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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Becki L. Melli, MBA, Gretchen A. Brown, MSPH, Ladan Keene, MA, and Maria Nieto. CalOptima, 1120 W. La Veta Ave., Orange, CA 92868, (714) 246-8635, bmelli@caloptima.org
The Qualified Medicare Beneficiary (QMB) program was designed to protect low-income Medicare beneficiaries from the burdens of “cost-sharing” and premium liabilities. This program, which was implemented through each state’s Medicaid program, serves individuals with modest resources and incomes at or below 100 percent of the federal poverty level. Numerous reports, however, have indicated that the actual number of QMBs is far below the number of those who are potentially eligible. Several suggestions offered as to why participation rates are so low include lack of knowledge and understanding of the program as well as a complex application process. Exploring these barriers, however, is beyond the scope of this project. CalOptima, a managed health care system for Medi-Cal (Medicaid) beneficiaries in Orange County, California, has developed an innovative approach to disseminating information about the QMB program and simplifying the application process that has proved effective in enrolling QMBs. Through links with local agencies (i.e. the Social Security Administration and the local Social Services Agency) together with a targeted outreach, CalOptima has significantly increased the number of QMB beneficiaries. These beneficiaries now have expanded health care benefits, which are increased access to physicians and hospitals. CalOptima will outline the development and implementation of the QMB outreach including the development of materials, obtaining support from outside agencies as well as community input and targeting a multicultural community. Also, the outreach results will be presented.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.