Healthcare Business Week in Review: Health Insurance Exchanges, Navigators, Medication Adherence

Friday, August 30th, 2013
This post was written by Cheryl Miller

Contrary to popular opinion, young adults between the ages of 19 and 26 do not think they’re immortal and do think they need health insurance. In fact, according to a study from The Commonwealth Fund, if members of this population don’t have health insurance, it’s because they can’t afford it.

Nearly half of the 15 million young adults enrolled in a parent’s health plan last year most likely would not have been eligible for coverage without the health reform law’s dependent coverage provision.

The survey also found that only 27 percent of young adults were aware of the state health insurance marketplaces launching October 1. The demographic that would benefit most from these marketplaces are those without coverage and those from low- or middle-income households, or, those least likely to be aware of them.

But these young adults, and all other adults, can seek out help through a coterie of navigators funded by the HHS. The agency has granted $67 million to 105 applicants in federally run and state partnership marketplaces, for navigators trained to help Americans who need assistance in shopping for and enrolling in plans in the health insurance marketplaces beginning this fall.

Health information navigators are trained to provide unbiased information in a culturally competent manner to consumers about health insurance, the new HIEs, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program (CHIP). Funding was available to eligible private and public groups and the self-employed who met certain standards to promote effectiveness, diversity, and program integrity, HHS officials say.

If all the health reform changes have made Americans’ blood pressure soar, there is help: a large scale study from Kaiser Permanente found that single pill combinations and consistent follow-ups with hypertension patients helped improve the rate of blood pressure control by nearly twice as much. Through one of the largest community-based hypertension programs in the nation, Kaiser Permanente Northern California nearly doubled the rate of blood pressure control among adult members with diagnosed hypertension between 2001 and 2009, helping to reduce the risk of stroke and heart attack for patients.

And speaking of soaring, accountable care organizations are flooding the healthcare landscape; with the number of public and private ACOs nearing 500, participants and pundits alike are looking more closely at the model’s structure, challenges and benefits.

How is your organization participating in ACOs? Take HIN’s third annual survey on ACOs by September 6, 2013 and receive a FREE executive summary of the compiled results.

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