Sep 3, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions An Expert’s Guide for State Medicaid Agencies Stakeholder engagement isn’t just a buzzword: it’s the starting point for any Medicaid agency seeking to make better, more informed decisions. Gathering and applying stakeholder feedback can ensure that an agency’s programs are effective, inclusive, and well-received. Stakeholder engagement requires frequent and consistent communication with the right contacts. However, this can be difficult for government employees juggling competing priorities or from states with large geographies, diverse and economically varied populations, or a mix of urban, rural, and suburban communities. These challenges have led to a growing trend: Many states are partnering with third-party organizations to help create and implement their health programs. This is especially true for large health assessment projects, where third-party experts are better equipped to have in-depth conversations with stakeholders and gather insights that can enhance operations, improve program performance, and ensure equity for all. Understanding the Value of Stakeholder Feedback Collecting and analyzing stakeholder data is essential to understanding the priorities and needs of a state's population and provider networks. Feedback from stakeholders provides valuable insights that can inform policy and program decisions, ensuring that initiatives are aligned with the community's needs. Stakeholder feedback helps identify gaps in services, areas for improvement, and potential innovations. For example, by engaging with healthcare providers and patients, state agencies can better understand the challenges faced in delivering and receiving care. This information can lead to higher member satisfaction as programs are tailored to address the growing needs and preferences of the community. Greater satisfaction can also lead to improved health outcomes and member experiences. Another cr

Aug 29, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Strategies to Enhance Member Experience Through Proactive Communication & Cutting-Edge Support Solutions Effective customer service centers are vital for exceptional healthcare. When people have health concerns, the last thing they want to do is navigate a complex web of appointments, paperwork, and conversations. Medicaid members are no different. Unfortunately, Medicaid members often receive varying levels of customer service support, with mixed reviews on the effectiveness of the services. This can cause great frustration and be a barrier to getting members the help they desperately need. That’s why it’s essential that Medicaid agencies—especially in populous and diverse states like New York, Texas, and Florida—develop call centers that can respond to members quickly and effectively. Here are four ways your Medicaid agency can deliver better customer service—and better outcomes—to its members: Communicate Proactively Anticipate member needs and reach out before issues arise. These outbound communications can help address common questions and concerns, reducing the volume of inbound queries. Tip: Collect data about the most common questions and send communications about these issues to avoid confusion and increase awareness. Industry insight: According to CMS, proactive communication and outreach can significantly improve healthcare outcomes by ensuring members are well-informed and engaged in their healthcare plan. Improve the Capabilities of Customer Service Representatives Onboarding and training are essential for preparing customer service staff to handle the specific needs of Medicaid populations. Additionally, effective training reduces staff turnover by creating a knowledgeable workforce capable of resolving issues efficiently. This leads to better service delivery, reduced wait times, and fewer call transfers— increasing customer satisfaction. Tip: If calls about

Aug 27, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Ensuring Fairness in Healthcare to Address Social Determinants of Health Health equity is essential in Medicaid administration. However, delivering on it can be especially difficult in states like New York, Texas, and Florida. These states have large and diverse populations and face unique challenges related to race, ethnicity, socioeconomic status, and geographic location. States facing these unique challenges are partnering with innovative organizations with deep expertise in Medicaid programs. Based on an examination of programs across 45 states in the US, success starts with: Address Geographic Diversity Medicaid programs must tailor their approaches to address these unique challenges presented by urban, rural, and suburban areas: Urban Areas: Focus on reducing overcrowding in healthcare facilities and improving access to preventive care. Rural Areas: Address the shortage of healthcare providers and improve transportation to medical services. Suburban Areas: Ensure healthcare services are accessible and affordable for low-income residents. States such as New York—comprised of urban, rural, and suburban areas—are in a particularly difficult situation. However, Medicaid programs that customize their strategies based on geographic needs see better health outcomes and higher patient satisfaction. Harness Local Knowledge & Language Support Many Medicaid recipients speak languages other than English. Implementing multilingual training programs and hiring bilingual staff can help bridge language barriers and improve patient satisfaction. Recruiting providers from your agency’s communities can also help build trust and lead to better health outcomes. Train Providers on Industry & Local Best Practices Proper training for healthcare providers and administrators is essential for delivering equitable care. Training should include: Cultural Competency: Understanding the cultural

May 21, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Stress is a normal part of life, but when it becomes chronic stress can hurt your physical and mental health. Whether you’re working from home, in an office setting, or in the field, stress is proven to play a huge role in employee burnout, absenteeism, and other related workplace issues. There are several simple, specific, and evidence-based relaxation techniques that you can use to help manage stress and improve your overall well-being. Discover more below. Deep Breathing Deep breathing is a simple but effective way to relax your body and mind. Also known as diaphragmatic breathing, belly breathing, abdominal breathing, and paced respiration, deep breathing allows you to fill your lungs with air, which is not the case with regular breathing. According to Dr. Yufang Lin, MD of the Center for Integrative Medicine at Cleveland Clinic Health System in Ohio, normal shallow breathing can result in unintentionally adding stress on your body. To practice deep breathing, sit or lie in a comfortable position and close your eyes. Take a deep breath through your nose, slowly and fully expanding your lungs. Hold your breath for a few seconds, then slowly exhale through your mouth. Repeat this process for 5-10 minutes. Meditation Meditation is another simple, but effective, way to relax and de-stress. There are many different types of meditation, so find one that works for you and practice it regularly. Some popular types of meditation include mindfulness meditation, transcendental meditation, and guided meditation. In this blog, we’re going to focus on mindfulness meditation; according to the Mayo Clinic, mindful meditation is a type of meditation in which you focus on being intensely aware of what you’re sensing and feeling in the moment without interpretation or judgment. In other words, mindfulness meditation is an intentional training of your attention to achieve a certain level of me

May 21, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Recommended Resource Download Now: Tips to Reduce Stress and Combat Burnout Stress is a normal part of life, but when it becomes chronic, it can hurt your physical and mental health. Included in this tip sheet are several, evidence-based relaxation techniques that you can use to help manage stress and improve your overall well-being, whether you are at home or in the office. Download Now The contents of this article and referenced websites, such as text, graphics, images and other material contained on the site are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Reliance on any information provided by these websites is solely at your own risk and Acentra™ Health is not responsible for the contents of any "off-site" webpage referenced from this server. Acentra Health. All rights reserved.

May 8, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Stress and burnout are the most common struggles for employees and a driving force of the current U.S. workplace mental health crisis. In recent years, burnout has emerged as one of the primary concerns among employees across various industries. Burnout is a pressing concern for federal government agencies, with studies indicating high rates of burnout among employees. According to a comprehensive report by Gallup: 1 in 4 employees feel burned out “very often” or “always.” Unfair treatment, unmanageable workloads, unclear communication from managers, lack of manager support, and unreasonable time pressure were cited as contributing to burnout. The consequences of burnout include: Lower engagement among managers and employees. Lower productivity. Increase in unplanned absences. Missed deadlines, delays, and negativity. Addressing Burnout in the Public Sector The good news is that effective interventions can be adopted to prevent and alleviate burnout. Employers can take the following steps: Demonstrate that the organization supports employee well-being Acentra Health partners with our clients to provide counselors in the workplace for convenient onsite support to help meet the needs of their employees. Employees and managers can receive quick and effective care. Support work-life balance through flexible scheduling and telework options. Engage with your people Keeping staff engaged typically starts with the manager. In fact, managers who regularly meet with their staff one-on-one for productive conversations provide their team with meaningful engagement in the form of recognition, opportunities, clarified expectations, and a forum for feedback. Acentra Health offers comprehensive solutions, including: Equipping managers with the tools they need to successfully engage their employees. Enhancing communication and transparency between managers and employees. Destigmatizing mental h

May 8, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Recommended Resource Download Now: Self-Service Quiz To help employees assess their risk of burnout, we've developed a simple eight question quiz that they can use to assess their well-being, seek appropriate support, and ultimately contribute to a healthier and more productive work environment. If your organization is looking for additional ways to foster a supportive environment, you may download and share the Mental Health Self-Reflection Quiz with your workplace. The contents of this article and referenced websites, such as text, graphics, images and other material contained on the site are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Reliance on any information provided by these websites is solely at your own risk and Acentra™ Health is not responsible for the contents of any "off-site" webpage referenced from this server. Acentra Health. All rights reserved.

Oct 9, 2023 – By Verlon Johnson, Chief Government & Corporate Affairs Officer Key Takeaways from the National Association of Medicaid Directors (NAMD) 2023 Fall Conference The NAMD Fall 2023 Conference brought together state agencies, Centers for Medicare & Medicaid Services (CMS) representatives, and industry leaders for insightful discussions on the future of Medicaid. This year’s conference focused on four different themes: PHE unwinding, long-term care, maternal health, and youth health. Additional conference insights and main discussion topics from some of the NAMD sessions include the following: Member Outreach and Leveraging Data Insights The importance of multi-modal outreach to members was a key topic of discussion, as consumer literacy and response rates are lower than expected. States are increasingly leveraging data insights to develop targeted outreach strategies, with over 40 states having published dashboards to track population needs, engagement rates, and areas for improvement. Churn rate, or more simply known as the rate of members dropping out or not finishing the enrollment process, is a frequent focus of many states. CMS representatives stressed this focus with the need to “avoid the churn” in the process, citing that 25-30% of the population accepts the current churn going through the process. Supporting Youth Health and Well-being Young adults who grew up with Medicaid shared their stories, highlighting the need for additional improvements in outreach and support tactics. The group emphasized “meeting members where they are,” not just physically but also in terms of digital presence, advocating for more social media engagement and content in multiple languages. Additional care coordinators were also suggested as a potential resource to help members navigate the Medicaid system more effectively, serving as a point of contact for various circumstances and helping as children on Medicaid aged up in the system. Importance of Strengthening Partnerships S

Sep 28, 2023 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions What We Know About the Latest Proposed Changes In the past two years momentum behind the need to update the Prior Authorization (PA) process has been growing at both the federal and state levels. From the Centers for Medicare & Medicaid Services (CMS) proposing new rules to the HHS Office of the Inspector General (OIG) raising concerns about access to care through a fair and equitable process for Medicaid beneficiaries, it's clear that changes to the PA process will be required for Medicaid prior authorizations in the foreseeable future. As planning begins for the implementation of the proposed CMS rules in January 2026, our Acentra Health experts are considering updates to four key areas: The latest CMS proposed rule is slated to go into effect on January 1, 2026, and applies to Medicaid managed care plans, the majority of Medicaid fee-for-service plans , Children’s Health Insurance Program (CHIP) managed care and fee-for-service arrangements, Medicare Advantage (MA) plans, and Qualified Health Plans (QHP) on the federally facilitated health insurance marketplace (i.e., healthcare.gov). The new ruling focuses on improving automation of the PA process , increasing access to data , and enhancing the beneficiary and provider experiences. States may add additional requirements on top of the new CMS rules. In addition, the HHS OIG’s July 2023 report detailed variations in the Medicaid MCO prior authorization process. A significant number of states surveyed in OIG’s review reported they had limited oversight of the prior authorization process including initial decisions, appeals, and reconsiderations. The OIG is urging CMS to provide additional guidance to benefit states and to ensure Medicaid beneficiaries have equitable and timely access to all appropriate care. Leveraging Key Focus Areas for a Smoother Transition With changes inevitably on the horizon for Medicaid Prior Autho