A key provision of the Patient Protection and Affordable Care Act of 2010 is up and running, according to an informational bulletin recently released by the Baltimore-based Center for Medicaid, CHIP and Survey & Certification (CMCS).

 

The Federal Coordinated Health Care Office, the creation of which was a provision of the act, is anticipated to bring together officers and employees at the Centers for Medicare and Medicaid Services (CMS) “in order to more effectively integrate benefits” under the Medicare and Medicaid programs, the bulletin indicated.

 

The new office also will focus on fostering improvements in the quality of healthcare and long-term services for people who are dually eligible for both federal programs, according to the bulletin, striving to help simplify processes for acquisition of items and services while also increasing understanding and satisfaction of the coverage. This will be done in a number of ways, the bulletin indicated, two of which will be eliminating regulatory conflicts between the two federal programs and improving coordination between the federal government and individual states.

 

Dual-eligible beneficiaries account for 16 to 18 percent of enrollees in Medicare and Medicaid, but roughly 25 to 45 percent of spending in the programs, respectively, the bulletin indicated, making care offered to them a key target for financial and logistical reform. The “vast majority” of the nine million beneficiaries receive fragmented care at an estimated annual cost of more than $300 billion in state and federal spending, according to the bulletin.

 

To read more about the new office, check out the Federal Register notice announcing its establishment.

 

Additional Improvements

 

But that effort isn’t the only provision of the Affordable Care Act to start gaining momentum during recent weeks, CMCS noted. Also recently published was a recommended set of core quality measures that can be used for voluntary reporting by states to monitor and improve the quality of care obtained by adults enrolled in Medicaid, the bulletin added.

 

The Agency for Healthcare Research and Quality (AHRQ), on behalf of CMS, in October 2010 convened a meeting of a subcommittee to its National Advisory Council on Healthcare Research and Quality to provide guidance on the measures. According to the bulletin, the subcommittee consisted of state Medicaid representatives, quality experts from a range of clinical disciplines and representatives of health professional organizations.

 

The subcommittee reviewed about 1,000 measures for assessing quality of care for adults from a list of previously established measures, the bulletin indicated. From those, the subcommittee identified 51 measures to recommend as an initial core set, breaking them into categories including prevention and health promotion, management of chronic conditions, management of acute conditions, family experiences of care and availability of services.

 

To read more about this initiative, read the Federal Register notice announcing the measures.

 

CMCS also is seeking feedback through the Federal Register on “how to balance the need for quality measurement with minimizing the reporting burden on states,” the bulletin indicated. AHRQ will also be providing additional information about the process for identifying the core set of adult quality measures on its website at www.ahrq.gov.

 

Various Reports

 

The bulletin further outlined a series of reports recently released by the federal Department of Health and Senior Services, the umbrella entity for CMCS and CMS alike. One such annual report, also recently established by the Affordable Care Act, is intended to “provide guidance to states regarding preventive and obesity-related services available to individuals enrolled in Medicaid,” the bulletin indicated. States have been instructed to design public awareness campaigns to educate Medicaid enrollees on the availability and coverage of such services.

 

The report of this kind was delivered to Congress a little more than a week prior to a New Year’s Day deadline, with more to come every three years through 2017. The initial report provided baseline information on the types of preventive and obesity-related services covered by Medicaid, as well as a summary of current and planned federal and state activities, according to the bulletin. Future reports will identify and assess the effectiveness of efforts to increase awareness of coverage for obesity-related services.

 

A separate recent report covered progress being made in relation to the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which includes a series of provisions designed to improve the quality of care provided to children in the Medicaid and CHIP programs.

 

Law requires the department to submit to Congress a report that details the status of “efforts to improve the duration and stability of children’s health insurance coverage in Medicaid and CHIP; voluntary quality reporting by States under Medicaid and CHIP, utilizing the initial core quality measurement set established under the statute; and recommendations for legislative changes needed to improve the quality of care provided to children in Medicaid and CHIP,” the bulletin indicated.

 

The report was transmitted on Dec. 30, 2010 and soon is expected to be available on the CMS website.

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