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Robin Callahan

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Which practices are eligible? DSS kids, elders, special needs, high risk, everyone? ... (underuse, misuse, resource use) (NQF endorsed) NCQA Qualification as PCMH ... – PowerPoint PPT presentation

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Title: Robin Callahan


1

Health Care Reform Implementation January 22,
2010
Robin Callahan Director of Member Policy
Program Development, Office of Medicaid
2
Health Care Reform Implementation
  • Countless moving parts
  • Strong centralized coordination needed to track
    progress and share information
  • Secretary of Health and Human Services convened
    weekly cross agency meetings
  • HCR project leaders from each agency reported
    progress and challenges

3
Leveraging Existing Medicaid Infrastructure
  • One front door for subsidized health programs
    (MassHealth, Commonwealth Care, and the
    Health Safety Net)
  • Medicaid program has the staffing and systems
    required to determine income eligibility
  • Adding Commonwealth Care rules to the existing
    eligibility system ensures maximum benefits for
    applicants and notice of eligibility for all
    family members

4
Virtual Gateway The programs
  • These programs can be applied for online using
    the Virtual Gateway
  • MassHealth, including
  • Children's Medical Security Plan
  • Healthy Start
  • Health Safety Net
  • Commonwealth Care
  • Child Care
  • Food Stamps
  • Women Infants Children (WIC)
  • Womens Health Network
  • Department of Mental Retardation services
  • Mass. Rehabilitation Commission services
  • Elder services
  • Mass. Commission for the Blind Services
  • Mass. Commission for the Deaf / Hard of Hearing
    services
  • Veterans Services Holyoke / Chelsea
    Soldiers Homes

5
Virtual Gateway Award 2008
6
Massachusetts Health Care Training Forum
  • Massachusetts Health Care Training Forum (MTF) -
    Program Goal
  • MTF communicates accurate, timely information
    about operations and policies of Massachusetts
    State Health Care Programs to community health
    and human service partners.

7
Massachusetts Health Care Training Forum
  • North (Tewksbury)
  • Central (Shrewsbury)
  • Boston
  • West (Holyoke)
  • Southeast
  • (Taunton)

20 Meetings Annually in 5 locations Total
Attendance annually 2,000 - Email Updates
- Website - Outreach (Formal and Informal)
8
Massachusetts Health Care Training Forum
  • Formal presentations about issues related to
  • Eligibility/Enrollment
  • Case Management
  • Billing/Claims
  • Advocacy
  • Information directly enhances attendees ability
    to assist current and potentially eligible
    individuals
  • Roundtable sessions with state experts, trainers
    and advocates
  • Network opportunity for state and community
    organizations to build collaborative relationship

9
EOHHS Enrollment, Outreach Access to Care
Grants Grant Recipients51 Community Based
Organizations
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