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Community Catalyst: Collaborating to Improve Community Health
New Hampshire Provider AssociationOctober 15th, 2015
Meredith MunnState Advocacy Manager
AGENDA
© 2015
1. Community Catalyst 2. Behavioral Health Discrimination
Insurance discrimination Behavioral health parity
3. Consumer Complaints Advocacy Why take action? Consumer support Advocacy priorities
Community Catalyst is a national non-profit advocacy organization that works with national, state and local consumer organizations, policymakers and foundations to build consumer and community leadership to improve the health care system.
Community Catalyst
© 2015
• Advocates for high-quality, affordable health care for all
• Work with national partners
• Networks in 40+ states, connect states and communities
• Issue campaigns
• New models of care
• Support of major foundations
Community Catalyst Overview
© 2015
Systems of Advocacy•Usually, no one organization can move an issue
•You need people coming together to advocate
•In an advocacy system, the complementary capacities of different organizations are knit together to create a coherent whole.
•Advocacy is a shared task, with each participant bringing its skills to the table.
Community Catalyst Philosophy of Change
© 2015
Community Catalyst System of Advocacy
© 2014
1. Strategic coaching
2. A toolkit of best practices
3. Peer to peer learning community
4. Organizational development coaching
Community Catalyst Learning Model
© 2015
• Prevention/Address Social Determinants
• Coverage/Enrollment
• Strong Benefits/Access to Quality Care
• Protecting the Safety Net
• Hospital Community Benefits
• Health Systems Transformation
Community Catalyst Policy Priorities
© 2015
SUBSTANCE USE DISORDERSWORK
© 2015
• Leverage opportunities to improve substance use disorders coverage and benefits under the ACA
• Increase access to prevention, treatment, and recovery services
• Promote coverage, health and social services for justice involved people
• Health system transformation
Substance Use Disorders Project Goals
© 2014© 2015
• Bring together consumer advocates, addiction services providers, people in recovery, family and friends of those not yet in recovery, and other allies as a force for change
• Partner with national organizations, foundations, and government officials
• Promote promising community, county and state models
Substance Use Disorders Project Work
© 2014© 2015
BEHAVIORAL HEALTH DISCRIMINATION
© 2015
• Despite progress, behavioral health discrimination continues
• Parity law non-compliance
• Consumers deserve better health benefits and access to behavioral health services
Scope of the Problem
© 2014© 2015
Behavioral Health Parity
© 2014© 2015
• Mental Health Parity and Addiction Equity Act (2008)
• Parity: a health plan’s policies and practices for mental health and substance use disorders services (MH/SUD) cannot be more restrictive than policies and practices for medical or surgical services.
• Federal and state enforcement State Attorneys General
CONSUMER HEALTH INSURANCE COMPLAINTS
© 2015
Using Consumer Complaints to Improve Healthcare
© 2014© 2015
• Consumer complaints are one way to ensure that health care consumers get the care they deserve
• Complaints are underutilized
• Educating consumers, supporting complaints, and advocating for better complaints systems can make a difference
Roles for Health Care Providers
© 2014© 2015
• Why providers?
Providers are often the first to hear about problems with insurance
Providers are impacted
• What can you do?
Supply information
Provide support
Work in partnership
Health Stakeholders and Collaboration
© 2014© 2015
• Connect with:
Consumers
Health advocates
Other providers/provider associations
Navigators and other enrollment assisters
Consumer Complaints: Step by Step
© 2014© 2015
1. Identify a problem
2. Collect information
3. Exhaust appeals mechanisms
4. Determine where to file the complaint
5. Filing a complaint
6. Ask your state to improve the process
CONSUMER COMPLAINTS ADVOCACY
© 2015
Improving Consumer Complaints Systems
© 2014© 2015
• Make complaining easier
• Jargon-free complaints systems
• Consumer liaisons
Leveraging Consumer Complaints for Systemic Change
© 2014© 2015
• Collect better complaints data
• Mandate systemic analysis
• Public reporting
• Use data to identify and fix problems
Connecting to Community Catalyst
Meredith MunnState Advocacy ManagerCommunity [email protected]
Stay in touch!
• Join our email list
• Use Community Catalyst resources
• Ask for introductions to our partners
• Read our blogs
• Find us on the web:www.communitycatalyst.orgblog.communitycatalyst.orgtwitter.com/healthpolicyhub
© 2015
QUESTIONS?