HHS plans single state contact for Medicaid/SCHIP by creating CMS
The Department of Health and Human Services (HHS) says one aspect of the morphing
of the Health Care Financing Administration into the Centers for Medicare and Medicaid Services (CMS) will be naming a single Medicaid/State Children’s Health Insurance Program (SCHIP) contact person to work with each state at the regional and central office levels. HHS documents announcing the agency name change and new initiatives directed at consumers said the contact persons will "troubleshoot, resolve disputes, and generally break through bureaucratic bottlenecks within CMS.
"They will also be directly accountable to the CMS administrator [Thomas Scully] and the director of the Center for Medicaid and State Operations as they respond to state issues," the documents stated.
Reforms announced by HHS Secretary Tommy Thompson are intended to make the agency more responsive to consumers, providers, and state officials, and make it a source of readily available help and information.
The new name was chosen after focus group sessions with beneficiaries and interviews with other stakeholders. It is intended to increase consumers’ understanding of the government’s role in health care, while making sure that they know where to get the information and assistance they need about the Medicare and Medicaid programs, Mr. Thompson said.
CMS will conduct business through three subcenters:
• the Center for Medicare Management, which will deal with the traditional fee-for-service Medicare program;
• the Center for Beneficiary Choices, focusing on providing beneficiaries with information on Medicare, Medicare Select, Medicare+Choice, and Medigap options;
• the Center for Medicaid and State Operations, which will handle state-administered programs, including Medicaid, SCHIP, insurance regulation functions, survey and certification, and the Clinical Laboratory Improvements Act.
Based on comments by Mr. Thompson and others, it appears the initial push will be to position CMS as a consumer-friendly agency that can be counted on especially to help Medicare beneficiaries navigate their way through a very complex system.
"Few beneficiaries understand Medicare and the coverage options and costs associated with Medicare, such as Medigap and Medicare+Choice," HHS staff say.
"Results from the 1999 Medicare Current Beneficiary study found that nearly half of Medicare beneficiaries do not know they can select among different health plan choices within Medicare, and about one-fourth do not know that Medicare does not pay for all of their health care expenses. More than half say they know little or nothing about the availability and benefits of Medicare+Choice plans. Only about one-fourth say they know everything or most of what they need to know," they explain.
The initial Medicare consumer push will include these actions:
1. expansion of a toll-free telephone call center to 24-hour service;
2. development, by Oct. 1, of a web-based decision-support tool to help users narrow down health plan choices available in their geographic area based on what’s important to them and to allow a direct comparison of out-of-pocket costs;
3. a $35 million national advertising campaign corresponding with the 2002 Open Enrollment period this fall to inform beneficiaries about the expanded services and sources of information available to them.
"We need to make sure that the people who are covered by Medicare know exactly what choices they have for their health care coverage," says Mr. Scully.
"Too many consumers just don’t understand Medicare coverage options and the costs associated with them, from their Medigap options to Medicare+Choice to the cost of prescription drugs," he says. "We need to get that information to them and their family members, while working closely with the doctors and other health care providers who give them medical care."
Still to be seen is the degree to which these reforms can and will be applied to beneficiary outreach efforts to Medicaid and SCHIP. Studies of these programs often have indicated a need for more outreach to consumers and efforts to make the programs more understandable.
(For more information, see documents on the change in the news media section at http://www.hhs.gov.)
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