- The Enterprise
- The Recorder
Calvert Healthcare Solutions was selected to serve as the region’s Maryland Health Connection to assist with eligibility and enrollment into Medicaid and qualified health plans under Maryland Health Care Reform, the Maryland Health Benefit Exchange announced last week.
CHS was one of six organizations in the state chosen as a connection by the MHBE, which is responsible for implementing the state-based insurance exchange through the federal Affordable Care Act, according to a Department of Health and Mental Hygiene press release.
Beginning July 1, CHS will serve for a year as the prime grantee to meet the needs of individuals and small employers in Charles, Calvert and St. Mary’s counties, the press release states. CHS will receive an anticipated $1.4 million in grant funding to provide education, outreach, and eligibility and enrollment services for the nearly 31,000 uninsured residents in Southern Maryland once the new health insurance coverage options become available in October.
Sen. Thomas “Mac” Middleton (D-Charles) said that once health care reform under the Affordable Care Act “kicks in” on Jan. 1, “everyone is going to be entitled to health care coverage.”
The connection program is beneficial to the region, he said, because it will make people aware of what services are available to them. Middleton said designating CHS as the connection is good for all three counties because the organization is already in place and “equipped to take on the job.”
“I think it’s good news for Calvert County and for Southern Maryland,” Middleton said.
During a recent panel presentation at the College of Southern Maryland’s Prince Frederick campus, Calvert Memorial Hospital President and CEO Jim Xinis said that if CHS was not selected as the region’s connection, it would go out of business.
CHS Executive Director W. Michael Shaw said during a phone interview Friday that CHS’s main mission is to provide services to people who are no longer eligible or make too much money to be eligible for medical assistance, but who do not have access to or can’t afford commercial insurance. Had CHS not been named as the region’s connection, it would have gone out of business because the connection’s services would overlap with theirs and CHS essentially would not have a population to serve.
Shaw said CHS currently operates as an organization that provides access to health care services through participating providers. He said CHS has an agreement with certain physicians in which they agree to see CHS clients for a reduced fee.
“The client member benefits we provide right now, once those changes take effect Jan. 1, 2014, that certainly is going to change,” Shaw said.
Once the open enrollment period begins in October, CHS benefits will no longer be “valid,” Shaw said, so CHS and partnering organizations are currently performing outreach education about enrollment possibilities to its target, hard-to-reach population.
CHS staff is currently considering how to “start tapering out of the current program, but in the meantime, certainly with [the connection program] becoming funded July 1, all the other stuff will be starting by that point,” Shaw said.
As the connection, CHS will have 20 navigators and assisters providing outreach and education, providing information about eligibility requirements for federal premium subsidies and cost-sharing assistance, and assessing eligibility requirements for Medicaid and Maryland Children’s Health Program, the press release states. Navigators will counsel and enroll residents into qualified health plans and Medicaid, and assisters will provide information, assistance and enrollment into Medicaid, according to the release.
CHS will partner with three organizations: Health Partners in Charles County, Walden Sierra in St. Mary’s County and Greater Baden Medical Services in both counties, Shaw said. The three partnering organizations will provide outreach services in their respective counties because they have strong relationships within the community and can provide insight to the target population eligible for coverage from the connection, Shaw said.
“They already have existing relationships and reputations within their own communities,” Shaw said. “We’ll all be doing the same thing, but Calvert Healthcare Solutions is going to be the lead organization that’s responsible for all of the management and the oversight of the entire region.”