By Jill Zorn
The Access Health CT board met on May 19 with two of the main agenda items being to approve their annual budget and hear a report about perceptions about how well the exchange is addressing health equity.
The FY 2017 budget for the exchange was presented and approved. Here is how the FY 2017 expense budget compares to the forecasted FY 2016 expenses:
Access Health CT Budget
2017: $34.6 million | 2016: $32.6 million
These numbers reflect some fancy accounting that subtracts out grant support and reimbursements AHCT receives from the Department of Social Services (DSS), based on the fact that the AHCT supports some DSS functions, particularly enrollment.
While the federal government funded start-up of the exchange and much of the initial operating costs, those days are over – the last federal grant will be spent by the end of December 2016. In the upcoming fiscal year, which begins on October 1, 2016, Access Health CT will have to be almost completely self-sufficient. It will have to rely almost exclusively on revenue it generates from a 1.65 percent assessment it levies on the insurance premiums that it collects to cover expenses.
The presentation (it starts on page 19) on health equity was intended to start a dialogue regarding how well Access Health CT is meeting its goal of advancing health equity in their work and how it can continue to improve. Researchers surveyed both Access Health CT staff and consumer groups.
While consumer groups had positive things to say about Access Health CT’s community engagement work, (slide 35) they gave them lower marks for incorporating feedback from consumers into their work, particularly from people of color.
This disconnect is not a surprise because Access Health CT lacks sufficient mechanisms to receive regular input by consumers. There still is no consumer representative on the Board – a concern that advocates have raised for over five years.
The Consumer Experience and Outreach Advisory Committee rarely meets as a stand-alone committee. Instead, this committee has largely been folded in with a benefits group and is mainly consulted annually about plan design. Compare that to the regular meetings held by a similar advisory committee of the California exchange.
And there is no longer an identifiable navigator and in-person assistance program. Navigators and assisters, were shown in this study to have been extremely effective in reaching vulnerable populations, and also served as another valuable resource for how to improve outreach.
There is a connection between the budget presented at the beginning of the meeting and the presentation on health equity. Outreach to help people enroll, use their insurance effectively, and remain enrolled is crucial to maintain the funding mechanism for the exchange-premiums.
Good business practice should lead Access Health CT to have more and better ways to engage in a two-way dialogue with the people it is intended to serve.