCommunity Health Centers Are Ready to Enroll More Uninsured (NACHC)

A NACHC survey revealed that Community Health Centers were ready for the open enrollment period. Nearly ninety-seven percent (97.2%) of respondents said that they felt ready.  When asked to describe how they have prepared for open enrollment, respondents described a range of activities that include training staff, sustained community outreach and health center “in reach” to existing patients.

State Health Insurance Exchanges Hope to Woo Urban Minorities (Kaiser Health News)

Connecticut and California’s exchanges were successful last year but both still lacked reach to young urban minorities so this year they dialing up their efforts to reach them.

People Auto-Enrolling into Federal Marketplace Coverage Could Overpay (CBPP)

In 34 states, people who enrolled into 2014 coverage through the Federally Facilitated Marketplace (FFM) will be automatically re-enrolled in the same plan in 2015 unless they choose a new plan. This report from the Center on Budget and Policy Priorities outlines the key factors that could impact a family’s or individual’s changes in subsidies for health coverage.

Insurance Exchanges Launch with Few Glitches (Kaiser Health News)

Kaiser Health News reported early this week that more than 100,000 Americans signed-up for coverage on Saturday—the first day of open enrollment—through the ACA’s online insurance exchanges. However, they also noted that “the enrollment process continues to face plenty of uncertainties, including the response of a confused and still uninformed public, among them 20 million uninsured who did not enroll the first year; a shorter enrollment period and premium increases that many of the 7 million people who bought coverage last year will face unless they shop around.”

California Enrolls 11,357 in First 4 Days of Obamacare Open Enrollment (Los Angeles Times)

According to the LA Times article, Covered California indicates they are ahead of last year’s enrollment pace. Comparatively, during the first enrollment period it took them 15 days to enroll 11,000 Californians.

What Makes an Obamacare Website Work? Ask Kentucky (USA Today)

While many websites had issues during the first open enrollment period Kentucky’s Kynect site was successful and continues to be. Kentucky says they kept it simple and used technology they familiar to them. “We did not put in a lot of fancy slides or other things,” said Chris Clark, technical program manager for kynect. “We kept ours very simple and straightforward.”

A Quarter of Uninsured Say They Can’t Afford to Buy Coverage (Kaiser Health News)

According to a poll, taken just days before open enrollment, 25 percent of those without coverage expected to remain uninsured due to cost. The poll also noted that 9 in 10 of the uninsured where unsure of when open enrollment began.

Living in Louisiana’s Tragic Healthcare Limbo

Louisiana’s refusal to expand Medicaid is leaving 242,000 of the most vulnerable state residents without healthcare. According to the article researches from a Harvard-CUNY study “found that because of the states’ opting out of the expansion, 7.78 million people who would have gained coverage will remain uninsured, causing up to 17,000 more avoidable deaths because sickly patients get care too late.”

Focus on Hepatitis C: Health Centers Work to Address the Chronic Disease

This three-part blog series spotlights the great work of three Community Health Centers addressing Hepatitis C. Hepatitis C is a significant public health problem in the United States.  Of the approximately 3.2 million people in the US who have chronic hepatitis C (HCV), most do not know they are infected. HCV is more prevalent in patients who are seen in Community Health Centers than HIV.  According to the 2013 Uniform Data System (UDS) 145,309 patients had a primary diagnosis of HCV, up from 61,294 in the prior year. Left untreated, chronic HCV can cause significant liver complications, including cirrhosis, cancer and failure.  It is the leading reason for liver transplants in the United States. The first blog in this series focuses on the importance of partnerships in addressing the chronic disease.

For Erie Family Health Center in Chicago, Illinois external partnerships have been critical to their ability to care for their patients with chronic HCV.  Caroline Teter, PA-C, MPH, a provider and HCV champion at the health center, describes some of these essential partnerships. Through the University of Chicago’s Extension for Community Healthcare Outcomes (ECHO) Program, Erie’s providers receive training on HCV treatment from specialists—without leaving the health center and without any direct cost.  Advanced communication technologies are used during bi-weekly calls to deliver education about the latest news in HCV treatment and to discuss the health center’s active patients.

According to Teter, “the ECHO program makes treatment possible by giving providers both skills and confidence.” And, she adds, “there is comfort in knowing that expert consultation is readily available.”

Additional support for providers to screen for and treat HCV comes from the health center’s own electronic medical record (EMR)—thanks to another important partnership. The center collaborated with the International Association of Providers of AIDS Care (IAPAC) and the Alliance of Chicago, a health center controlled network, to develop and implement decision making support tools and templates for HCV screening readiness based on age and risk factors.  These tools lead to more patients being screened at the point of care and facilitate tracking and follow up based on test results. Reports pulled from the EMR guide quality improvement activities to improve screening rates.  Treatment modules in the EMR, also developed in partnership with IAPAC and the Alliance of Chicago, help providers track and manage the patient’s course of treatment.

Partnerships have also been vital in addressing the high costs associated with HCV screening and treatment. Patients who are uninsured and income qualify receive free lab work through an agreement the center has with an outside laboratory vendor.  Erie’s patients receive specialty care at no cost at nearby Northwestern Memorial Hospital and other local hospitals as a result of relationships the center has developed over the years.  Walgreens, a 340B provider in Illinois, helps the center complete the paperwork that many public and private insurers require for prior approval for HCV drug therapies. The approval process is a significant struggle—it is burdensome on staffing and a barrier to treatment for patients. Walgreens is able to manage the process electronically, freeing up staff time.

Caroline is hopeful. With partnerships in place and new treatments that are easier for providers to administer, easier for patients to tolerate, and have a higher cure rate than previous treatments, she expects that Erie Family Health Center will be able to positively impact the lives of more patients with chronic HCV.  She reminds her health center colleagues that relationships make the job easier.

For more information and resources on HCV, visit

Ready, Set, Go! It’s Open Enrollment Time

OEGIFNACHC marked the beginning of the 2015 Open Enrollment Period with a Teleforum this week to continue building momentum as health centers get ready to enroll eligible uninsured individuals into coverage.

According to the Department of Health and Human Services (HHS), through the end of September health centers reported having more than 19,000 outreach and enrollment staff and have succeeded in enrolling 7 million people into coverage. Also, a new NACHC survey reveals that 97 percent of health center enrollment staff report they are ready for Open Enrollment.

Mandy Cohen, MD, Principal Deputy of the Center for Consumer Information and Insurance Oversight (CCIIO), used the Teleforum to thank health centers for their work, saying, “We could not have been as successful if it had not been for all your hard work, dedication, and sticking with us through some tough times.”

Cohen added that through the Health Insurance Marketplace and Medicaid 10.3 million adults are newly insured and that the uninsured rate has dropped by 25 percent.

Learn about the Health Insurance Marketplace & your new coverage options. She also emphasized that outreach efforts would focus on people who enrolled last year—to encourage them to renew and update information—and to those who remain uninsured. Cohen highlighted a few changes made to the Health Insurance Marketplace to make it simpler to renew/enroll this time around, including a reduction in the number of questions and a triage method of questioning on the sign-up form. The form will also be pre-populated with about 90 percent of a returning customer’s application information, which the customer will simply need to review and update before re-enrolling into coverage.

Another new development is returning customers have been notified about their current plan and have been provided with a 14 digit plan ID number to confirm their information and update their income. Cohen told participants on the call that enrollees can use that ID to find their plan and comparison shop. She also stressed that December 15 is the cutoff date to make changes that will take effect on January 1st and that consumers who don’t make changes by that date need will be automatically rolled over.

Cohen also encouraged health centers to use testimonials from within the community and social media to help spread the word. According to Cohen, one out of four Facebook ads for the Health Insurance Marketplace leads to a new account.

Dan Hawkins, NACHC’s Senior VP for Policy and Research, also participated in the Teleforum and underscored the importance of boosting health literacy among health center patients seeking coverage.

“We need to educate them on the language of insurance coverage and improve health literacy,” said Hawkins. “People need to understand not only what the terms mean but their importance to the coverage they have.”

Hawkins also touched on the health center movement’s history of helping people access care, community outreach, and enrollment into health insurance coverage.

“Health centers have been doing this since the very beginning of the program 50 years ago, helping people to enroll into Medicare and Medicaid coverage during the first years of those programs’ existence,” he said.  “We have known forever how important it is to help those we serve to secure coverage for the care and services they need and to make that care affordable for them.”

If you missed the Teleforum you can listen to it here. For more information and resources on open enrollment visit the NACHC O& E page.

FOM-IT What Happened in Vegas Didn’t Stay in Vegas

FOM/IT attendees listen to opening remarks at the General Session at Planet Hollywood, Las Vegas, NV.

FOM/IT attendees listen to opening remarks at the General Session at Planet Hollywood, Las Vegas, NV.

Our guest blogger today is Zach Zagar, Sales and Marketing Specialist with NACHC Membership, who offers this wrap up of the NACHC FOM-IT conference in Las Vegas, NV.

With nearly 800 people in attendance, this was the best-attended FOM/IT conference ever.  If you are part of the executive team at your health center responsible for decisions impacting these areas of your operations, you missed a great conference.

Of the several annual gatherings NACHC hosts each year, FOM/IT is often referred to as the “roll up our sleeves” conference due to the rigorous “classroom” work being undertaken. Attendees participated in educational sessions, user groups, forums, learning labs, and heard from our engaging keynote presenter, Jonathan Cohn.  Mr. Cohn is an author, senior editor of The New Republic magazine, and a leading voice in the health care reform debate.

Selected Sessions Offered:

  • What’s Not Happening in Your Billing Department: You Would be Surprised
  • Best Practices in Health Center Financial Operations Including Payment
  • Rip and Replace: Changing your EHR
  • Attending to Privacy and Security in HIT
  • Does EMR Adoption Create Value?

Learning Labs:

  • Data-Driven Decision Making
  • Managed Care Cost Reporting for FQHC

For a full list of the sessions, labs, and forums offered at FOM/IT, see the “Schedule at a Glance” here.

On the Monday prior to the start of FOM/IT, many took advantage of NACHC’S Chief Financial Officer (CFO) Institute course. The CFO Institute is a new leadership development program for CFO’s designed to enhance skills for those in the position less than two years.  The CFO is critical in ensuring the financial health of the health center they work in. Feedback on the first in-person course of the series has been great. While the current series of courses is at capacity, please stay tuned to NACHC’s website for news on the series. Learn more about the CFO Institute here.

Also new this year was an update from Amanda Pears Kelly, NACHC’S National Advocacy Director, on the Access Is The Answer campaign. Normally, advocacy and legislative updates are presented at NACHC’s Policy and Issues forum held during March in Washington, DC; however, the months ahead require an “all hands on deck” strategy from the health center movement. Amanda updated attendees on the E-mail Surge to Members of Congress advocating for a fix to the funding cliff that health centers face if Congress and the President fail to act. The “E-mail Surge” comes on the heels of the successful efforts of NACHC advocates to send a bipartisan letter to Congressional leaders in support of a long-term legislative fix to the funding cliff.  Stay up to date and become a health center advocate by joining the Access IS The Answer campaign at

In addition to the informative and exciting programming at FOM/IT, attendees met with vendors who provide the many solutions that are making the mission of operating a health center easier, efficient, and more cost effective on the FOM/IT EXPO floor. It was a fantastic opportunity to learn what new solutions and technologies are available today and what is on the horizon in the future. The Expo concluded with great “NACHC-OPOLY” prizes like a Mac Book Pro and an iPad Air from NACHC, as well as gift certificates from several of the exhibitors.

MyNACHC users who where unable to attend should stay tuned for content from FOM/IT in the coming weeks. With such an aggressive course catalog as well as the other highlights, it is easy to see why FOM/IT continues to receive such high marks from conference attendees. Next year’s programming aims to build on the successes of years’ past.

Make time on your calendar for October 27-29 2015 today.

News for Health Centers about Outreach and Enrollment

Our guest blogger today is Ted Henson, Director of the Robert Wood Johnson Outreach and Enrollment Project, with the latest updates and information for health centers as they get ready for Open Enrollment on November 15.

The Open Enrollment period to enroll in coverage for 2015 begins on November 15, 2014, and health centers that did not originally receive FY13 Outreach and Enrollment (O&E) supplemental funding from the Health Resources and Services Administration (HRSA) recently got some good news.

HRSA awarded supplemental funding for outreach and enrollment (O&E) work to 91 health centers in 36 states and the District of Columbia. The awards went to health centers that were newly funded in FY 2013 or FY 2014 and to health centers that had not previously received HRSA O&E supplemental funds.

These O&E funds will help health centers that were not funded previously to provide outreach to uninsured patients and communities and to enroll eligible patients and service area residents into affordable health insurance coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the state and federal health insurance exchanges.

Enrollment in Medicaid and CHIP is year-round, but enrollment in insurance coverage through the exchanges is only possible between November 15, 2014 and February 15, 2014, notwithstanding any potential life changes that would qualify an individual in a special enrollment period.

For more information, refer to HRSA’s webpage on health center O&E Assistance.