As consumers navigate the new landscape of increasingly narrow networks and high deductibles, they need the right tools and information to choose a health insurance plan that best fits their medical needs and their household budgets. Provider directories are the primary tool available to consumers to determine whether the plan they are selecting has a narrow or broad network and to identify which providers are in their plan. As such, these directories should be accurate, up-to-date, and should truly function as a tool. Despite the important role directories play, they are notorious for being rife with errors and for lacking the functionality to help consumers make optimal choices in the market. By drawing upon model legislation from the National Association of Insurance Commissioners (NAIC) and best practices from other states, Georgia can take steps to improve directories. This policy brief:

– explains the role provider directories play as a tool for consumer decision-making

– describes current provider directory provision in Georgia

– describes common problems with provider directories

– outlines recent policy activity around provider directories

– highlights other state examples of provider directory improvements

Download the brief here.

When consumers enroll in a health insurance plan, they gain access to a network of medical providers. This network must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. While network adequacy is not a new concept, it has a new urgency in light of the sheer number of newly insured Georgians enrolled in individual plans; the move on the part of insurance companies toward narrow networks and tiered networks, which limit the number of providers plan enrollees can access; new federal standards; and a new model act from the National Association of Insurance Commissioners (NAIC) that provides updated guidance for states. Georgia health care consumers need and deserve clear standards and protections that ensure their coverage translates to access to care without financial hardship. Georgians for a Healthy Future released today at a public policy form held in Atlanta a new policy brief on network adequacy. This policy brief:

– explains the importance of network adequacy for access to care

– outlines current network adequacy standards in Georgia

– summarizes recent policy activity around network adequacy

– sets forth consumer-oriented principles for network adequacy standards in Georgia

– provides policy recommendations to achieve network adequacy in Georgia.

Download the brief here. 

Week 3

Week three was a very exciting one for Georgia health care consumers! The introduction of SB 302 signaled true movement on consumer priorities, like insurer provider directory transparency. Check below to see what happened and how you can get involved.

If you’re looking for a list of all the bills we’re tracking and their status in the legislature, click here.

What Happened This Week

Improving Provider Directories 

We are very excited to share with you that last week Senator P.K. Martin (R-9th)  introduced legislation to address provider directory inaccuracies and usability limitations. Senators Burke (R-11th), Watson (R-1st), Parent (D-42nd), and Unterman (R-45th) are also co-sponsors of SB 302. The bill has been assigned to the Senate Insurance Committee and we expect it will receive a hearing within the next week. Read SB 302.

Please join us in thanking Sen. Martin for introducing such an important piece of legislation! You can email him here or call him at 404-656-3933.

GHF helped over 100 people get covered

Open enrollment formally concluded on January 31, 2016 and 587,845 Georgians enrolled in the Marketplace (healthcare.gov).

Throughout open enrollment, GHF worked to get Georgians enrolled through direct service and the creation of GEAR (or the Georgia Enrollment Assister Resource Network). GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners who work with consumers to educate them on their health and health care coverage options. If you are interested in learning more about GEAR or want to sign up for the newsletter, email Whitney. Additionally, during this open enrollment period we have provided enrollment assistance to 78 applicants and their families, totaling 141 Georgians. Of those, 91%  received financial assistance.

The second week of the Legislative Session was primarily focused on the budget. Check out the updates below on provider directories, closing the coverage gap, and other issues that are important to Georgia health care consumers.

YOU’RE INVITED!

As the newest member of GHF, I am excited to spend the next seven weeks with the GHF team as they work to bridge the coverage gap, improve health insurance literacy, and reduce health disparities in the state of Georgia. This internship will not only provide an amazing experience to learn more about consumer health care issues, but it will allow me to pursue a passion of mine,  helping people to improve their health. During my time here I will assist in conducting outreach and education and engage in health care policy advocacy during the legislative session.

Interning at GHF isn’t just an opportunity to learn about health care issues in Georgia. I am looking forward to applying and use all of the knowledge and skills I gain here in my future career and in my civic life. I hope to learn more about health policies and programs and their impact on Georgians, how to build sustainable coalitions, and how to create and improve media messages. I also look forward to learning how to brainstorm and implement new ways to do community outreach. This internship will serve as part of my last semester at the State University of New York at Potsdam, providing me with a Bachelors degree in both Community Health and French. After graduation I hope to pursue a career  in health policy advocacy, recreational therapy, international health education, being an entrepreneur on health topics, or nutrition education. This internship will be another step towards my future career. I look forward to working with all of you during my time at GHF.

by Victoria Congleton

In December, the ACA Implementation Research Network released its Georgia state report at a policy forum held at the Community Foundation for Greater Atlanta. The report provides a detailed look at the key decisions made by Georgia policymakers around the implementation of the Affordable Care Act over the past five years. Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated in a discussion with advocates, policymakers, and stakeholders to reflect on the report’s findings. The conversation ranged from health insurance enrollment best practices to health system reform to what it will take to close the coverage gap in Georgia. The ACA Implementation Research Network is jointly operated by the Nelson A. Rockefeller Institute of Government, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania. The Georgia state report was written by Michael Rich, Professor of Political Science and Environmental Sciences at Emory University.  Download the Report.