Category Archives: Health Insurance Exchanges
RWJF Scholars in the News: Simulating combat conditions for medical and nursing students, enriched maternity care, GMO confusion and more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:
An article on dcmilitary.com describes a recent training exercise conducted for medical and nursing students at the Uniformed Services University of the Health Sciences (USU). The students cared for “patients” under simulated combat conditions that included mock explosions and casualties, operational problems, and reality-based missions. Arthur Kellermann, MD, MPH, dean of the F. Edward Hébert School of Medicine of USU, noted that while the exercise is focused on enhancing leadership and patient care skills, students are also practicing cultural sensitivity and problem-solving abilities. “All of this is wrapped into an incredibly challenging series of unfolding scenarios,” Kellermann said. “They are constantly being thrown problems. They have to adapt and learn to work with one another in a variety of ways and a variety of combinations.” Kellerman is an alumnus of the RWJF Clinical Scholars and Health Policy Fellows programs. Read more from Kellermann on the Human Capital Blog.
A study by Sara Rosenbaum, JD, examines the challenge of maintaining and coordinating “enriched health care” for pregnant women in California who purchase subsidized coverage from Covered California, the state’s health care exchange, and are also eligible for the state’s Medicaid program (Medi-Cal) and the Comprehensive Perinatal Services Program (CPSP) it offers. Science Daily reports that CPSP makes enriched maternity care available to pregnant women facing elevated health, environmental and social risks due to their economic status. Researchers compared maternity care under the two programs and identified a number of care coordination and integration challenges. Rosenbaum is an RWJF Investigator Award in Health Policy Research recipient.
Cynthia Crone, MNSc, APRN, CPNP, is deputy commissioner of the Arkansas Insurance Department, where she created and now leads the state’s Partnership Health Insurance Marketplace. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program.
Being asked to write a post about nurse leadership for National Nurses Week presents a wonderful opportunity to reflect on my nursing journey and express appreciation for the many nurses and other leaders who have played a supportive role in my development. A career in public health with an emphasis on vulnerable populations, including most recently directing efforts in Arkansas to implement the Health Insurance Marketplace, has reinforced with me the critical role nurse leaders play in the politics and policy of health care and how very important it is to foster and support community involvement and interdisciplinary collaboration by younger nurses.
I started nursing school in the mid-1970s. Nurse practitioners were just coming on the scene. After graduation I obtained certification as a pediatric nurse practitioner and traveled to 10 rural counties to hold “well child clinics.” I learned a lot from the public health nurses. I loved my job. The work helped me better understand the bio-psycho-social-spiritual art and science of nursing and the social determinants of health. Further, through interaction with nurse and other community leaders, I learned that another element—political–can’t be ignored.
Sue No, RN, BSN, is a fellow in the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at the University of New Mexico (2013-2017). She is working toward her PhD in nursing with a concentration in health policy. This post is part of the “Health Care in 2014” series.
Every New Year brings New Year’s resolutions. It is a time for reflection on years past and to develop actionable changes needed for a hopeful and productive new year. Clearly 2014 is no exception. With the New Year already in full swing, I encourage people—yes, this also includes you, Generation Y—to enroll in a health insurance plan and take advantage of the Affordable Care Act’s (ACA) current and new coverage opportunities in an effort to advance our nation’s culture of health.
You might be asking yourself a few questions such as: Who is Generation Y and why are they important? I am happy to provide answers.
The largest generation, Generation Y, or Millennials, consists of young adults born between 1977 and 1994. This important demographic is key to obtaining a sustainable health care exchange system with affordable insurance plans. Healthy Millennials must enroll in the marketplace to offset the high costs acquired by the disproportionate number of Americans with high medical costs. Unfortunately, only a small number of young adults have participated in the health care exchange since open enrollment. This isn’t surprising.
Jay Himmelstein, MD, MPH, is a professor of family medicine and community health and chief health policy strategist at the Center for Health Policy and Research at the University of Massachusetts Medical School (UMMS). He serves as a senior advisor to the UMMS Office of Policy and Technology, and is a senior Fellow in health policy at NORC, University of Chicago. Himmelstein is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program, where he worked on the health staff of Senator Edward Kennedy. This post is part of the “Health Care in 2014” series.
The nation's attention has focused in recent months on the politics and challenges related to the roll-out of state and federal health insurance marketplaces created by the Affordable Care Act (ACA). Despite website technical woes, significant numbers of Americans have already gained access to affordable insurance plans through the marketplaces and other provisions of the ACA, and it appears likely that the ‘marketplace’ concept will be successful over time in connecting consumers to health insurance and significantly decreasing the ranks of uninsured.
The better functioning marketplaces currently allow consumers to: 1) determine eligibility for subsidized health insurance, 2) use basic online shopping tools to compare and purchase health insurance plans based on four different "metallic tiers" (i.e., the platinum, gold, silver, and bronze tiers), and 3) make side-to-side comparisons between these plans on features such as deductibles, out-of-pocket cost limits, and number and proximity of doctors and hospitals. A few marketplaces also offer information about plan quality, the ability to search for health care providers and hospitals associated with specific plans, and rudimentary ‘cost calculators’ which estimate the total cost of plans inclusive of premiums, deductibles, and out-of-pocket costs.
Sue Birch, MBA, BSN, RN, is executive director of the Colorado Department of Health Care Policy and Financing, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2002).
Now that I have caught my breath, I wanted to share the Colorado report on Obamacare’s October 1st Birthday! Our state has decided to expand our Medicaid program and to form our own marketplace for Coloradans to shop and compare health insurance plans. These changes will help us cover many uninsured Coloradans.
In its first week, Connect for Health Colorado, our state’s health insurance marketplace, successfully attracted more than 162,941unique website visitors, had 9,658 calls and chats to the service center, and 18,174 accounts created. We think this is a strong start and know that it will take time for Coloradans who have not had insurance before to learn about their options and apply for coverage. We are working across state government to help make this happen.
At my department, Health Care Policy and Financing, Coloradans can enroll through our new modularized interoperable cloud-based system, PEAK. We had more than 9,000 applications come through this site in the first 10 days of October. It is foundational to our desire to increase new consumerism and greater client responsibility by walking through a self-enrollment process. Our website is Colorado.gov/PEAK and we have seen record traffic to the application site.
Overall, the marketplace opening went quite smoothly for Colorado—the exchange opened successfully, Medicaid began, and our technology functioned efficiently for being such a large, complex system. With the marketplace now up and running, individuals, families, and small employers can start making appointments with Health Coverage-Guides, learn about plan options, and apply for insurance when ready.
This is an exciting moment in health care history and we are proud to be working with partners across our state and our nation to provide affordable health insurance options to all residents of Colorado!
This week, the U.S. Department of Health and Human Services is rolling out a new website that provides educational tools designed to help people understand their insurance choices and select coverage that best suits their needs when open enrollment begins on October 1st. With 99 days to go until then, the new effort includes a consumer call center that will offer help to consumers in more than 100 languages. It will eventually employ 9,000 people, who will answer questions from the public 24 hours a day.
HealthCare.gov is designed to be the destination for the new Health Insurance Marketplace, also called exchanges. The new website will add functionality over the next few months so that, by October, a consumer will be able to create an account, complete an online application, and actually shop for an insurance plan.
For Spanish speakers, CuidadoDeSalud.gov offers the same information and functionality in Spanish.