Camden Coalition of Healthcare Providers Collaboration in Healthcare: Examining the Affordable Care Act and Patient Centered Medical Home Nadia Ali, MPA Elizabeth Buck, MPA Camden Coalition of Healthcare Providers Public Service Orientation August 6, 2014 www.camdenhealth.org
Goals of Presentation 1. Understand the goals of the Affordable Care Act a. Increase Access b. Decrease Costs through system delivery changes (and through increased access) 2. Understand who is impacted 3. How does this impact my work with patients? 4. Moving from fee for service to pay for performance 5. Examining the ACO model 6. Is primary care the key to reducing cost and improving care in Camden and in the nation? 7. How will Americorp members impact primary care in Camden?
Miguel’s Story
Medical Manifestations of Social and Economic Crisis
Scope of the problem: Uninsured in Camden According to citywide data, there are 7,300 newly eligible for Medicaid, and approximately 10,000 are newly eligible for subsidies or credits for exchange Populati lower upper on % of population +/- end % end % range No Health ~14.5- Insurance 17,162 22.9% 2,624 14,538 19.4% 19,786 26.4% 20k Medicare Only 2,906 3.9% 736 2,170 2.9% 3,642 4.9% ~2-3.5k Medicaid Only 28,073 37.4% 3,060 25,013 33.3% 31,133 41.5% ~25-31k Medicare/Medicai d 2,967 4.0% 788 2,179 2.9% 3,755 5.0% ~2-4k ~11- Employer-Based 13,341 17.8% 2,131 11,210 14.9% 15,472 20.6% 15.5k Direct-Purchase 1,511 2.0% 900 611 0.8% 2,411 3.2% ~1-2k Employer&Direct 4,195 5.6% 1,737 2,458 3.3% 5,932 7.9% ~2.5-6k Employer&Medica RE 779 1.0% 488 291 0.4% 1,267 1.7% ~300-1k RATIO OF INCOME TO POVERTY LEVEL IN THE PAST 12 MONTHS Civilian noninstitutionalized population for whom poverty status is 17,071 +/-1,634 22.9% +/-2.2 determined Under 1.38 of poverty threshold 7,320 +/-1,147 19.0% +/-2.7 1.38 to 1.99 of poverty threshold 2,533 +/-792 25.7% +/-5.1 2.00 of poverty threshold and over 7,218 +/-1,351 27.6% +/-3.9
The Camden Coalition has analyzed Citywide data to determine uninsured “hot spots” in the City for targeted outreach and enrollment efforts by community organizations.
The Uninsured in Camden Implementation in Camden: As of October 1, 2014: Newly eligible through Medicaid: 7,300 Eligible for Exchange: approximately 10,000 Engagement: Hospitals, FQHCs, Providers, Camden Churches Organized for People, Citizen Action, CMS, Camden AHEC, Planned Parenthood, etc. Enrollment: CACs (NJ Hospital Association), Navigators (Center for Family Services), Cooper, Lourdes, Virtua, Project Hope, and CAMCare.
The Uninsured in Camden Implementation in Camden: As of October 1, 2014: Newly eligible through Medicaid: 7,300 Eligible for Exchange: approximately 10,000 Engagement: Hospitals, FQHCs, Providers, Camden Churches Organized for People, Citizen Action, CMS, Camden AHEC, Planned Parenthood, etc. Enrollment: CACs (NJ Hospital Association), Navigators (Center for Family Services), Cooper, Lourdes, Virtua, Project Hope, and CAMCare.
ACA: Expanding Access Remaining Challenges: Medicaid Backlog Advocacy Reuters: “The Medicaid Issue was raised by Democratic Senator Robert Menendez…” Courier Post: Local Medicaid Applications piling up NJ Spotlight: Backlog of NJ FamilyCare Applications Bogs Down County Office Staffs
What does this mean for our patients?
Treating Sickness to Providing Wellness 1. Access is the first step 2. Impacting behavior 3. Incentives are changing – Collaboration versus Competition 4. How does this work in Camden?
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