Nonprofit services and the Affordable Care Act: A Critical Issue for 2013. Nonprofits that provide community services can expect to see many changes as the Affordable Care Act (ACA) move forward at the state level. Each state is developing its own implementation plans during 2013, and the ACA will start implementation in January, 2014. Here are some important things to keep in mind as you consider nonprofit services and the Affordable Care Act.
Each state is developing plans for how many additional people will be covered under Medicaid expansion. In most states, we will see an increase in the number of adults and children that will be covered under Medicaid through ACA. Many states are contracting with what are called “Accountable Care Organizations” (ACOs) or “Managed Care Organizations,” (MCOs). These are, for the most part, proprietary businesses and not community nonprofits. These ACOs or MSOs come into states and communities when business contracts are available, and move out when they are no longer available. Most nonprofits that provide case management, counseling, primary care and other services are subcontractors to the ACOs and MCOs.
In many states, the biggest potential increase in funding for nonprofit health and human services will come from the expansion coming with the Affordable Care Act. Nonprofit services can expand through the Affordable Care Act if nonprofit leaders can:
- Meet with state policymakers, senior departmental officials and the MCOs/ACOs to discuss the importance of expanding care coordination and case management (called “care navigation” in the new ACA system). Nonprofit leaders can identify other community based services that are critically needed for improving family and community health.
- Discuss the importance of building community service systems that are not only based on medical models, but also include asset-based youth, family and older adult development;
- Provide research regarding the impact of community-based integrated care models, such as the PACE model for older adults, asset-based youth development models, care coordination models studied by Kellogg that improve mental and physical health of children and their families, and other research.
Nonprofit Services can expand under the Affordable Care Act, but it will require active leadership by nonprofits, strong public policy work, and service network planning. It will require a summary of models that work, with service and financial outcomes.Anne Hays Egan, New Ventures Consulting Ezine Articles Expert Author nonprofitsonline.net
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