Accountable Care Organizations, a Bridge to the Multicultural Insurance Market?

Accountable Care Organizations, a Bridge to the Multicultural Insurance Market? By Martha C. Rivera, Director of Strategy and Insights With the support of Anthony Gokianluy, Junior Executive Accountable Care Organizations, or ACOs, are the less visible component of the Affordable Care Act (ACA) in the health insurance news these days. ACOs, as created by the ACA, comprise distinct groups of providers that deliver coordinated long-term care and disease management to seniors and permanently disabled beneficiaries. The ACOs program aims to improve health quality while reducing the total cost of care under the Medicare program. While the ACA already stands to have a tangible impact on multicultural populations, ACOs can be an effective bridge between the US health care system and the newly-insured in diverse communities, who would likely have no prior experience navigating the health system and need culturally-relevant attention to partake in insurance plans. Nearly one out of four Medicare users is multicultural, where Hispanics represent close to 8% of the total Medicare beneficiaries. ACOs should establish a presence within these multicultural communities, particularly to Spanish-speaking patients, to help overcome cultural and language barriers and effectively reach out to them, as their share of the insurance market is predicted to significantly increase under the ACA. “ACOs are called to play a vital role in connecting with multicultural populations that the healthcare reform targets,” said George L. San Jose, president and chief creative officer at The San Jose Group. “ACOs can be drivers of increased enrollment in available insurance...

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Supplemental Medicare and Obamacare

By Martha C. Rivera, Director of Strategy and Insights With the support of Nicha Ruchirawat, Junior Executive Medicare Advantage, which is the Medicare health plan offered by a private company, is going through some changes under the Affordable Care Act. The main transformation is that Medicare Advantage plans rated three out of five stars by Center for Medicare & Medicaid Services (CMS) will receive bonus payments acting as an incentive for Medicare Advantage carriers to offer better quality care. Thus, in order for private insurers providing the Medicare Advantage programs to receive these benefits, they should act to effectively improve their programs. To efficiently increase quality care, it is important for providers to observe the trends of consumers being served. The consumer segment with population enrolling most often in Medicare Advantage is the Hispanics. An estimated 42% of Hispanics enroll in Medicare Advantage, compared to 29% of African Americans and 24% of Whites who do so. This makes Hispanics a potential growth opportunity and an important target to consider. Consequently, Medicare Advantage carriers could enhance their existing efforts to better their plans by developing culturally-relevant communication platforms and staff training programs focused on improvements in quality care. While, not all Hispanic Medicare beneficiaries are eligible by age, approximately 78% of Hispanic Medicare Advantage enrollees are eligible by age, and 22% are eligible by disability status. The majority of Hispanic Medicare Advantage enrollees are also between the ages of 65 to 74. “Medicare Advantage carriers may sometimes underestimate the size of the multicultural segment,” said George L. San Jose, president and chief creative officer at The San Jose Group. “By realizing that Hispanics and African Americans enroll in Medicare supplemental plans more often, and developing the pertinent communication platform, an important impact on the bottom line can be promptly...

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Thinking of Medicare under the ACA

By Martha C. Rivera, Director of Strategy and Insights With the support of Nicha Ruchirawat, Junior Executive Medicare-related provisions are important components of the Health Care Law that will surely have a strong impact on multicultural segments. The ACA includes new rules that strengthen the Medicare program. Figures show that the multicultural group makes up a significant portion of Medicare participants who will be affected by this reform. Currently, approximately 16% of Hispanics and 23% of African Americans are enrolled in this federal insurance program, who will benefit from the ACA provisions aimed to decrease costs and ensure better protection to enrollees: 1. Closing the doughnut hole: Those who have Prescription Drug Coverage on their Medicare plan will get 50% discount on brand-name drugs and 14% discount on generic prescription drugs if they fall into the coverage gap. The coverage gap will narrow by year until it disappears in 2020. 2. Increased preventive care coverage: Cost-free preventive care services that were not part of the Medicare package before ACA, such as yearly wellness tests and screenings for diabetes, will be provided. Today, approximately 34 million Americans in traditional Medicare and Medicare Advantage plans have received at least one preventive service. 3. Improved access to primary care doctors: Primary care doctors and nurses receive bonus payments if they provide quality care, or provide primary care in areas with doctor shortages. 4. Ensure future protection: Life of Medicare Trust fund extended to at least 2029, which is a 12-year extension. Although the Medicare component of the ACA has received less media attention than some controversial issues of the law, it has already started its implementation process. For instance, by 2013, more than 1,550 hospitals were rewarded as the establishment of Medicare value-based purchasing program for incentivizing providers moves forward. Source: The Affordable Care Act (ACA) of 2010: May 2013 Progress Report. Deloitte Center for Health Solutions. Cover Photo Source: txking /...

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Exchanges Enrollment Implementation at the Consumer Level

By Martha C. Rivera, Director of Strategy and Insights Consumer education should be at the core of any efforts to implement the ACA. As the deadline for enrollment through health insurance market places approaches and the government and health insurance organizations rush out to be up and running within the Exchanges by October 1, all of them at the local and national level should be developing strong consumer education strategic platforms as well. Otherwise, how can they drive the uninsured for enrollment starting in January 1, 2014, when more than 78% of the people who would be eligible for enrollment through the Exchanges have never heard of them? “Creating awareness of the ACA’s key components and milestones, providing plain-language, culturally-sensitive understanding of the Exchanges at a general level and generating consumer intention to learn more about what can be in the ACA for them are three key objectives that Exchange-related education should accomplish in the immediate term,” said George L. San Jose, president and chief creative officer at The San Jose Group. A recent study sponsored by the Robert Wood Johnson Foundation, revealed that, after being provided with general information on the matter, about 73% of people who would be eligible for enrollment through Exchanges would be interested in doing so, while 55% use the internet on a daily basis and 79% would confide on their internet-related skills for that. Source: http://www.rwjf.org/content/dam/farm/reports/surveys_and_polls/2012/rwjf73113...

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Five Ways Increasing Multicultural Enrollment Helps the Economy

By Cassandra Bremer, Content Manager and Developer and Troy Pritchard, Junior Executive- San Jose Group College campuses around the country often house the most multicultural and diverse communities in the U.S. As summer comes to a close, colleges nationwide have begun welcoming students back to campuses for the fall semester, now more diverse than ever as multicultural enrollment continues to steadily increase. During the 1980s, when marketers first realized the emerging multicultural market, Latino education grew by 60.7% according to Manuel Zamarripa’s “Education.” Last year, Hispanic high school graduate’s fall semester college enrollment was a record-high 69%, while non-Hispanic whites’ enrollment dropped to 67%, reports a 2012 Pew Research Center analysis. As young multicultural adults plan to earn college degrees, their lives as well as the economy will see vast improvements. Here are five ways increasing multicultural enrollment can help the economy. 1. Increased spending power Americans with bachelor’s degrees make 84% more over a lifetime than high school graduates, reports a recent Georgetown University study. On average, a college graduate will earn $2.3 million over a lifetime compared to high school graduate’s $1.3 million. Multicultural college enrollment means higher earning potential, making them powerful consumer markets. Some companies have already started marketing towards different multicultural markets in pursuit of their increasing spending power (Hispanics will have a $1.5 trillion spending power by 2015). 2. Dynamic consumers Healthy economies depend on active consumers. Educated consumer bases not increase the per capita earning, but consumers begin to spend their money in different sectors of the GDP including housing, insurance, automotive, retail, education and entertainment. As multicultural dollars stimulate different sectors of the GDP with their increasing spending power, the economy strengthens. 3. Increased need for technological devices The Unite States, home of “the largest and most technologically powerful economy in the world” according to the CIA’s World Fact Book, depends on the technology industry to help drive a strong economy. In 2008, the information and communication technology expenditure in the U.S. accounted for 7.36% of...

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