Health Plans Often Fail To Provide Free Coverage For Women’s Health : Shots – Health News : NPR

Health Plans Often Fail To Provide Free Coverage For Women’s Health : Shots – Health News : NPR.

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What They Learned From the First ACA Open Enrollment Period in California

Affordability means different things to different people, target enrollment groups have unique interests and require tailored messaging, partnerships matter and are transformative, and, many consumers are new to insurance and need extensive education about health insurance terminology, are among the lessons learned by officials at the California Health Benefit Exchange called Covered California in a review of its first open enrollment period 2013-2014.

The new report, “Covered California Open Enrollment 2013-2014: Lessons Learned” looks at the experience from the first year California offered expanded health coverage through new Affordable Care Act subsidies and the expansion of Medi-Cal through the Covered California marketplace, the organization said.

More than 3 million state residents were enrolled in coverage during the first enrollment period — 1.4 million in health insurance through Covered California2 and more than 1.9 million in Medi-Cal, officials said.

“The report,” the organization said, “provides the first in-depth review of our efforts in the first year, including marketing, outreach and education, eligibility and enrollment support, consumer profiles, marketing research, and information about those we still need to enroll.”

The populous state faced “outsized challenges, making it unique among states establishing state exchanges. From the start, California focused on addressing these challenges in the design of the marketplace and in the state’s approach to reaching, educating and enrolling millions of uninsured and underinsured Californians, particularly those who struggle to afford the costs of health care and coverage.”

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Covered California said it was also “mindful that its marketplace design and implementation would shape the broader health insurance market in California for those who were not eligible for subsidies through the exchange, many of whom had coverage before the initial open enrollment.”

Some 7.1 million state residents were uninsured, officials said, sometime during the year before implementation of reform.

Among the lessons learned:

* Many consumers are new to insurance and need extensive education about health insurance terminology, how to enroll in coverage and how to use insurance.

* Consumers need clear, straightforward information that explains how insurance works in plain language, without jargon. There is an ongoing need for a comprehensive,accessible, educational campaign to help answer common questions about Covered California’s products and promote the value of insurance. For 2015 open enrollment, advertising messaging is attempting to explain, in first-person testimonials, that health coverage means going to the doctor and getting the care you need.

* Affordability means different things to different people. Many consumers, even with financial assistance through federal subsidies, found cost to be a barrier to obtaining coverage. Future communications need to address the issue of affordability by emphasizing the value of having insurance and the financial security (protection from arge medical bills) that it provides. New advertising and marketing materials include testimonials from newly insured Californians explaining that insurance is a bill they don’t mind paying each month, with an emphasis on the peace of mind of having coverage and the financial security it brings for those able to purchase it.

* Target enrollment groups have unique interests, experiences and perspectives and require tailored messaging and customizable materials. Consumers in different age, income, gender and ethnic groups reflect different circumstances, knowledge and needs for information and support. Media messaging, marketing and collateral materials, assister training, and community outreach and enrollment efforts need to address the specific needs and interests of diverse communities. Community partners, grantees, agents and enrollment counselors need simple, updated fact sheets, fliers, brochures and other materials, including customizable materials for local events and target groups.

Covered California expanded its targeted support to local outreach and has developed, and will continue to develop, customizable, focused materials available to community partners and insurance agents for open enrollment in 2015.

* Most consumers relied on a variety of touch points, including in-person assistance, to successfully complete enrollment. Most consumers needed multiple touch points, whether pursuing self-service or an assistance pathway. They wanted to ask questions, get answers, identify the options and then consider, often in consultation with friends and family, the coverage most suitable for them. Covered California responded by shifting marketing and outreach messaging and encouraging Californians to take advantage of free, confidential, in-person assistance in local communities. More than 6,400 Certified Enrollment Counselors and more than 12,000 Certified Insurance Agents will be part of a comprehensive campaign for enrollment in 2015.

* The multi-channel marketing and media mix struck an effective balance between brand (awareness) and direct response (enrollment) and will continue to be tailored to specific target audiences. The large number of those eligible who enrolled is the strongest indicator that the community-level outreach, marketing and media campaigns, as adjusted in real time, were successful in accomplishing the two program goals: brand awareness and enrollment. Going forward, marketing and advertising will support the community outreach campaign targeting key demographic groups and segments. Building on brand awareness, advertising will be aimed at explaining how to enroll and motivating audiences to enroll by sharing the tangible ways having health coverage is improving the lives of real people.

* Partnerships matter and are transformative. At every stage of planning and implementation for the first open enrollment, Covered California relied on and collaborated with a multicultural and varied set of state and local partners who made the unprecedented effort possible. Covered California partners made real-time adjustments and accommodations as challenges surfaced and consistently helped in resolving and addressing those challenges. The partnerships reaffirm the power of shared commitment, collaboration and common effort.

Following is the link to the report: http://www.coveredca.com/resources/PDFs/10-14-2014-Lessons-Learned-final.pdf

 

 

 

Health Plan Member Satisfaction in 2014

Issues surrounding the time a member must wait after a pre-approval request has been submitted to their health plan before they hear from their provider, to concerns about having adequate health coverage, and health plan notices of changes in their coverage, networks or rates are having an impact on members satisfaction with their plan, found a recent study.

Some 41 percent of existing health plan members believe that they lack enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics and drug coverage, found the study by market research firm J.D. Power.

Concerns over not having enough health coverage negatively impacts overall satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan StudySM.

The study, in its eight year, measures satisfaction among members of 136 health plans in 18 regions throughout the United States by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service.

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In 2014, overall member satisfaction averages 669 (on a 1,000-point scale), the firm said.

Key Findings include:   Continue reading

News Release – 2014 National Directory of Managed Care Organizations Database Produced

News Release

For Immediate Release

New Edition of Database Provides Overview, Details and Managed Care Market Key Decision Makers

Phone: 1- 800-516-4343

ALLENWOOD, NJ – The 2014 edition of the National Directory of Managed Care Organizations has been published by the Managed Care Information Center.

As in other industries – there has been consolidation in the managed care organization arena as well, Managed Care Information research has found.

Research on the 2014 edition of the National Directory of Manaaged Care Organizatyions project results reflects the various health plan consolidations – mergers and acquisitions.

The unique database provides market intelligence information on more than 1180 managed care organizations representing 5,279 health insurance plans.

The new edition includes listings of all managed care companies including health maintenance organizations (HMOs), preferred provider organizations (PPOs), consumer driven health plans (CDHPs), health savings accounts (HSAs), point-of-service plans (POS), and several other types of managed care organizations.

The directory database also covers specialty HMOs and PPOs, and includes details on TPAs, POSs, EPOs, Medicare and Medicaid health insurance plans, and Medicare Advantage Health plans and Medicare Part D prescription plans.

The directory is known for providing more “need to know” detail in the managed care organization profiles presented.

Organization profiles include the health insurance companies’ main address, phone, fax, and key executive officers.

To help users ‘size’ a market, the directory includes the number of primary care physicians and specialist physicians in the managed care company network; and the number of hospitals with which the health plan has contracts.

The database includes such key contact names as CEO, CFO, COO, medical director, and CIO. The name of the parent organization, the year the organization was founded, and web site address also is provided.

The National Directory of Managed Organizations Database with user’s manual and instructions is delivered on CD-Rom.

For more information contact The Managed Care Information Center – Health Resources Online  toll-free telephone 1-800-516-4343, email: info@healthresourcesonline.com

Or click on this link: National Directory of Managed Care Organizations Database

Address: The Managed Care Information Center, PO Box 456, Allenwood, NJ 08720

Contact: 1-800-516-4343

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The 2014 edition of the National Directory of Managed Care Organizations Database is Now Available

The 2014 edition of the National Directory of Managed Care Organizations Database is now available.

We have completed a full, thorough update and verification of the database. So it is ‘squeaky clean.’

For ‘bragging’ rights we want you to know that our work is extremely detailed. We especially zeroed in on C-Suite and other senior health plan executives.

Results: 12,282 changes to the database.

There has been – as in other industries – consolidation in the managed care organization arena as well, our research has found.

The research project results reflects the various health plan consolidations – mergers and acquisitions.

The National Directory of Managed Care Organizations Database has been continually researched, verified and compiled by the Managed Care Information Center team since 1996.

The database includes hard-to-find managed care information on HMOs, PPOs, POSs, Specialty MCOs,  health plans that offer consumer driven health plans (CDHPs) and health savings accounts (HSAs) , Medicare Advantage plans, Medicaid Managed Care plans,and Medicare Part D prescription plans.

For details on the new edition of this trusted database visit: http://bit.ly/1gJFVba