Coverage

Coverage

Coverage will focus on universal coverage as a long-term goal, defining a set of essential benefits with public input, and, in the near term, supporting existing efforts to maintain and expand coverage for children, high-risk individuals, health care workers and small employers.

Jan VanRiper with the Montana State Auditor’s office and Claudia Clifford with AARP are co-leading this group.

If you wish to participate, please contact David Kendall, workgroups facilitator at 406-543-2265 or david “at” ekendalls dot net. (this address is spelled out to prevent web crawlers from recognizing it).

Document for Sept. 17, 2008 Meeting

Coverage Workgroup Recommendations

Commissioner of Insurance Coverage Funding Proposals Document

Download Commissioner of Insurance – Funding Proposals 4-28.doc
Download Coverage-Health Care Commission Background Notes.doc

Coverage Workgroup would like your feedback on the draft proposal below.

Please send any thoughts or comments through David Kendall, workgroups facilitator at 406-543-2265 or david “at” ekendalls dot net (this address is spelled out to prevent web crawlers from recognizing it). Thank you!

Given the enormous task of improving our health care system, Montana needs a commission that can oversee the work to contain costs, improve quality, and increase access to care for all Montanans. It is the sense of the committee that this work is complex and long-term, requiring the oversight and direction of a commission that has staff and resources. It is also possible that Congress may pass measures requiring significant changes in our health care system and a Montana Health Care Commission would be in the position to help transition our state in the best way.

A bill creating a Montana Health Care Commission needs the following elements.
Your suggestions about these topics are welcome.

Mission Current law states the following as the State Health Care Policy which could be updated and used as the mission of the Commission.
50-4-104. State health care policy.
(1) It is the policy of the state of Montana to continue to investigate and develop strategies that result in all residents having access to quality health services at costs that are affordable.
(2) It is further the policy of the state of Montana that:
(a) Montana’s health care system should ensure that care is delivered in the most effective and efficient manner possible;
(b) health promotion, preventative health services, and public health services should play a central role in the system;
(c) the patient-provider relationship should be a fundamental component of Montana’s health care system;
(d) individuals should be encouraged to play a significant role in determining their health and appropriate use of the health care system;
(e) accurate and timely health care information should play a significant role in determining the individual’s health and appropriate use of the health care system;
(f) whenever possible, market-based approaches should be relied on to contain the growth in health care spending while attempting to achieve expanded access, cost containment, and improved quality; and
(g) the process of health care reform in Montana should be carried out gradually and sequentially to ensure that any undesirable impacts of the state’s reform policies on other aspects of the state’s economy, particularly on small businesses, are minimized.
(3) The legislature recognizes the need to increase the emphasis on the education of consumers of health care services. Consumers should be educated concerning the health care system, payment for services, ultimate costs of health care services, and the benefit to consumers generally of providing only those services to the consumer that are reasonable and necessary.
History: En. Sec. 2, Ch. 378, L. 1995.

Compiler’s Comments:
Termination Date Extended: Section 3, Ch. 517, L. 1997, amended sec. 25, Ch. 378, L. 1995, by extending the termination date of subsection (4) from June 30, 1997, to June 30, 2001.
Effective Date — Termination: Section 24(1), Ch. 378, L. 1995, provided that this section is effective on passage and approval (approved April 12, 1995), and sec. 25, Ch. 378, L. 1995, provided that subsection (4) of this section terminates June 30, 1997.

Commission structure and duties
* Number of commissioners and method of appointment – The Coverage Committee feels that there should be broad representation of stakeholders, consumers, and representatives of key department and elected officials. Commissioners should be a appointed by various elected officials (governor, leaders of the legislature, AG, State Auditor)
* Determination of Chair of Commission
* Term of commissioners – which needs to be staggered
* Duties and powers

Key shorter term projects and goals – The statute could direct the commissions focus on main projects. For example, it could direct the commission to draft legislation on a topic, coverage for all Montanans through insurance exchanges, study mandated benefits, or create a website of information comparing quality of care factors in various settings. This section of law would be reviewed by each legislature to affirm continuation of certain projects and determine new directions.

Staff and resources – Your input on adequate staff and resources in needed.