Margaret A Murray Chief Executive Officer November 2017 About ACAP Mission To strengthen notforprofit Safety Net Health Plans in their work to improve the health of lowerincome and vulnerable populations ID: 658543
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How Safety Net Plans Address Social Determinants of Health
Margaret A. Murray, Chief Executive Officer
November 2017Slide2
About ACAP
Mission:
To strengthen not-for-profit Safety Net Health Plans in their work to improve the health of lower-income and vulnerable populations.
Membership: 61 member Safety Net Health Plans cover more than 21 million people in 29 states through Medicaid, Medicare, Marketplaces and other public health coverage programs.
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Capitated Managed Care Accounts For Almost Half of All Medicaid Spending
Capitation as a Percentage of All Medicaid Spending, 2000 – 2016
Source:
“Projected Savings of Medicaid Capitated Care: National and State-by-State.”
The Menges Group, 2017.
2016:
$266.8 B
paid via
capitation
$228.6 B
paid via fee-for-service$50.4 B paid via DSH, supplemental payments
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Safety Net Health Plans Make Up 41% of All Medicaid Managed Care Plans, Serve 43% of Enrollees
Sources:
HMA Enrollment Data, 2017
ACAP Plan Survey results, 2017
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A Path Toward
Alternative Payment Models
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Health Care Payment Learning & Action Network. (2017).
Measuring Progress: Adoption of Alternative Payment Models in Commercial, Medicaid, Medicare Advantage, and Fee-for-Service Medicare Programs
[Report].
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Value-based Payment Framework Using the Health Care Payment
Learning and Action NetworkSlide7
Participants
– 78 plans, 3 FFS states, and FFS Medicare (includes ACAP)
ACAP Plans –
14 participating plans (all lines of business)Lives covered –
245.4 million (84% of national market)
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Almost 30% of Payments are APMs or Population Based Slide8
ACAP’s Plans are Bridging the Gap
SOCIAL DETERMINANTS
VALUE-BASED PAYMENTS
ACAP Plans
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What determines health?
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ACAP Plans’ Innovations
Addressing
Social Determinants of Health
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Housing and
HomelessnessSlide12
Community Care Setting Pilot (CCSP)
Partnership with:
The Institute on Aging (Case Management)
Brilliant Corners (Housing services) Yields 46 percent Cost Savings
“For me, it’s amazing,
this kind of program.”
“The program gave me a place of
my own where I have many friends.”
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Cardinal Innovations Healthcare
Transition to Community Living at Cardinal Innovations
The In-Reach Team
Transition TeamHousing and Employment Specialists TeamPost Transition Team
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Food Security
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Partners with GA Food for the Community-Based Transition of Care Pilot
Pilot includes home-delivered meals
“Building Bridges to Healthy Youth”
Offers nutrition and wellness educational programs targeting parent(s)/caregiver(s) of children and adolescents
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Partner with Urban Gleaners to deliver donated food that gets distributed to housing and service buildings
Cooking Matters – Partnership with Oregon Food Bank that offers cooking classes for members
Prenatal Nutrition
Curative Nutrition Program
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Employment and Job TrainingSlide18
Life Services –
JobConnect
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Meg Murray
Chief Executive Officer
202-204-7508
mmurray@communityplans.net
@
safetynetplans
www.communityplans.net
Thank you!