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Title V Technical Assistance Meeting

 Health Reform Implementation: Looking Back, Looking Forward

By The AMCHP Health Reform Implementation Team

(Stacy Collins, Atyya Chaudhry, Emily Eckert, and Carolyn McCoy)HRI Team.jpg

Through national policy and program efforts, AMCHP's Health Reform Implementation (HRI) team continues to advance its goal of ensuring that health reform promotes the well-being of Title V's core constituencies - women, children, including children and youth with special health care needs (CYSHCN), and families. 2015 was a productive year for the HRI team, whose activities ranged from working intensively with state teams on health reform-related projects, to protecting the rights of vulnerable populations in the on-going regulatory modifications of the Affordable Care Act (ACA). The start of the New Year offers a chance to reflect on the successes of the past 12 months and share highlights of our 2016 agenda. 

The National MCH Workforce Development Center

In 2015, the HRI team worked diligently on a variety of projects with the National MCH Workforce Development Center (NWDC) at UNC-Chapel Hill. The HRI team was heavily involved in the preparation and implementation of the three 2015 NWDC intensive trainings in Chapel Hill, Denver and DC. HRI staff served as coaches and subject matter experts, to help states move their health transformation projects forward. In addition, members of the HRI team played leadership roles in the NWDC's Access to Care and Systems Integration Cores, which developed specialized presentations and learning modules tailored to MCH audiences, including the Affordable Care Act: A Working Guide for MCH Professionals, the Health Reform State Assessment Tool the Five-minute System Mapping Video Series, which introduces system mapping tools in brief, two-to-five minute videos.

AIM-Access Project

Throughout 2015, AMCHP served as the backbone organization for the MCHB-funded Alliance for the Innovation in Maternal and Child Health: Expanding Access to Care for MCH Populations (AIM- Access) project. The project is a collaborative of six national organizations committed to working intensively with states to achieve impact in three health reform focus areas: strengthening continuity of coverage and care for pregnant women and children, improving systems of care for CYSHCN, and promoting implementation of Bright Futures.  In October, the HRI team produced an AIM webinar in conjunction with the National Institute for Health Care Management Foundation (NIHCM). "Improving Continuity of Coverage and Care for Pregnant & Postpartum Women" featured speakers from the health insurance industry, women's health community, and the state health department sector. In November, AMCHP and its fellow AIM partners hosted a kickoff meeting in Washington, DC for the first cohort of AIM states. Five multi-disciplinary state teams from CA, KY, NV, PA, and RI participated in the event, which featured presentations from national children's health experts and discussion of related state efforts. AMCHP will continue to provide technical assistance to the first cohort of states throughout 2016.

Kellogg Foundation support for member education on MCH and health reform

With support from the Kellogg Foundation, the HRI team has produced a series of member educational materials on ACA provisions that directly support women and children's health.  Materials include fact sheets on essential health benefits in qualified health plans (QHP) and ACA provisions that promote women's preconception health, as well as detailed issue briefs on the implementation of ACA breastfeeding provisions and the implications of the ACA for health care coverage for children and youth with Autism and other developmental disorders.  The HRI team contributed to the development of Health for Every Mother, A Maternal Health Resource and Planning Guide for States that includes a menu of strategies and program and policy resources for states such as promotion of insurance coverage. 

Health Reform Policy Efforts

In 2015, the HRI team worked collaboratively with the Policy and Government Affairs team to monitor and respond to Federal action on provisions of the Affordable Care Act (ACA) that impact MCH populations. Specifically, AMCHP staff submitted comments to the Department of Health and Human Services (DHHS) on proposed regulations affecting women's and children's health coverage, including changes to Medicaid, the Children's Health Insurance Program (CHIP), and QHPs sold in the insurance Marketplace.  AMCHP made recommendations to strengthen the proposed DHHS rules to better support MCH populations, including suggested improvements in provider network adequacy standards, benefit design, essential health benefit structure, consumer assistance programs, and special QHP enrollment periods, among others.  

A core function of the HRI team's work is participation in federal policy coalitions.  These coalitions bring together national experts, advocates, and other stakeholders, whose collective mission is to improve the health of women, children and families.  By participating in these groups, the HRI team can discuss emerging issues and policies, stay up-to-date on health reform trends, and engage in collective action on federal issues of importance to AMCHP members.  In 2015, the HRI team participated in the Essential Health Benefit (EHB) Coalition and three of its related subgroups focusing on pediatrics, maternity, and habilitative services. In addition, the HRI team participated in the Children's Health Group coalition, First Friday coalition (focused on healthcare policy), the national Preconception Health and Healthcare Committee leadership team, the National Pregnancy Workgroup and the Coalition for Whole Health (focused on maximizing access to mental health services under the ACA).

Looking ahead to 2016

In 2016, the HRI team will continue to build on the success of the past year and delve into new opportunities to support AMCHP members.

Supporting members in National Performance Measure (NPM) implementation

 The HRI team will continue to play a central role in AMCHP's NPM member education efforts.  In 2016, the team will release the "ACA – Title V NPM Crosswalk," which demonstrates how ACA provisions can support members in reaching their NPM goals.  Another member education resource is the January 2016 webinar geared to states that have chosen NPM number 15: percent of children aged 0-17 who are adequately insured. This webinar will feature national experts and AMCHP state leaders discussing strategies that Title V staff can use to improve rates of comprehensive coverage for children in their states.  The webinar recording will be housed on the AMCHP website for member use throughout the year. 

Cutting Edge – Disseminating innovative MCH practices

In January 2016, AMCHP's Innovation Station will feature a new MCH best practice category: Cutting Edge. These practices are considered emerging innovations of existing or new methods and practices, with a special emphasis on those that focus on health transformation activities. Specifically, Cutting Edge practices provide an innovative approach to an evolving public health issue; align with experiential evidence inside or outside of public health; show early signs of promise or success; and have an evaluation or quality improvement plan in development. The January 2016 launch features four case studies from WA, IA, GA and NY. 

Helping members navigate the continually evolving health reform landscape

Keeping our members informed with the most up-to-date information is a priority of the HRI team.  Health reform fact sheets and issue briefs on the team's resource page, are updated regularly. New topics planned for 2016 include the impact of health reform on mental health and substance use services for MCH populations, Title V experiences with the ACA "Health Home" program, opportunities for working with state insurance commissioners, and other timely issues.  The HRI team will also collect and disseminate information on member health reform activities and priorities, gathered from the AMCHP annual survey and member regional calls.  And as always, HRI staff are readily available to AMCHP members for consultation and technical assistance on all MCH health reform matters.

We look forward to engaging AMCHP members and partners throughout 2016, as the scope and impact of health reform and the ACA continue to unfold.