HJBR May/Jun 2023

HEALTHCARE JOURNAL OF BATON ROUGE  I  MAY / JUN 2023 51 Joseph Tidwell, PT, MHA, CPHQ Vice President Network Development & Provider Engagement Louisiana Healthcare Connections go to the doctor or have a hospital stay. To receive either type of financial assistance, qualifying individuals and families must enroll in a Marketplace plan. KFF provides a helpful online calculator for estimat- ing insurance premiums and subsidies at: www.kff.org/interactive/subsidy-calcula- tor/. Marketplace plans are offered in four “metal” levels — bronze, silver, gold, and platinum — and the premium tax credit can apply to any of these levels. However, silver plans are typically the best value for members because they balance low pre- miums with moderate out-of-pocket costs and cost-sharing reductions for those who qualify. Many plans also include or of- fer optional dental and vision for adults. At minimum, all Marketplace plans must cover ten essential benefits: • Ambulatory patient services. • Emergency services. • Hospitalization (surgery and over- night stays). • Pregnancy, maternity, and newborn care (before, during, and after birth). • Mental health and substance use dis- order services, including behavioral health treatment (counseling and psychotherapy). • Prescription drugs. • Rehabilitative and habilitative ser- vices and devices. • Lab services. • Preventive and wellness services and chronic disease management. • Pediatric services, including oral and vision care. Other helpful resources to share with pa- tients losing Medicaid coverage include: • healthcare.gov (800-318-2596) — for Marketplace enrollment. • https://localhelp.healthcare.gov — for application assistance targeted by re- gion. • https://ldi.la.gov/onlineservices/ shiipmap — for Medicare assistance and special counseling. A big lift Louisiana has invested in strategies, solutions, and partnerships aimed at keeping our most vulnerable population insured. And providers can help in three simple ways: 1. Reminding patients that Medicaid re- newals have begun. 2. Assisting patients with updating their address if it’s changed (using the LDH Contact Information Form). 3. Telling patients who may no longer qualify for Medicaid about low-cost Marketplace options and sharing online resources with them for infor- mation about — and access to — other plans and subsidies. The stakes are high. Unwinding the Medicaid continuous coverage require- ment while ensuring continuous care will be an immense challenge for every state and their enrollees, but if we are all com- mitted to the same goal, we can achieve it . n REFERENCES 1 HHS. “Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap.” Feb. 9, 2023. www.hhs.gov/about/news/2023/02/09/ fact-sheet-covid-19-public-health-emergency- transition-roadmap.html#:~:text=Based%20 on%20current%20COVID%2D19,day%20on%20 May%2011%2C%202023 2 www.medicaid.gov 3 Corallo, B.; Burns, A.; Tolbert, J.; Claxton, G. “What Happens After People Lose Medicaid Coverage?” Kaiser Family Foundation, Jan. 25, 2023. www.kff.org/medicaid/issue-brief/ what-happens-after-people-lose-medicaid-cov- erage/#:~:text=KFF%20estimates%20that%20 between%205,first%20time%20since%20 March%202020. 4 Turner, B.E.W. “Google tackles Medicaid redeter- minations by updating search.” Modern Health- care, March 14, 2023. www.modernhealthcare. com/digital-health/google-search-update-med- icaid-redeterminations-ai-check-up-event 5 O’Donoghue, J. “With pandemic protec- tions ending, Louisiana will reach out to every Medicaid enrollee.” Feb. 27, 2023. lailluminator.com/2023/02/27/with-pandemic-pro- tections-ending-louisiana-reaches-out-to-every- medicaid-enrollee/#:~:text=Louisiana%20 estimates%20it%20will%20be,director%20 for%20Louisiana’s%20Medicaid%20program. 6 Kaiser Family Foundation. “Explain- ing Health Care Reform: Questions About Health Insurance Subsidies.” Oct. 27, 2022. https://www.kff.org/health-reform/issue-brief/ explaining-health-care-reform-questions-about- health-insurance-subsidies/ A veteran healthcare administrator and native of Leesville,JosephTidwell brings over 30 years of sol- id clinical and quality experience to his role as vice president of network development and provider en- gagement and in implementing the state’s premiere value-based payment models for capitatedMedicaid. Prior to his tenure with Louisiana Healthcare Connec- tions,Tidwell served as an administrator at Phoenix Behavioral Hospital in Rayne,Louisiana where he led a successful Joint Commission Certification survey for both the inpatient and outpatient programs. He holds amaster’s degree in health administration from Tulane University and a BS in physical therapy from TexasWoman’s University.