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In the Face of Public Charge Fears, Enrollment Navigators Advocate for Families

July 28, 2023 | By Herlinda Ibarra

Public Charge has been on the minds of immigrants and those working with the immigrant community for many years. Determining whether someone will be a “public charge,” or dependent on government help through reliance on public benefits, has always been a part of the immigration process in the United States.

Addressing Health-Related Social Needs: Medicaid Begins Going Towards Rent in Certain States

June 22, 2023 | By Sarabeth Zemel, JD

The COVID-19 pandemic exacerbated longstanding racial and ethnic health inequities and disparities in health care. As we move out of the pandemic, there is a growing recognition that focusing on the social determinants of health—or health-related social needs—can improve health disparities and the health outcomes of populations.

Outreach and enrollment work translates to hope

May 31, 2023 | By Heather Bates, MSW and Herlinda Ibarra

Our team has a saying—“if people aren’t enrolled in health coverage, health systems change won’t work.” As a firm that’s dedicated to driving health systems change, we know that to stay healthy, people need access to high-quality, affordable, health care. Our mission is to drive systems change to build healthy communities, and enrollment is central to that mission….

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MEDICAID “UNWINDING” IS HERE: AN UPDATE ON STATE ACTIONS AND RESOURCES FOR OUTREACH AND ENROLLMENT ASSISTERS

February 10, 2023 | By Sarabeth Zemel, JD and Heather Bates, MSW

Over 91 million individuals are now enrolled in Medicaid and CHIP. That’s an astonishing 29.5% increase in enrollment since the beginning of the COVID-19 pandemic. Thanks to the continuous coverage requirement, states could not disenroll anyone in Medicaid until the end of the COVID-19 Public Health Emergency — until now. While coverage losses are still very much a threat, the recently enacted Consolidated Appropriations Act, 2023 (CAA) de-coupled the Medicaid continuous coverage…

THE END OF THE FEDERAL PUBLIC HEALTH EMERGENCY IS NEAR – STATEWIDE CASE STUDIES ON HOW TO PREVENT COVERAGE LOSSES

November 7, 2022 | By Sarabeth Zemel, JD

The COVID-19 pandemic brought a host of unimaginable losses. But with the declaration of a federal public health emergency (PHE), also came an increased reliance upon public health care systems like never before. National and state Medicaid programs experienced a surge of health care enrollment, with nearly 90 million individuals gaining coverage under the federal PHE declaration…

MEDICAID WORKFORCE & THE PUBLIC HEALTH EMERGENCY “UNWINDING”

August 15, 2022 | By Heather Bates, MSW and Sarabeth Zemel, JD

For more than two years – the duration of the COVID-19 pandemic – Medicaid programs across the U.S. have provided continuous coverage for Medicaid enrollees. In exchange for enhanced Medicaid funding, states agreed to not disenroll anyone as long as the federal public health emergency (PHE) remained in effect. As a result of this requirement, in tandem with the medical, physical, socioeconomic toll the pandemic caused to individuals and families, Medicaid enrollment skyrocketed to more than 88 million individuals nationwide…

CALIFORNIA UNLOCKS ONE MORE PIECE OF THE UNIVERSAL COVERAGE PUZZLE: OLDER ADULTS EXPANSION

March 10, 2022 | By Sarabeth Zemel, JD

California has been making strides toward ensuring that all populations have access to health coverage. In 2021, Governor Newsom proposed, and the legislature enacted, an expansion of full-scope Medi-Cal to older adults age 50 and over regardless of their immigration status. This builds on California’s previous Medi-Cal expansions to children in 2016 and young adults in 2020 regardless of immigration status. The older adult expansion will go into effect on May 1, 2022. It is estimated that 235,000 individuals will be eligible…

DISC CASE STUDY: A RELIABLE TOOL FOR CULTURE CHANGE

February 4, 2022 | By Heather Bates, MSW and Alexis Sabor, CAPM

The National Association of Community Health Centers (NACHC) recognizes that strong team development is essential for fostering a successful work environment. Organizations who dedicate time and resources to enhancing their teams often experience increased trust, improved communication, and increased productivity and NACHC members identified this as need at health centers now more than ever. In 2021, NACHC developed a team development training pilot that utilized DiSC…

NAVIGATORS ARE A CRITICAL COMPONENT TO ENROLLING INDIVIDUALS IN MEDI-CAL

February 4, 2022 | By Heather Bates, MSW and Sarabeth Zemel, JD

Over the years, California has generously expanded Medi-Cal to many populations so that it now serves as a lifeline for more than 13 million people or one-third the state’s population. Despite its size, there remains a percentage of eligible but unenrolled individuals, as well as those who cycle on and off Medi-Cal (also known as churn). In 2019, the California Legislature passed a bill that created the Medi-Cal Health Enrollment Navigator Project…

HEALTH POLICY THROUGH A CRYSTAL BALL: WHAT WE’RE TRACKING IN 2022

January 19, 2022 | By Sarabeth Zemel, JD

Although COVID-19 continued to dominate the health policy and public health sphere in 2021, there was plenty of other exciting health policy news that will continue to make waves in 2022. This blog provides a high-level summary of what we are following from federal and state agencies, such as the Centers for Medicare and Medicaid Services (CMS) and others…

THE ART OF MANAGING COMPLEX PROJECTS – LESSONS LEARNED

November 12, 2021 | By Alexis Sabor and Danielle Rossoni

Calling all Project Managers! This post is for the Project Managers out there who may need some guiding principles for managing remote, iterative projects. By iterative projects, we mean projects that are subject to ongoing change and require collaboration and input to adapt over time. These tend to be more agile and less linear projects. How do you plan when the landscape is constantly shifting? Below are some of the best practices we apply at Transform Health for tackling large, complex projects that may only be clear in hindsight…

OPEN ENROLLMENT AND WHAT’S AHEAD FOR 2022: HEADLINES AND RESOURCES

October 7, 2021 | By Heather Bates, MSW, Transform Health and Anna Szilagyi, Medicare Rights Center

In the early days of passing the Affordable Care Act (ACA) the cultural buzz was to get everyone thinking about their coverage options for the upcoming year, regardless of how one is insured. This cultural shift is happening now and, while the dates are not quite aligned, the last quarter of the year where people decide on their coverage options is now inclusive of Medicare beneficiaries, employees, and those needing coverage through the qualified health plans made possible through the ACA. While Medicaid and theChildren’s Health Insurance Program (CHIP) remains year-round, due to advertising, this is also a time when people with Medicaid and CHIP may also pay closer attention .…

Reunification: A Critical Piece of the Puzzle for the Unhoused

June 15, 2021 | By Heather Bates, MSW, Alexis Sabor, CAPM, Sarabeth Zemel, J.D., Transform Health and Madeline Connolly, Miracle Messages

At any given time in 2020, more than half a million people experienced homelessness in the United States. A consequence of becoming homeless is losing crucial social connections with family and friends leading to loneliness and isolation. Social supports from family, friends, and neighbors have been shown to lead to better physical and behavioral health outcomes for unhoused individuals and can ultimately help them transition out of homelessness. One organization is working to reestablish social networks for those experiencing homelessness in California and throughout the United States, with international reach in some cases.…

REFLECTION AND ANTICIPATION: WELCOMING 2021 WITH IMPORTANT LESSONS LEARNED

December 28, 2020 | By Transform Health

Given the socially distanced world we are living in right now, at Transform Health we took a beat at the end of this profoundly tumultuous year to write down some of the things we are grateful for and eager to get to work on next year. Hint: we are ready to roll up our sleeves along with you to tackle some of the biggest problems facing health care yet. We began 2020 with the hope and promise of a new year replete with challenges, but also a bounty of opportunities in the form of solving big health policy problems.…

Navigators: The workforce that can support vaccine education

December 18, 2020 | By Heather Bates and Sara Gleysteen

The vaccines are out. There is now hope on the horizon for what may be the end of this global pandemic. Logistics, trust, time, and education are what remain between vaccines and the public. All health care is local and we know from multiple outreach and enrollment efforts in the recent past that trusted messengers are a key part of ensuring sustained community participation. While vaccine-related decision-making is complex– over 27% of adults say they will likely not get the vaccine– it does not require a complex solution. It is proven that education can help overcome vaccine hesitancy…

THE ICYMI CMS 2020 BLOG

December 9, 2020 | By Transform Health

There has been much coming out of the Trump Administration. This blog post serves as a touchstone to keep up. We will continue to update as new guidance and resources get released by CMS. Updates will be inclusive of COVID-19. The Center for Medicare & Medicaid Services (CMS), an agency within the Health & Human Services Administration (HHS), is responsible for oversight and regulatory compliance in health care programs such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP)…

VIRTUAL OUTREACH AND ENROLLMENT DURING A PANDEMIC: HOW ENROLLMENT ASSISTANCE IS MEETING THE NEEDS OF CONSUMERS

September 22, 2020 | By Heather Bates and Sara Gleysteen

LEVERAGING MEDICAID ADMINISTRATIVE CLAIMING FOR HEALTH CENTERS

April 30, 2020 | By Lisa Chan-Sawin and Gretchen Schroeder, Transform Health

Due to the COVID-19 outbreak, critical safety net providers such as Community Health Centers are experiencing significant drops in patient revenue as a result of stay-at-home orders across the nation. During this global public health crisis it is critical to explore innovative strategies to draw down additional dollars to support health centers while ensuring the continuity and livelihood of community-based health care services remains in place in rural and urban areas across the country. One such strategy, Medicaid Administrative Claiming (MAC), can be a useful tool in .…

ESSENTIAL CONSIDERATIONS TO SUPPORT A REMOTE WORKFORCE: INFOGRAPHICS

April 24, 2020 | By Heather Bates and Alexis Sabor

With estimates showing that 75 million employees may be working from home due to COVID-19, Transform Health, a nationally certified women and minority owned health care consulting firm, has compiled some of our key considerations for establishing a remote workforce through a four-part info graphic series. We offer tips for staying motivated and focused, maintaining balance and boundaries, key considerations around data and technology needs, as well as address the basic operational rules of the road…

1135 WAIVERS: WHAT THEY ARE AND HOW STATES CAN USE THEM IN AN EMERGENCY

April 17, 2020 | By Transform Health

In light of the Trump Administration declaring a state of emergency in order to respond to COVID-19, State Medicaid agencies may be interested in utilizing the 1135 waiver mechanism to act quickly and decisively in providing care to their residents. 1135 Waivers are used when the President declares a disaster or state of emergency under the following conditions…..

THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS PRIORITIZES ENABLING SERVICES: CASE STUDIES FROM ALASKA, ARIZONA, CALIFORNIA AND NORTH CAROLINA

March 16, 2020 | By Transform Health

In 2019, through support from the Health Resources & Services Administration (HRSA), the National Association of Community Health Centers (NACHC) published four case studies highlighting the critical importance of enabling services provided in our health centers and supported by primary care associations. Each case study focuses on some of the innovative approaches health centers and primary care associations are taking to meet the specific needs of…..

INTIMATE PARTNER VIOLENCE – TRENDS IN POLICY ACROSS SECTORS

March 4, 2020 | By Transform Health

One of the most pervasive issues continuing to impact the social determinants of health for women, children and families around the world is intimate partner violence (IPV). IPV, also widely termed “domestic violence”, is experienced by people of all ages, races, and socioeconomic backgrounds. Over the past few months, staff at Transform Health have researched IPV policies across various sectors – including government, community, and health care – in order to get a better understanding of how these policy recommendations interact…

HEALTH ACTION 2020 – WHAT YOU MISSED FROM THE OUTREACH & ENROLLMENT TRACK

February 14, 2020 | By Transform Health

Health Action 2020 has come and gone, but we wanted to be sure to bring our outreach and enrollment experts who could not attend this year some of the highlights through this blog. We are grateful we were able to celebrate and highlight the incredible work you are doing through the Transform Health sponsored enrollment track. Over the course of #HA2020, our team heard from many different voices in the outreach and enrollment space, from Navigators…

WHAT YOU MISSED AT THE 2019 SOUTHERN CALIFORNIA STATE OF REFORM CONFERENCE

January 7, 2020 | By Transform Health

In early December, State of Reform hosted it’s 2019 Southern California State of Reform Health Policy Conference, bringing together attendees and presenters from across the silos of heath care to cover some of the most complex issues in health care policy and reform. One of those presenters was Transform Health’s own Lisa Chan-Sawin. Lisa, and Margaret Tatar of Health Management Associates, discussed what we can learn from the last few years of working within the current California waiver ecosystem…

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