State Medicaid records contract awarded to ACS

Filed under: Health Care |

Affiliated Computer Services will continue to manage the state’s Medicaid records for the Colorado Department of Health Care Policy and Financing as part of a three-year, $67 million contract.
ACS has held the contract since 1996. The company processes more than 25 million claims annually.
The contract also includes systems development and maintenance, pharmacy benefits management, decision support services, fraud and abuse detection and recovery, claims processing, call center and program policy support and third party recovery.

COBRA not always cheapest option for coverage

Colorado workers who lose their jobs should consider an individual health insurance policy as an alternative to continuing their former group policies through the Consolidated Omnibus Budget Reconciliation Act, more commonly referred to as COBRA.
The cost of COBRA coverage is surprising, said Healthquotes.com founder Michael Horvat, who has more than 28 years of experience as a Colorado health insurance broker.
“Individual policies can be prohibitively expensive in some states, however, Colorado has very reasonable rates, making individual policies an attractive alternative to COBRA,” he said.
COBRA, which became law in 1986, provides former employees, retirees, spouses and dependent children the opportunity to continue health coverage at group rates on a temporary basis.
The cost is often more expensive than the cost for active employees because COBRA participants can be required to pay up to 102 percent of premium costs.
In Colorado, inexpensive short-term policies are available, particularly for people with no pre-existing conditions. Policies typically provide 90 days of coverage but can be extended for up to a year.
COBRA coverage might be the best option if a separated employee has a pre-existing medical condition, but Horvat said it is important to determine how those conditions affect the cost of an individual policy.

SET clinic makes temporary move

The SET family medical clinic will move while the Marian House undergoes renovations.
The clinic will be temporarily housed at 424 W. Kiowa, Unit B. Its hours are 11:30 a.m. to 1 p.m. Monday through Friday. Transportation is available from the Marian House Inter-Agency Bus and the Colorado Metro Interstate Expansion bus.
The clinic has an average of 3,200 visits each year and is a faith-based organization that provides basic medical services and holistic health programs to uninsured, underinsured, homeless and low-income people.

Commission recommends language strategies

A Joint Commission report recommends targeted strategies to address language and cultural issues that hinder hospitals from delivering effective care.
The recommendations are the result of a study about how 60 hospitals provide health care to culturally and linguistically diverse patient populations.
The project examined the challenges of providing care and services to groups that might not speak the same language or share the same customs. It also looked at how hospitals are addressing the challenges.
The study shows inconsistent practices — both in the aggregate and in individual hospitals. The recommendations include:
Leadership. Hospitals serving linguistically and culturally diverse patient populations should consider establishing a centralized program to coordinate services relating to language and culture as a part of a commitment to quality. Other recommendations for hospital leadership include a commitment to culturally and linguistically appropriate care and fostering discussions about the issues.
Quality improvement and data use. Hospitals should implement a uniform framework for systematic collection of data about race, ethnicity and language, and should stratify by language, race, and ethnicity, service and technical quality measures.
Work force. Hospitals should work to find ways to meet the needs of diverse populations and should provide training to staff about how and when to access language services. Accrediting bodies should require continuing education and training that supports the provision of culturally and linguistically appropriate care
Patient safety and provision of care. Hospitals should formalize their processes for translating patient education materials, such as patient rights and informed consent documents, into languages other than English and should use health care interpreters and cultural brokers to facilitate communication and education.
Language services. Hospitals should establish written policies regarding language services, including prohibiting the use of family members and children as interpreters except in emergencies.
Community engagement. Hospitals should work with community members from diverse cultures and language groups through formal boards and in hospital planning processes, as well as consider partnerships with ethnic media to promote better understanding about available hospital services and appropriate routes for accessing care.
Copies of the report are available at www.jointcommission.org.
Amy Gillentine covers health care for the Colorado Springs Business Journal.