Health Connector Update

Transcription

1 Health Connector Update Massachusetts Health Care Training Forum October 2011

2 Agenda Commonwealth Care Current enrollment Post-open enrollment results Operational Updates Commonwealth Choice Current enrollment Open enrollment results Special conditions tool Health Connector Outreach 2

3 Current Commonwealth Care Enrollment

4 Commonwealth Care Enrollment Aug 2010 Sept , , , , , , , , , , , , , ,323 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 (Preliminary) 4

5 Commonwealth Care Bridge Enrollment Aug 2010 Sept ,438 23,248 23,096 22,775 21,611 20,389 19,922 19,215 18,535 18,061 17,418 16,521 15,802 14,708 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 (Preliminary) 5

6 Commonwealth Care Post - Open Enrollment Results

7 Commonwealth Care Enrollment By MCO (Aug 2010 vs. Aug 2011) There have been some changes in membership distribution by MCO during FY11 and in early FY12 40% 35% 30% 25% BMCHP 36% BMCHP 34% NWH 31% NWH 28% NHP 22% NHP 25% BMCHP 30% NWH 30% NHP 25% 20% 15% 10% 5% CeltiCare 6% Fallon 4% CeltiCare 10% Fallon 4% CeltiCare 12% Fallon 4% 0% Aug 2010 Jun-11 Aug

8 Early FY12 Enrollment Results Actual enrollment results to date have been consistent with our expectations Open Enrollment 11,048 members, representing nearly 7% of Commonwealth Care enrollment, switched to different health plans The level of transfer activity is moderately higher than in previous years Network Health, with its significant changes in both premium and network, experienced the most membership turnover NHP, which offers the most competitively-priced broad network, had the highest net growth 8

9 Open Enrollment Details Gain/Loss By MCO PT II & III only BMCHP NWH NHP CeltiCare Fallon Premium $ $0-116 $ $0-116 $ Premium Network Broader Narrower Broader Narrower Broader Significant Network Unchanged Narrowed Unchanged Unchanged Unchanged (# of Members) PT II & III gain PT I gain 674 3,335 3,988 2, PT I loss (1,060) (907) (271) PT II & III loss (3,789) (5,021) Net Change (3,114) (1,686) 2,928 2,017 (145) 9

10 Member Web Utilization During Open Enrollment (June and early July), 28% of plan changes were made by web Web registration reached high of 28% in July 2011 Compared to 4% in July % of new enrollees in July used web to enroll Compared to 19% in July % of premium payments for July 2011 were made through EFT Compared to 6% in July 2010 Use of HIP message center increased to 600 messages for both June & July Compared to 400 messages/month for past months 10

11 Commonwealth Care Operational Updates

12 Copayment increases for Plan Type 1 members Beginning on October 1 st, Plan Type 1 members have a copay increase for certain prescription medications Increase is from $3. to $3.65 Members will have received written notification from their MCO Benefits and Co-pays have been updated on the Health Connector website 12

13 Program Guide Updates Go to Mahealthconnector.org Search for Program Guide 13

14 Program Guide Updates Purpose of the guide: Explain the Commonwealth Care program and Member responsibilities Updated to reflect the results of FY12 procurement Areas of note for Outreach staff - Incoming PT1 members - Late or missed payments 14

15 Premium Billing Address Change Starting in November, Commonwealth Care payments must be sent to a new Massachusetts address This change means Members payments will be credited to their accounts faster We will be notifying Members by mail and , as well as including notices on invoices for the next few months To avoid delays in processing, please make sure any payments you send on behalf of Members are sent to the new address 15

16 Premium Billing Address Change Members who use their banks online bill pay services must change the Commonwealth Care address with their banks Members who pay by EFT on Mahealthconnector.org or use the coupon and envelope we provide don t need to do anything different Help us communicate this change to members New address: Commonwealth Care P.O. Box Boston, MA

17 Commonwealth Choice

18 Commonwealth Choice Enrollment 40,000 CommChoice Non-Group Enrollment (Paid members)* 35,000 35,458 32,699 33,182 31,578 30,000 25,000 Jun-11 Jul-11 Aug-11 Sep-11 *Enrollment for all non-group members, including YAP. 18

19 Commonwealth Choice Enrollment CommChoice Group Enrollment (Paid members) Bus Express - Converted Bus Express - New CP VP 5,000 4,228 4,121 4,217 4,205 2,577 2,554 2,534 2,480 2,500 2,244 2,228 2,200 2,272 1,651 1,567 1,683 1, Jun '11 Jul' 11 Aug '11 Sep '11 19

20 Open Enrollment for Commercial Insurance Open Enrollment for the purchase of commercial individual plans took place July 1, August 15, ,970 new Commonwealth Choice members enrolled during that timeframe Individuals now interested in shopping for health insurance should use the Special Conditions Tool on Mahealthconnector.org to find out if they are able to purchase 20

21 Special Conditions Tool (3 steps) 1

22 Special Conditions Tool (3 steps)

23 Health Connector Outreach "HealthWise: Strategies for your Healthcare Costs" The Mass Non Profit Network has partnered with the Health Connector and Health Care for All to present a series of regional meetings for its membership. Purpose: To provide information to help attendees navigate the existing health care system and participate in a discussion with legislators about the need for payment reform in the Commonwealth to help address rising costs. Friday, September 23 Berkshires BCC Intermodal Center, Pittsfield** Monday, October 3 MetroWest Harvard Pilgrim Health Care Offices, Wellesley Friday, November 4 Cape Cod Hyannis (Location TBD) Friday, November 18 Pioneer Valley HCC Kittredge Center, Holyoke Monday, November 21 Central UMASS Medical School, Worcester Friday, December 2 Northeast United Way Lowell, Lowell Monday, December 5 Greater Boston The Boston Foundation, Boston Friday, December 9 Southeast Whaling Museum, New Bedford

24 Questions Website: Commonwealth Care Member Service Center Call 877-MA-ENROLL ( ) TTY for people with partial or total hearing loss