PA

GE

1

PA

GE

2

He

alt

hca

re F

ina

nci

al M

an

ag

em

en

t

Ass

oci

ati

on

Co

nfe

ren

ce

Josi

e S

ilve

rma

n,

Re

gio

na

l O

utr

ea

ch C

oo

rdin

ato

r

Jon

McD

aid

, R

eg

ion

al

Ou

tre

ach

Co

ord

ina

tor

Ore

go

n H

ea

lth

Au

tho

rity

/Co

ver

Ore

go

n

MA

Y 1

6,

20

14

WH

AT W

E’L

L C

OV

ER

TO

DAY

•C

urre

nt s

tatu

s of

Cov

er O

rego

n•

Web

site

vs.

Por

tal

•In

itial

bus

ines

s pl

an k

ey p

oint

s•

Com

mun

ity P

artn

er P

rogr

am

•Ye

ar 1

ope

n en

rollm

ent

•M

ay-N

ovem

ber

activ

ities

•T

rans

ition

Pro

ject

•Ye

ar 2

ope

n en

rollm

ent

•C

all t

o ac

tion

•C

onta

ct in

form

atio

n•

Q&

A

1) W

e ar

e no

t…�

Fin

ance

exp

erts

�IT

exp

erts

�D

ata

expe

rts

2) E

VE

RY

TH

ING

is s

ubje

ct to

cha

nge/

a lo

t no

long

er a

pplie

s…

DIS

CLA

IME

RS

•C

over

Ore

gon

is n

ot s

hutti

ng it

s do

ors.

•C

over

Ore

gon

does

not

nee

d le

gisl

ativ

e ap

prov

al to

tran

sitio

n to

the

fede

ral e

xcha

nge.

•C

over

Ore

gon

will

rem

ain

a st

ate-

base

d m

arke

tpla

ce th

roug

h 20

14.

•T

he p

lan

is to

mov

e to

the

fede

ral e

xcha

nge

in

time

for

the

next

ope

n en

rollm

ent p

erio

d st

artin

g N

ovem

ber

2014

.

CO

VE

R O

RE

GO

NIS

ST

ILL

HE

RE

•W

e w

ill c

ontin

ue to

sup

port

our

cus

tom

er

base

and

par

tner

s.

•P

eopl

e w

ho e

nrol

led

durin

g ye

ar o

ne o

pen

enro

llmen

t do

not n

eed

to d

o an

ythi

ng r

ight

no

w.

•P

eopl

e w

ho r

ecen

tly a

pplie

d do

not

nee

d to

re

appl

y.

CO

VE

R O

RE

GO

N IS

ST

ILL

HE

RE

Cov

erO

rego

n.co

msi

nce

Oct

ober

201

3:

�B

row

se Q

ualif

ied

Hea

lth P

lans

(Q

HP

s)

�S

ubm

it P

DF

app

licat

ions

ele

ctro

nica

lly, o

r do

wnl

oad

and

prin

t pap

er a

pplic

atio

ns (

mai

l/fax

in)

�P

ublic

sea

rch

for

appl

icat

ion

assi

stan

ce

Sin

ce la

te fa

ll 20

13:

�S

hop

and

enro

ll in

a Q

HP

with

sho

ppin

g gr

oup

info

rmat

ion

WE

BS

ITE

VS

. PO

RTA

L

Por

talf

rom

Oct

ober

201

3 –

Janu

ary

2014

:

�O

nly

avai

labl

e fo

r C

omm

unity

Par

tner

and

Age

nt (

CP

A)

use

�Li

mite

d fu

nctio

nalit

y

–U

nabl

e to

sub

mit

a co

mpl

ete

appl

icat

ion

onlin

e

–U

nabl

e to

enr

oll f

or a

QH

P o

nlin

e

Feb

ruar

y –

Apr

il 20

14

�O

nly

avai

labl

e fo

r C

PA

use

�E

nd-t

o-en

d fu

nctio

nalit

y

–A

ble

to s

ubm

it a

com

plet

e ap

plic

atio

n on

line

–R

eal t

ime

elig

ibili

ty

–A

ble

to s

hop

and

enro

ll in

a Q

HP

onl

ine

WE

BS

ITE

VS

. PO

RTA

L

•F

eder

al g

rant

s fu

nded

the

star

t up.

•T

hese

gra

nts

will

end

Dec

embe

r 20

14.

•B

egin

ning

in 2

015,

CO

will

be

self-

fund

ed

thro

ugh:

�A

n ad

min

istr

ativ

e fe

e on

QH

P e

nrol

lmen

ts s

et fo

r 20

14 a

t $9.

38 P

MP

M

�A

n as

sess

men

t on

publ

ic p

rogr

ams

prop

osed

at

$6.9

5 P

MP

M

YO

U M

AY R

EC

ALL

…

•In

tent

ion

was

to p

rovi

de s

eam

less

elig

ibili

ty

dete

rmin

atio

ns fo

r ta

x cr

edits

and

sta

te p

rogr

ams.

•In

divi

dual

s an

d sm

all b

usin

esse

s ab

le to

app

ly a

nd

enro

ll in

a p

lan

onlin

e.

•C

usto

mer

ser

vice

and

out

reac

h w

ere

desi

gned

to

ensu

re in

divi

dual

s an

d sm

all b

usin

esse

s ar

e ad

equa

tely

ser

ved.

Thi

s in

clud

es a

cus

tom

er s

ervi

ce

prog

ram

in a

dditi

on to

a b

road

com

mun

icat

ions

and

ou

trea

ch p

lan.

YO

U M

AY R

EC

ALL

…

To h

elp

mor

e O

rego

nian

s ge

t and

mai

ntai

n he

alth

cov

erag

e, C

over

Ore

gon

has

join

ed

forc

es w

ith th

e O

rego

n H

ealth

Aut

horit

y to

ad

min

iste

r th

e C

omm

unity

Par

tner

Pro

gram

.

CO

MM

UN

ITY

PA

RT

NE

R P

RO

GR

AM

•C

over

Ore

gon

built

upo

n th

e su

cces

sful

Hea

lthy

Kid

s ou

trea

ch c

ampa

ign

mod

el.

•M

any

com

mun

ity p

artn

ers

had

exis

ting

outr

each

pr

oces

ses

and

rela

tions

hips

in p

lace

from

the

Hea

lthy

Kid

s ca

mpa

ign.

•C

omm

unity

par

tner

s ha

ve b

uilt

rela

tions

hips

with

co

nsum

ers;

the

com

mun

ity c

an r

ely

on p

artn

ers

as

esta

blis

hed

and

trus

ted

reso

urce

s fo

r as

sist

ance

.

OU

TR

EA

CH

BE

ST

PR

AC

TIC

ES

Gra

ntee

s, D

MA

P C

ontr

acte

d P

rovi

ders

, Vol

unte

ers:

•H

ospi

tal s

yste

ms

•P

rivat

e m

edic

al g

roup

s

•S

afet

y ne

t clin

ics

•C

ount

y he

alth

dep

artm

ents

•F

aith

-bas

ed o

rgan

izat

ions

•C

omm

unity

-bas

ed o

rgan

izat

ions

•S

mal

l bus

ines

ses

•S

choo

l dis

tric

ts

•U

nion

s

PAR

TN

ER

S IN

CLU

DE

•$6

mill

ion

in g

rant

s aw

arde

d:

�O

utre

ach

and

Enr

ollm

ent (

12 m

onth

s; 3

1 gr

ante

es)

�P

rovi

der

Out

reac

h an

d E

nrol

lmen

t (12

mon

ths;

18

gran

tees

)

�C

omm

unity

Out

reac

h an

d E

duca

tion

(6 m

onth

s; 1

4 gr

ante

es)

•O

vera

rchi

ng g

oal o

f the

gra

nt p

rogr

ams:

�R

each

und

erse

rved

, har

d-to

-rea

ch c

omm

uniti

es w

ith

Cov

er O

rego

n in

form

atio

n an

d ap

plic

atio

n as

sist

ance

.

GR

AN

TE

ES

Con

duct

targ

eted

out

reac

h an

d in

-rea

ch a

ctiv

ities

to

conn

ect O

rego

nian

s w

ith a

fford

able

hea

lth in

sura

nce

�Ta

blin

g/pr

esen

ting

at c

omm

unity

eve

nts

�E

nrol

lmen

t fai

rs

�M

edia

cam

paig

ns (

prin

t, w

ebsi

te, s

ocia

l med

ia, r

adio

, TV

)

�P

hone

/nei

ghbo

rhoo

d ca

nvas

sing

�R

elat

ions

hip

build

ing

with

com

mun

ity g

ate

keep

ers

PAR

TN

ER

RO

LES

Offe

r cu

ltura

lly a

nd li

ngui

stic

ally

app

ropr

iate

ass

ista

nce

�P

rovi

de g

ener

al in

form

atio

n on

Cov

er O

rego

n

�E

xpla

in th

e ap

plic

atio

n/en

rollm

ent

proc

ess

�A

ssis

t clie

nts

with

com

plet

ing

the

appl

icat

ion

(in-p

erso

n, o

ver

the

phon

e, h

ome

visi

ts, e

tc.)

�C

larif

y el

igib

ility

crit

eria

, doc

umen

tatio

n re

quire

men

ts a

nd te

rms

�S

ubm

it th

e ap

plic

atio

n on

beh

alf o

f the

app

lican

t

PAR

TN

ER

RO

LES

Pro

vide

follo

w-u

p as

sist

ance

and

clie

nt a

dvoc

acy

�O

nce

appl

icat

ions

has

bee

n su

bmitt

ed, p

rovi

de fo

llow

-up:

•C

hang

es to

app

licat

ion

•S

tatu

s of

app

licat

ion

•Q

HP

/CC

O e

nrol

lmen

t

•G

ener

al q

uest

ions

•E

xpla

inin

g el

igib

ility

/req

uire

men

ts a

nd a

lert

ing

Cov

er O

rego

n to

in

corr

ect e

ligib

ility

det

erm

inat

ions

�R

efer

app

lican

ts to

lice

nsed

, cer

tifie

d in

sura

nce

agen

ts

�Li

nk a

pplic

ants

to o

ther

soc

ial s

ervi

ces,

as

need

ed

PAR

TN

ER

RO

LES

•M

ost c

omm

unity

par

tner

s ar

e do

ing

this

wor

k in

add

ition

to

thei

r re

gula

r jo

b du

ties,

som

e ar

e st

rictly

vol

unte

ers.

•M

uch

larg

er b

urde

n of

wor

k th

an e

xpec

ted,

due

to p

orta

l is

sues

.

•T

hey

wou

ld li

ke to

mai

ntai

n th

e tr

ust o

f the

ir cl

ient

s by

co

ntin

uing

a r

easo

nabl

e re

spon

se r

ate

whe

n ac

ting

on

thei

r be

half.

•T

hey

are

advo

cate

s fo

r pe

ople

who

ofte

n ha

ve a

har

d tim

e ad

voca

ting

for

them

selv

es.

A D

AY IN

TH

E L

IFE

•Adv

ise

on p

lan

sele

ctio

n fo

r Q

HP

s or

CC

Os

•Offe

r pe

rson

al p

refe

renc

es fo

r pl

ans

or p

rovi

ders

•Acc

ept a

ny fo

rms

of p

aym

ent f

or a

ssis

tanc

e

•Act

as “A

utho

rized

Rep

rese

ntat

ives”f

or a

pplic

ants

PAR

TN

ER

S D

O N

OT

…

•H

ouse

d at

the

Ore

gon

Hea

lth A

utho

rity

with

an

Inte

r-G

over

nmen

tal A

gree

men

t with

Cov

er O

rego

n fo

r ou

trea

ch

and

enro

llmen

t wor

k ac

ross

the

stat

e

•8

Reg

iona

l Out

reac

h C

oord

inat

ors

•C

omm

unity

Eng

agem

ent C

oord

inat

or

•P

rovi

der

Cam

paig

n C

oord

inat

or

•B

usin

ess

Team

OU

TR

EA

CH

TE

AM

•C

omm

unity

Eng

agem

ent C

oord

inat

or, A

nton

io

Torr

es:

deve

lops

and

impl

emen

ts a

n en

rollm

ent

cam

paig

n ta

rget

ing

hard

-to-

reac

h an

d un

ders

erve

d co

mm

uniti

es, i

nclu

ding

com

mun

ities

with

div

erse

cul

tura

l ba

ckgr

ound

s.

•P

rovi

der

Cam

paig

n C

oord

inat

or, B

etse

Thi

elm

an:

deve

lops

and

impl

emen

ts a

cam

paig

n ta

rget

ing

FQ

HC

s,

rura

l hea

lth c

linic

s, h

ospi

tals

, priv

ate

clin

ics,

and

oth

er

stak

ehol

ders

.

CA

MPA

IGN

CO

OR

DIN

ATO

RS

RE

GIO

NA

L O

UT

RE

AC

H C

OO

RD

INAT

OR

S

Ru

by

Gra

ve

n

No

rth

We

st

Jon

McD

aid

& J

osi

e S

ilv

erm

an

Po

rtla

nd

Me

tro

Co

lett

e G

illi

es

So

uth

We

st

De

an

na

Sim

on

Ce

ntr

al/

So

uth

-Ce

ntr

al

Ma

rin

a

Ca

ssa

nd

ra

No

rth

Ce

ntr

al

Ke

lly

Pa

ige

Fro

nti

er

Ch

ris

Ho

use

Wil

lam

ett

e V

all

ey

•D

evel

op a

nd im

plem

ent o

utre

ach

stra

tegi

es in

our

re

spec

tive

terr

itorie

s

•Tr

ain

and

prov

ide

on-g

oing

sup

port

to c

omm

unity

pa

rtne

rs

•O

ffer

com

mun

ity p

artn

er te

chni

cal s

uppo

rt

•H

elp

com

mun

ity p

artn

ers

trou

bles

hoot

and

nav

igat

e th

e sy

stem

on

beha

lf of

thei

r cl

ient

s

•F

acili

tate

mon

thly

cou

nty

colla

bora

tive

mee

tings

•H

elp

man

age

the

gran

tee

prog

ram

RE

GIO

NA

L O

UT

RE

AC

H C

OO

RD

INAT

OR

S

Oct

ober

201

3 –

Apr

il 20

14N

ote

spec

ial e

nrol

lmen

t per

iod

from

Apr

il 1

–A

pril

30, 2

014

Enr

ollm

ents

thro

ugh

Cov

er O

rego

n

•M

edic

al E

nrol

lmen

ts: 2

71,1

80

�77

,583

QH

P

�19

3,59

7 O

HP

/HK

•D

enta

l Enr

ollm

ents

: 15,

926

•P

orta

l enr

ollm

ents

: 36,

516

•N

et e

nrol

lmen

ts:

�N

et Q

HP

: 72,

890

�N

et d

enta

l: 14

,602

(dat

a as

of M

ay 8

, 201

4)

RE

CA

P: O

PE

N E

NR

OLL

ME

NT

Cov

er O

rego

n R

anki

ngs

Nat

iona

lly:

Raw

num

bers

; com

pare

d to

all

stat

es a

nd D

.C.

•To

tal e

nrol

lmen

t: 15

thou

t of 5

1 st

ates

•Q

HP

enr

ollm

ents

: 28

thou

t of 5

1 st

ates

•M

edic

aid

enro

llmen

ts:

5th

out o

f 51

stat

es

(dat

a as

of M

ay 8

, 201

4)

RE

CA

P: O

PE

N E

NR

OLL

ME

NT

Dem

ogra

phic

s (Q

HP

s)

(dat

a as

of A

pril

19, 2

014)

RE

CA

P: O

PE

N E

NR

OLL

ME

NT

Ind

ica

tor

Ore

go

n Q

HP

en

roll

me

nt

Na

tio

na

l Q

HP

en

roll

me

nt

GE

ND

ER

Fe

ma

le5

7%

54

%

Ma

le4

3%

46

%

Dem

ogra

phic

s (Q

HP

s)

(dat

a as

of A

pril

19, 2

014)

RE

CA

P: O

PE

N E

NR

OLL

ME

NT

Ind

ica

tor

Ore

go

n Q

HP

en

roll

me

nt

Na

tio

na

l Q

HP

en

roll

me

nt

AG

E

<1

85

%6

%

18

-25

7%

11

%

26

-34

15

%1

7%

35

-44

15

%1

7%

45

-54

21

%2

3%

55

-64

37

%2

5%

≥6

50

%0

%

18

-34

22

%2

8%

Met

al T

ier

(QH

Ps)

(dat

a as

of A

pril

19, 2

014)

RE

CA

P: O

PE

N E

NR

OLL

ME

NT

Ind

ica

tor

Ore

go

n Q

HP

en

roll

me

nt

Na

tio

na

l Q

HP

en

roll

me

nt

ME

TAL

TIE

R

Ca

tast

rop

hic

1%

2%

Bro

nze

22

%2

0%

Sil

ve

r6

6%

65

%

Go

ld1

1%

9%

Pla

tin

um

1%

5%

QH

Ps

Con

tinue

d…

•80

% q

ualif

ied

for

finan

cial

ass

ista

nce

(vs.

85%

nat

iona

lly)

•D

istr

ibut

ion

of e

nrol

lees

acr

oss

carr

iers

(11

car

riers

tota

l)

•M

oda:

76%

•K

aise

r: 8

.8%

•P

rovi

denc

e: 4

.5%

•A

ll ot

her

plan

s co

mbi

ned:

10.

7%

(dat

a as

of A

pril

18, 2

014)

RE

CA

P: O

PE

N E

NR

OLL

ME

NT

Med

icai

d/C

HIP

•13

8,16

2 en

rollm

ents

thro

ugh

Fas

t Tra

ck

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S

Josi

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Cel

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3-26

9-70

92

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ail:

josi

e.j.s

ilver

man

@st

ate.

or.u

s

Jon

McD

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MA

Cel

l: 50

3-26

9-08

80

Em

ail:

mic

hael

.j.m

cdai

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or.u

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TAC

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