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Sister Carol Keehan, president and CEO of the Catholic Health Association

Hospital association leaders push members to educate patients about exchanges

By Jessica Zigmond
Posted: September 16, 2013 - 6:15 pm ET

With open enrollment on the public exchanges starting in 15 days, the leaders of the nation's major hospital associations Monday urged their members to do all they can to help patients learn about the health reform law's insurance coverage options.

People will enroll in coverage only if they understand what's available to them and how they can access it, American Hospital Association President and CEO Rich Umbdenstock said at the start of an hourlong webcast. Umbdenstock hosted the session along with Sister Carol Keehan, president and CEO of the Catholic Health Association, and Chip Kahn, president and CEO of the Federation of American Hospitals.

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The hospital leaders acknowledged difficulty of the challenge. Keehan noted that about 75% to 85% of the people the Patient Protection and Affordable Care Act is meant to help believe there's nothing in the law that can benefit them.

Kahn said that while hospitals alone can't do all that is needed to enroll millions of Americans, healthcare providers are “uniquely positioned” to identify community resources and spur community partnerships, which are required for this initiative to be successful.

Offering practical advice for healthcare providers during the webcast, Cynthia Taueg, vice president for ambulatory and community health services at Warren, Mich.-based St. John Providence Health System, said the organization has set up a hotline to field calls and established an Intranet so system employees can learn more about enrollment.

The five-hospital system, which serves metropolitan Detroit, is a certified application counselor, or CAC, organization, which uses staff and volunteers to help enroll in coverage, but it is not part of a federal grant program like the navigator program. The system also is well versed in helping patients apply for federal health benefits, Taueg said. In fiscal 2012, the system processed 19,000 Medicaid applications, of which 49% came from the emergency department, 40% came from inpatient admissions and 11% came from outpatient admissions.

Taueg also said something that Umbdenstock underscored later: The system has not expended more resources in its efforts, but rather shifted or re-deployed existing resources.

She offered three suggestions of what hospitals could be doing now: Promote the law's coverage options through mailings or health fairs to patients they serve already who are uninsured; inform their employees, who she called the “ambassadors” in their communities; and reach out to other community partners. For instance, hospitals should know who the federally funded “navigators” are in their service area.

Dr. Mandy Cohen, senior adviser to the CMS administrator, told the participating hospital officials that HHS continues to focus its outreach efforts on the “younger cohort”—the 17.8 million uninsured individuals between the ages of 18 and 35—of whom more than 90% will be eligible for some sort of financial benefit for health insurance. Meanwhile, Cohen said, HHS continues to concentrate on eight states where more than 50% of the nation's uninsured individuals reside: California, Florida, Georgia, Illinois, New York, North Carolina, Ohio and Texas.

Relaying questions from participants, the AHA's Umbdenstock asked Cohen to clarify the difference between navigators and CAC organizations, such as St. John Providence.

“The CACs are designed for those organizations that have done this type of work before, have helped others apply for federal benefits, for example,” Cohen said. “The CACs will need to do some training in order to go into our database and for HHS to send someone in your direction” for training, which she said lasts about five hours.

Finally, Umbdenstock asked Cohen the question on everyone's minds: Will the federal exchange be up and running in a few weeks?

“We are going to be ready on Oct. 1,” Cohen said. “We're not moving that deadline. Oct. 1 is coming and we will be open for business,” she said, adding, “It's not election day on Oct. 1. It's just the beginning—we will have six months to do this work.”

Follow Jessica Zigmond on Twitter: @MHjzigmond

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