• Governor’s Panel on Health Care Reform Implementation Proposes Work Groups

    October 27, 2010
    A meeting of the Governor’s Health Care Reform Implementation Advisory Group has proposed seven sub work groups to examine various aspects of health care reform implementation in New York State and make recommendations. The work groups, listed below in detail, are tentatively scheduled to start meeting in mid-November in Albany, and will be open to all. Stay tuned for more details.

    HEALTH CARE REFORM IMPLEMENTATION ADVISORY GROUP

    Work Group 1 – Health Insurance Exchanges

    Meeting 1 Topic: Impact on small group/individual markets
    Meeting 2 Topic: Role of the Exchange-Active Purchaser, Clearinghouse or selective contracting agent?
    Additional Topics:
    • Include large groups in the exchange?
    • Establishment of a basic health plan?
    • Certification of Qualified Health Plans
    • Enrollment navigation
    • Information Technology
    • Statewide exchange vs. regional exchange?

    Work Group 2 – Commercial Market Reforms

    Meeting 1 Topic: Legislation to synthesize 6 month reforms with state managed care laws
    Meeting 2 Topic:Impact on commercial market resulting from decision to combine or separate individual and group exchanges
    Additional Topics:
    • Include large groups?
    • Transparency of Benefits provided by plans
    • Quality Measurements for both plans and providers
    • Premiums

    Work Group 3 – Public Health Insurance Program

    Meeting 1 Topic: Medicaid Eligibility Rules/Streamlining Eligibility
    Meeting 2 Topic: Prevention and quality measures
    Additional Topics:
    • Medicaid reimbursement alternatives
    • Medical homes, ACOs and integrated care models
    • DSH Reduction
    • Coverage for Immigrants
    • Establishment of a basic health plan

    Work Group 4 – Outreach and Enrollment

    Meeting 1 Topic: Effective enrollment and retention strategies for low-income childless adults
    Meeting 2 Topic: Effective enrollment and retention strategies for children and families
    Additional Topics:
    • Effective enrollment/retention for low-income seniors and immigrants
    • Navigator roles
    • Exchange outreach and enrollment strategies

    Work Group 5 – Cost Containment/Delivery Reform

    Meeting 1 Topic: Primary Care
    Meeting 2 Topic:Medical homes, ACOs and Integrated Care Models
    Additional Topics:
    • Evidence-based Medicine
    • Paying for Value
    • Dual Eligibles
    • Administrative Efficiencies
    • Standardization
    (Dr. Hughes raised need for medical liability reform here)

    Work Group 6 – Public Health

    Meeting 1 Topic: Role of Public Health in federal health care reform
    Meeting 2 Topic: Public health grants – anticipated future funding
    Additional Topics:
    • Planning for the future (Healthy People 2020, DOH Prevention Plan, Surgeon General’s Prevention Plan, etc.)
    • Disease Management
    • Workforce Development

    Work Group 7 – Long Term Care

    Meeting 1 Topic: Balancing Incentives/Community First Option
    Meeting 2 Topic: CLASS Act and Nursing Home Transparency
    Additional Topics
    • Removal of barriers for home/community based services
    • Spousal Provisions
    • Dual Eligibles
    • CMS Center for Medicare and Medicaid Innovation