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Public Health and the Affordable Care Act—Key Implementation Issues

Public Health and the Affordable Care Act—Key Implementation Issues. Jeffrey Levi, PhD National Summit on Preconception Health and Health Care June 13, 2011 Session on Public Policy and Finance. Overview. Opportunities for public health to engage the reformed system at the state level

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Public Health and the Affordable Care Act—Key Implementation Issues

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  1. Public Health and the Affordable Care Act—Key Implementation Issues Jeffrey Levi, PhD National Summit on Preconception Health and Health Care June 13, 2011 Session on Public Policy and Finance

  2. Overview • Opportunities for public health to engage the reformed system at the state level • Medicaid • Exchanges • Public health programs need a new business model • Leveraging opportunities in the Community Transformation Grants

  3. Engaging Medicaid • Expansion population as a means of addressing preconception care • Assuring comprehensive benefits for the expansion population • Assuring broader preventive services for the entire Medicaid population

  4. Engaging the Exchanges • Exchanges are the vehicle for uninsured between 133-400% of poverty to receive subsidized coverage • Opportunities • Board membership; other forms of engagement • Outreach and enrollment roles • Essential Health Benefits Package • Essential Community Providers • Linkage to public health programs • Surveillance and Quality Assurance

  5. Engaging Medicaid and Exchanges • Churning between Medicaid and Basic Health plan • Achieving continuity of care • Assuring same networks • Assuring same benefits • Minimum enrollment period

  6. New business model for public health programs • Discretionary (grant) dollars must be payer of last resort • Billing and enrollment practices • Being part of a network

  7. Community Transformation Grants • Part of the public health team on the community coalition • Bringing in community partners for the coalition • Defining the reach of programs/policies to include preconception care • Enrollment in preventive services • Chronic disease prevention

  8. Multi-stage engagement • New partners • New entities • New programs • New functions • New procedures

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