Contracting Update California Health Benefit Exchange Peter V. Lee - - PowerPoint PPT Presentation
Contracting Update California Health Benefit Exchange Peter V. Lee January 17, 2012 The Exchanges Process for Evidence-Based Policy Making Legal Scope 1. Regulatory requirements Prohibited approaches Allowable
1 California Health Benefit Exchange
1.
Regulatory requirements Prohibited approaches Allowable alternatives
2.
Current California activities California and National relevant data
3.
4.
5.
2 California Health Benefit Exchange
Business, Operations, and Financial Sustainability Enrollment & Information Technology Stakeholder Consultation Research and Analysis Communication Support; Research and Marketing, Outreach,
Assisters Strategy Health Plan Management and Delivery Reform Small Business Health Options Program (SHOP) Essential Benefits Basic Health Plan …and many more
3 California Health Benefit Exchange
The Board approved Solicitation and Delegated Award in
Joint solicitation in partnership of Exchange, the
Solicitation was informed by input gained in multiple in-
3
4 California Health Benefit Exchange
Development of a statewide marketing, outreach and education strategy and plan to reduce the number of uninsured Californians by:
Ensuring eligible individuals are aware of their options for
subsidized and unsubsidized coverage through the Exchange, Medi-Cal and Healthy Families;
Assisting individuals with applying for and retaining coverage
through appropriate and eligible program options; and
As part of a comprehensive plan, developing outreach and
communication strategies that are consumer-friendly, culturally and linguistically appropriate, and use targeted media and other strategies to reach the large and diverse population of Californians.
Initial marketing and communications support, branding and design for the California Health Benefit Exchange and its programs to be coordinated with the overall outreach theme.
Development of a plan for implementation of an Assisters Program.
4
5 California Health Benefit Exchange
Released on December 27, 2011 on Website, Bid-Sync
Thirteen additional vendors have also indicated interest Proposals due on January 30, 2012 Planned start date is March 1, 2012 5
6 California Health Benefit Exchange
The Board approved Solicitation and Delegated Award
Statement of Work was developed with input from state
6
7 California Health Benefit Exchange
Develop standards and process for certification and
Develop ongoing program for certification, performance
Develop implementation timeline, process & solicitation
Recommend strategies for using Exchange programs to
7
8 California Health Benefit Exchange
Developing standards and criteria for qualified health
Aligning quality improvement and reimbursement
8
9 California Health Benefit Exchange
9
10 California Health Benefit Exchange
10
11 California Health Benefit Exchange
Health Plan Procurement Tentative Timeline Deliverable Date Draft Contractor report with detailed task, timeline and resources that will be needed to support health plan selection and procurement as background to the level II grant application
April 15, 2012 Draft Contractor combined report and recommendations for health plan certification standards, selection process and for delivery system improvements
June 1, 2012 Draft Contractor developed health plan solicitation document and model health plan contract
September 1, 2012 Health plan solicitation released October 1, 2012 Health plan solicitation responses are due January 1, 2013 Exchange preliminary health plan selection April 1, 2013 Final selection of Health plans and adjustment of rates July 2013 (TBD) Coverage begins in the Exchange January 1, 2014