Community Catalyst: Collaborating to Improve Community Health

New Hampshire Provider AssociationOctober 15th, 2015

Meredith MunnState Advocacy Manager

AGENDA

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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

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• 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

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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

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Community Catalyst System of Advocacy

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1. Strategic coaching

2. A toolkit of best practices

3. Peer to peer learning community

4. Organizational development coaching

Community Catalyst Learning Model

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• 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

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SUBSTANCE USE DISORDERSWORK

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• 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

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• 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

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BEHAVIORAL HEALTH DISCRIMINATION

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• 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

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Behavioral Health Parity

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• 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

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Using Consumer Complaints to Improve Healthcare

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• 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

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• 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

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• Connect with:

Consumers

Health advocates

Other providers/provider associations

Navigators and other enrollment assisters

Consumer Complaints: Step by Step

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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

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Improving Consumer Complaints Systems

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• Make complaining easier

• Jargon-free complaints systems

• Consumer liaisons

Leveraging Consumer Complaints for Systemic Change

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• Collect better complaints data

• Mandate systemic analysis

• Public reporting

• Use data to identify and fix problems

Connecting to Community Catalyst

Meredith MunnState Advocacy ManagerCommunity Catalystmmunn@communitycatalyst.org

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

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QUESTIONS?