The Health Care Reform Coordinating Council held a meeting on November 14, 2011 to discuss the Health Benefit Exchange and other reform developments. Click on the links below to view the presentations from the Meeting.

Power Point Presentation: Advisory Committees and Exchange Board’s Consideration of Key Policy Issues

Power Point Presentation: Health Care Reform Implementation Updates

Maryland Health Benefit Exchange
Rebecca Pearce, the Executive Director of the Health Exchange and Secretary Sharfstein gave an update report from the various committee meetings on the Maryland Health Benefit Exchange. 

Of particular interest to me was the discussion around the Navigator and enrollment model and method. This is a key area because if not done properly, many of the State’s vulnerable citizens could be left out in the cold, defeating the purpose for the Exchange.  

Key Questions Regarding Scope of Work Include:

The design and operation of the Exchange’s Navigator program and any other appropriate consumer assistance mechanisms, including:

1. Infrastructure of the existing private sector health insurance distribution system in the state to determine whether private sector resources may be available and suitable for use by the Exchange
2. The effect the Exchange may have on private sector employment in the health insurance distribution system in the state
3. What functions, in addition to those required by the ACA, should be performed by Navigators
4. What training and expertise should be required of Navigators, and whether different markets and populations require Navigators with different qualifications
5. How Navigators should be retained and compensated, and how disparities between Navigator compensation and the compensation of insurance producers outside the Exchange can be minimized or avoided
6. How to ensure that Navigators provide information in a manner culturally, linguistically, and otherwise appropriate to the needs of the diverse populations served by the Exchange, and that Navigators have the capacity to meet these needs
7. What other means of consumer assistance may be appropriate and feasible, and how they should be designed and implemented

What kind of advertising should be used for the Exchange?

Options:
Range of options depending an amount willing to spend Data: Environmental scan, benchmark strategies Input: producers, advocates, carriers, providers, experts Key considerations for the exchange board:
-   Reaching the right mix of uninsured within the market
-   Ensuring cultural and linguistic differences are addressed appropriately and directly

Lt. Governor Brown emphasized the point that there should be a distinct difference between advertising and outreach to take into consideration the diverse population that we need to reach, to which I wholeheartedly agree. Secretary Sharfstein commented that the model that Massachusetts used proved to be very effective and it would be judicious of the State to examine their model.

In summary information gathered through the advisory committee, reports and public feedback will be provided to the General Assembly by December 23, 2011.

Other Reform Developments
Deputy Director Fran Phillips gave an update on the Transformational Grant. Maryland will receive funding, however it will be nowhere close to the figure that was requested. In total, DHMH was awarded $1.9 M annually with a 5 year anticipated project period.

-   Difficult focus: the State minus the Big 5 which are Montgomery, Baltimore County, Baltimore City, Anne Arundel, Prince George’s counties
-   Set aside for rural counties
-   Required priority areas to promote:
Tobacco prevention/cessation
Obesity Prevention (through nutrition and physical activity)
Hypertension screening and control

Anticipated 2012 Legislative Agenda will be:

-   Health Benefits Act of 2012
-   Health Disparities (Specifically Health Quality and Cost Council’s Health Disparities Recommendations)
-   Workforce Development (Specifically Occupational Boards and Scope of Practice)

Their next meeting will be held on January 5, 2012.