ACA PREVENTION SERVICE OPPORTUNITIES Merced CaLAPH Team

Merced County Opportunities for Prevention (MCOP)  Cindy Valencia, Supervising Health Educator, Merced County Public Health Department  Myisha Reed, Program Manager, First 5 Merced County  Isai Palma, Administrative Coordinator, Building Healthy Communities  Desirre Herrera, Regional Program Manager, Planned Parenthood Mar Monte  Crisantema Gallardo, Community Organizer, Merced Organizing Project

Team Project Goal  To increase local preventive health services, particularly availability and accessibility of chronic disease management tools

Preventative Care  Health care focused on disease prevention and health maintenance  Early diagnosis of disease  Identify people at risk of development of specific health problems  Early intervention such as health education, counseling, screening tests and immunization programs

Prevention Services Available with ACA  Preventative services that must be covered without the patient having to pay copayment, co-insurance or meet deductible  Preventative Services for Adults (15 services)  Preventative Services for Women, including pregnant women (22 services)  Preventative Services for Children (26 services) services-list.html

Prevention Services Available with ACA  ACA offers protection for the patient  ACA requires insurance companies cover people with pre-existing health conditions  ACA makes it illegal for health insurance companies to cancel health coverage if a person gets sick  ACA and Chronic Disease Management

Center for Medicare and Medicaid Services (CMS) Preventive Service Rule Change  New regulatory change for preventive services furnished under the Medicaid state plan. This change allows additional practitioners (e.g. non- licensed workers), who are subject to qualifications established by the state, to provide preventive services to Medicaid eligible beneficiaries Prevention.pdf

$2 trillion dollars in annual U.S. health care costs, 75% of which are related to chronic disease conditions Chronic disease burden

Improve care for chronic illness Medical Management – Lifestyle – Medication

Health Maintenance/Self-Management  Clinical Care Measures  High blood pressure control  Cholesterol control  Diabetes  Behaviors  Nutrition & Physical Activity  Patient Experience  Improving patient satisfaction  Operational Measures  Reducing no shows  Improving access  Reducing hospital readmission rates

Policy Brief Outline -Executive Summary -Introduction/Purpose New Opportunities for Prevention Services in Merced County; Prevention Service provisions in the Affordable Care Act -Approaches and Results Existing Chronic Disease Management Services in Merced County -Conclusion Promising Chronic Disease Management Service Models - Recommendations For Action Opportunities and Viable Recommendations

How Do We Get There?  Gather support and input from stakeholders  Gap Analysis examining low-cost/free preventative services  Develop policy brief that identified promising models and approaches for local implementation