May 22 Boston HAN: where’s my doctor now?

• Attendance and Agenda (PDF), Metro Boston Health Access Network, 5-22-08

This month, outreach workers gave some powerful examples of how the Commonwealth Care Open Enrollment process has added some new twists to the problem of access to providers.

Do consumers understand Commonwealth Care Open Enrollment?
In an effort to help consumers understand how changes in health plan premiums, co-pays and benefits will affect them, the Connector sent out mailings in April outlining the changes and telling people how they could change plans if they wanted to. Kate Bicego of Health Care For All reported that the Connector had hired additional support staff to handle incoming questions about premiums or changing plans – but that they aren’t getting calls. In response, the Connector was planning to send out an emergency postcard to enrollees reminding them of Open Enrollment and what it means and encouraging them to call 1-888-MA-ENROL.

Other HAN members said they also expected many more Open Enrollment questions than they were getting. They were worried that their clients didn’t receive the mailings, didn’t open them, or didn’t understand them; perhaps they’ll get a deluge of questions when increased premiums come due in July. We were reminded that CommCare members actually have 60 days starting July 1 to switch their plans if they hadn’t done so already.

Access to providers
One outreach worker on Cape Cod reported seeing clients about Open Enrollment, but it’s primarily because they are afraid they won’t be able to afford premium increases. She felt the Connector’s information packet was pretty clear; her clients’ biggest challenge is that BMC Health Net, which was the least expensive plan in her communities, has gone up in price, and that NHP (Neighborhood Health Plan), which will become the least expensive in July, has very few providers on the Cape. Clients can’t afford to stay with BMC, she says, and "they’re angry because they have to change to a plan they don’t know. They’ve gotten over the big hurdle – they’ve learned about insurance during past 12 months, and now have to switch to a plan for which there are no specialists available. It means they have to cross the bridge, which is an hour and 15 minutes at least – just to get across the bridge, not to get to Plymouth or Boston..."

Network Health has recently expanded its network to the Cape, but again, there are few providers. The lack of providers is making the whole health care reform package a hard sell. Fall River is having the same problems. Network Health’s representative said that the plan was working to develop its provider network, and that he would bring the issue back to the company.

Kudos for the Virtual Gateway
Outreach workers love the My Account Page (MAP) – one reason is because you can print out letters MassHealth has sent to homeless clients – and the fact that patient information has been added to the PSI. And they’re excited about the possibility of online renewals before too long.

Policy discussion with Health Care For All

Outreach funding uncertain
Current EOHHS outreach grants expire on June 30, and the Senate did not include the $3.5 million proposed by the Governor and approved by the House in its budget. Jen Chow of Health Care For All encouraged HAN members to call their Senators to support an amendment filed by Sen. Moore to fully restore it. CP update: The amendment was ultimately withdrawn from consideration during the Senate’s budget debate so advocates are hoping that funding will be restored during Conference Committee negotiations.

Where will the money come from?
HAN members, like everyone else, wonder how Massachusetts is going to maintain financial support for health care reform programs in a difficult economic environment. One member pointed out that health care coverage is often portrayed as the big budget buster in the media. To help counter this attitude, CP’s Meg Kroeplin suggested a presentation prepared by the Herndon Alliance and 3 other partners titled "How to Talk About Health Care Reform: Summary of Research on Health Care Messaging" (PowerPoint file). An outreach worker suggested that all state-subsidized health care programs be consolidated under Commonwealth Care, which could increase efficiency, reduce coverage gaps, and save money.

MassHealth/Commonwealth Care update
MassHealth Essential enrollment is approaching its new cap, but it’s not there yet. The Patrick administration has said publicly that they do not want a waitlist.

Picture of Health Care Reform Emerging
Special guest Valerie Bassett, Director of Policy and Research at the Blue Cross Blue Shield of Massachusetts Foundation, told HAN members that a more detailed picture of how health care reform is working for people and how much it’s costing would be available after the results of a survey conducted by BCBSMA and the Urban Institute were released on June 3.

CP Update: More studies have been released since the May 22 meeting. To be incredibly well informed, click on the reports below:

• The Division of Health Care Finance and Policy’s 50+ Employer report indicating which employers in the Commonwealth have fifty or more employees on publicly subsidized health coverage/care
• The Department of Revenue’s preliminary report on the individual mandate (PDF) providing information on the number of residents who were penalized and those who were not
• The Division of Health Care Finance and Policy quarterly indicators report
• The Mass. Budget and Policy Center’s report on Massachussetts rankings for state & local tax collections (PDF)