The Courage in Making Business Decisions In Today’s Environment.

Michigan Association of Health Plans
FALL 2014
MORE INSIDE
Page 4
MDCH Update
Pages 6-14
Health Plan Updates
Page 15
MAHP PAC Awards
Pages 16-19
Summer Conference
The Courage in Making
Business Decisions In
Today’s Environment.
By Rick Murdock, Executive Director,
Michigan Association of Health Plans
As I was going through what we typically do at this time of year—assess our direction
for the remainder of this year relative to our annual strategic plan—I was quickly struck
by the challenges in front of our members and their need to make significant business
decisions in the middle of tremendous uncertainty.
These decisions will determine product development, marketing, network support,
and information technology platforms. Decisions regarding entering or exiting product
lines also take place as members determine where to make their stand on competition.
Whether they are profit or non-profit organizations, our members fundamentally know that
success is linked to “making their margins.” The decisions made by our members affect
thousands of individuals, account for millions of dollars in resource commitments and will
undoubtedly influence future decisions within our industry.
Talking with individual health plan CEOs, I know very well the concerns and angst
they have as they take actions that in turn create a growing sense of urgency that we must
achieve our strategic objectives in order to best serve our industry.
As a trade association director, I know very well that our prime obligation is to serve
our members and provide trusted and reliable information and guidance regarding current
and pending state policy, projected state budget targets and expected rates and regulatory
changes. Similar to other trade associations, we identify, as best we can, the strategic
measures that are important to our industry and the annual initiatives that we must support. Our legislative and regulatory advocacy efforts are driven by these strategic considerations. If we do our job well, our members are able to make more informed decisions and
beneficiaries will ultimately benefit.
So as we move into the final months of 2014, and begin the FY 2015 state fiscal year
while anticipating a “lame duck” legislative session, our challenge is to sort through the
issues we anticipate to surface and the issues on which we need to be pro-active? Here is
a sample of what we expect.
Continued on page 3
Bill Burke’s View from the Capitol
Insurance Code Reform
By Bill Burke, Knight Consulting
The Michigan Association of Health
Plans supports an initiative to reform and
modernize the Michigan Insurance Code
provisions related to health insurance.
These changes are necessary due to the
fact that many of the legal and regulatory
provisions relating to health insurance
carriers, such as HMOs, have been on the
books for at least 40 years. It should come
as no surprise that the current format does
not adequately meet the needs of today’s
health insurance industry.
dence. In addition, the Department
provides consumer protection, outreach and education services to Michigan citizens”.
It is within this framework that we
must negotiate changes to the current
code. In his Executive Order that established DIFS, Governor Snyder made it
clear that he sees the insurance industry
as an economic engine that should be able
to attract new businesses to the state. He
has stressed the importance of competition
Greater access to health care and more
transparency to consumers is a shared goal of the
Snyder administration and the Michigan Association
of Health Plans. Greater competition will ultimately
result in lower premiums and better access in the
health care market place.
The Michigan Department of Insurance and Financial Services (DIFS) has
been open to discussions relating to this
objective. DIFS grants the certificate of
authority to HMOs and other carriers and
is responsible for the regulation of the
business practices and financial stability.
As a result, it is a key player as we negotiate the many changes to the current Code.
As we continue discussions on these bills
it is imperative that we not forget the
mission of DIFS, which is found on their
web site.
“The mission of the Michigan Department of Insurance and Financial
Services is to provide a business climate that promotes economic growth
while ensuring that the insurance and
financial services industries are safe,
sound and entitled to public confi2
as an economic driver that allows Michigan’s citizens with more choices as they
purchase health insurance. Greater access
to health care and more transparency to
consumers is a shared goal of the Snyder
administration and the Michigan Association of Health Plans. Greater competition
will ultimately result in lower premiums
and better access in the health care market place.
Rep. Tom Leonard (R-Lansing) has
agreed to be the lead sponsor the bills on
behalf of MAHP. We thank him for his interest and willingness to host workgroups
of interested parties to resolve any differences and provide input into the process. It
was clear from the first meeting that there
are several unresolved issues with the
original draft – those will be addressed by
MAHP and its advocacy team. We must be
M A H P F A L L 2 0 14
insights
mindful that this initiative may generate a
lot of activity and concerns from anyone
with a vested interest in the health insurance industry and they will want to weigh
in with their comments, concerns and proposed changes. This truly is the “sausage”
part of the legislative process. However,
the final product is intended to produce a
more consumer and business (payer)
friendly set of regulations.
While there are only a limited number of session days left in this session, we
have committed to meet on this issue from
now until the end of session in December.
We will continue to meet with representatives from DIFS, interested groups, other
health insurance entities and members of
the Legislature within this compressed
time frame. We understand that there are
no guarantees in the Legislature, but we
can promise a strong effort to bring all parties to the table in an effort to get this done
and secure the votes to enact this much
needed reform. After all, the objective of
enabling health insurance carriers to provide products (speed to market) that will
provide more competition, lower administrative costs and lower premiums is one
that we all can support.
Bill Burke has been
an associate of Knight
Consulting since 1998.
Prior to that, he was
Director of Legislation
and Associate
Executive Director
of the Michigan Dental
Association. His duties
included lobbying healthcare issues at the state
and federal levels for the 14 years that he held
those positions. He has been a registered
lobbyist for 20 years, specializing in health
care, insurance and appropriations issues.
w w w. m a h p . o r g
Healthy Michigan Act: What Are We Thinking?
The Courage in Making Business Decisions In Today’s Environment. (continued from page 1)
Insurance Code Reform
MAHP is promoting an important reform and updating of Michigan’s insurance
code. Our members are best served by a
modern insurance code, reflective of the realities of today’s industry and not snapshot of
an industry of decades ago, when much of
the insurance code was adopted. It should
be obvious to all now that it is essential for
our members, more than ever, to be adaptable, responsive to customer needs, and to
be enabled to offer a platform of products
that provide choice and cost efficiency.
Whether in the private market or public
sector, purchasers of health insurance products expect and demand this responsiveness
and flexibility. To be competitive, our members must be permitted to fairly compete in
all of the health insurance markets: individual, small market, large market, self-insured, Medicaid and Medicare. We cannot
expect to change the national ranking of
Michigan being one of the least competitive
states for health insurance unless we make a
number of changes—including those in the
insurance code.
We have previously indicated the extraordinary efforts of the Michigan Department of Insurance and Financial Services
(DIFS) in meeting the challenges for the
Michigan insurance exchange market place.
It is also worth noting the Vision of DIFS,
noted in Bill Burke’s column. We share
this vision and our proposed changes to
the insurance code is fully intended to
find that balance between economic
growth that our members can foster with
the traditional regulatory protection.
Medicaid/Healthy Michigan
Implementation/State Budget
Medicaid has always been a large item
in the state budget. With the adoption of the
Healthy Michigan Program, Medicaid will
now be the insurance carrier for one-quarter
of the state’s population. The resources to
fund Medicaid from State and Federal support are now in excess of $8 billion. Finan517. 3 7 1. 3 18 1
cial challenges in the next several years
need to be addressed squarely and in a
transparent way.
For example, we already know the state
will be call upon to provide additional match
support in FY 2016 for the regular Medicaid
program as the state’s improving economy
means reductions in the federal financial
participation (FFP) match rate. This additional state funding requirement will only
keep the program at maintenance. It cannot
be viewed as a program expansion.
It is not too early to begin planning for
how to address match requirements to begin
January 2017 for Healthy Michigan Program which must be provided through savings realized from efficiencies implemented
in the Medicaid program.
Further, issues that we raised in this
year’s budget discussions (Affordable Care
Act premium tax and other issues of actuarial soundness) were not one time issues
but will continue to place pressure on budget decisions. We will need to work with new
Appropriations Committee leaders and
members as a result of this year’s election
and term limits to find the ways to sustain
our program efforts while maintaining the
proper performance expectations.
All of this tells me that we need to work
closer than ever with the state budget process and officials and to begin that effort
earlier than before.
Competition
The MAHP Vision for 2020 and our
related Strategic Objectives will continue to
have a strong focus on how we can emphasize competition as a vehicle to provide more
affordable health care for Michigan’s citizens. The MAHP board of directors is reviewing a draft white paper on this topic and
I anticipate that final recommendations will
be established before the end of the year and
will be part of our strategic efforts for 2015.
To foster competition, we will need to
change perception and identify critical steps
that can make a difference. In addition to
M A H P F A L L 2 0 14
insights
the insurance code changes we are promoting and described earlier, this will include
examining how purchasing decisions by
state and local government can promote
competition, along with steps that the Legislature, Attorney General and DIFS director
may take. We will also continue to promote
the competition inherent in the current Medicaid managed care program, and remind
policymakers that it must be sustained under the expected rebid of the program.
Notes from Summer Conference
Finally, I want to take a moment to congratulate again those who were recognized
at our annual Summer Conference for their
contributions to health care. We again salute
Dennis Smith, CEO of the Upper Peninsula
Health Plan, for receiving this year’s “Ellis
Bonner Award”—the highest award granted
by MAHP. Dennis has been an innovator, a
mentor, and advocate for quality affordable
health care throughout his career and
MAHP was pleased to recognize his efforts.
MAHP also recognized key lawmakers
in different ways. First, Senator Roger Kahn
received the Eugene Farnum Award. This
award, named after my predecessor, recognizes those public servants who have a long
history and foundation for collaboration and
pursuit of affordable health care. Next were
the annual legislators of the year awards.
These were presented to Rep. Mike Shirkey
and Sen. Rebekah Warren in recognition of
their efforts in working with MAHP over the
past year. Finally, the Health Care Association of Michigan was presented with the
MAHP Presidential merit award in recognition of their collaboration with MAHP toward integrated long term care.
Our thanks to the many sponsors in
making the MAHP Conference the largest
and most successful ever. We now have
started our process in planning the 2015
conference to raise the bar even higher.
3
Is Your Health Plan Aware of Important State and Federal
Laws Related to Genetic Testing?
The Genetic Information Nondiscrimination Act (GINA) of 2008 protects Americans from being treated unfairly
because of genetic differences that may
affect their future health.
GINA prevents health insurers from
denying coverage or adjusting premiums based on genetic test results, and
prohibits insurers from requesting that
an individual undergo genetic testing for
any reason. Under GINA, genetic
information cannot be considered
a pre-existing condition.
In addition, GINA prevents employers
from using an individual’s genetic
information in employment decisions
such as hiring, firing, job assignments,
and promotions. And, as with health
insurers, GINA states that employers
may not request or require genetic
information about an individual or their
family members.
Prior to GINA, federal policy did not
adequately protect an individual’s
genetic information from misuse in
health insurance and employment.
Furthermore, the fear of genetic discrimination was preventing individuals from
undergoing potentially lifesaving
genetic testing.
In 2010, the Michigan Department of
Community Health found that only 13.3
percent of Michigan adults were aware
of this law. A recent survey of primary
care providers found that 47.6 percent
were unaware of GINA; furthermore,
one-third reported that knowing about
this law would change their willingness
to recommend genetic testing for their
patients in the future. Potential fears
about genetic discrimination can be
eased for providers and patients with
awareness of the protections by GINA.
4
It is important to note, that GINA does
not address life insurance, disability
insurance, or long-term care insurance.
GINA does not cover members of the
United States Military, and those service
members who receive care through
TRICARE, the Veteran’s Administrative,
or the Indian Health Service.
In the state of Michigan, the Informed
Consent law requires that providers
obtain written informed consent for all
pre-symptomatic or predictive genetic
tests. The law outlines the minimum
required concepts to be reviewed and
understood during the informed consent
process. These include:
•The nature and purpose of the test;
•The effectiveness and limitations of
the test;
•The implications of having the test,
including risks and benefits;
•Any future uses of the test sample and
who will have access to the sample
and testing information; and
•The meaning of the test results
and the procedure by which they
will be disclosed.
A model informed consent form and
brochure has been developed by the
Michigan Department of Community
Health (MDCH) and can be found at:
http://www.michigan.gov/documents/
InformedConsent_69182_7.pdf
Genetic testing is voluntary. Federal and
state laws such as GINA and Informed
Consent are
crucial so individuals can make the
choice that is right for them without the
fear of genetic discrimination.
For more information or about these
laws, please feel free to contact Nancie
Petrucelli at [email protected] or
313-576-8704.
Michigan Association of Health Plans’ Staff
Cheryl Bupp
Medicaid Policy Director
[email protected]
Laura Osminski
Executive Assistant
[email protected]
Kirsten Fisk
Special Events Manager
[email protected]
Dominick Pallone
Deputy Director
[email protected]
Christine Gray
Business Manager
[email protected]
Christine Shearer
Deputy Director,
Office of Legislation and Advocacy
[email protected]
Richard B. Murdock
Executive Director
[email protected]
MAHP Insights is a quarterly publication of the Michigan Association of
Health Plans. Past issues may be found at the MAHP website: www.mahp.org.
For information regarding advertising or inclusion of news and events, please
contact Christine Gray at the MAHP office 517.371.3181.
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g
MAHP Announces New Website and Brand Identity
Site aimed at educating consumers about health care changes
LANSING, Mich. – With more Michigan residents than ever looking for reliable information about health care and
health insurance, the Michigan Association of Health Plans today announced the
launch of its new website, aimed at being
the best source of information and guidance on how to meet the health insurance
needs of our state.
The new website launch comes in
conjunction with a redesign of MAHP’s
brand identity – represented by helpful
hands and approachable colors.
“We embrace the many changes that
are happening at the state and federal
level when it comes to health insurance,
and we are dedicated to remaining at the
forefront of advocating for quality, affordable, accessible health care for the citizens of Michigan,” said Rick Murdock,
executive director of MAHP. “We felt that
these changes demanded an updated
brand and a renewed focus on providing
Michigan residents with up-to-date information on what it means for them.”
The website can be visited at MAHP.
org. The site features information on
Michigan’s award-winning health plans
(ranked by Consumer Reports as among
the best in the country), the latest news
on state and federal reform issues, a blog
offering MAHP’s analysis of important issues, resources for consumers and media,
and more.
The Michigan Association of Health
Plans (MAHP) is an industry voice for
Michigan’s health care plans. MAHP facilitates communication among members,
government, and the industry regarding
health care issues of common concern.
The mission of the Michigan Association
of Health Plans is to provide leadership
for the promotion and advocacy of high
quality, affordable, accessible health care
for the citizens of Michigan.
517. 3 7 1. 3 18 1
M A H P F A L L 2 0 14
insights
5
Health Plan Updates
Grand Valley Health Plan Holds First Ever
‘Pool Bash’ Event
HealthPlus Welcomes
New Sales Executive
Grand Valley Health Plan is hosting
an afternoon of health and fun for
the entire family on August 21. Pool
Bash 2014 was a free pool day and
health fair that took place at Grand
Rapids Parks and Recreation
Richmond Pool. For one day only,
kids (18 and under) were invited to
swim for free. In addition, GVHP
hosted a health fair inside the pool
area featuring local organizations
promoting fun activities and
healthy living.
FLINT, Mich., May 12, 2014 –
HealthPlus today announced the
addition of Kevin Cox to its sales team.
A former sales representative for Blue
Cross Blue Shield of Michigan, Mr.
Cox brings extensive sales experience
to his new role at mid-Michigan’s
largest health insurer. Mr. Cox will
manage enrolled accounts from the
company’s Troy, Mich. location.
Mr. Cox, a graduate of Wayne State
University, holds a Michigan resident
producer license in accident and
health insurance.
“Being active is vital to good health,”
said Pool Bash planner Matt
Witkowski. “Grand Valley Health
Plan wanted to offer the community
an event that promoted both health
education and physical activity.”
HealthPlus Recognizes Top Sales Achievers for 2013
HealthPlus announced its 2013 “sales achiever of
the year” honorees in three categories.
Sara Frey, new business sales executive, earned
the honor for new business sales. Ms. Frey, who
joined HealthPlus in 2011 and is based in the
company’s Troy office achieved 103 percent of her
2013 goal.
For account retention, Scott Feldpausch, a senior
sales executive, is recognized by HealthPlus
leadership for achieving 477 percent of his 2013
goal. Mr. Feldpausch, a five-year HealthPlus
employee, works at the company’s Flint office.
Sara Frey
Three employees shared honors for performance
in individual plan sales. Lisa Maxwell, Linda
Jones and Cindy Kingsbury, all individual sales
representatives, are being honored for collectively
selling individual plans to more than 10,000 new
HealthPlus members in 2013. They have been with
the company for three years, two years and one
year, respectively. The trio works out of the company’s Flint office.
6
Scott Feldpausch
Linda Jones
M A H P F A L L 2 0 14
insights
Lisa Maxwell
Cindy Kingsbury
w w w. m a h p . o r g
Health Plan Updates
HAP Offers New Identity Theft Protection Service
HAP only insurer in Michigan to offer this free added layer of protection
Health Alliance Plan (HAP) is helping its members protect
themselves from credit and identity fraud by offering a new
value-added service that provides professional fraud support
24 hours a day, seven days a week and offers tools to safeguard personal identity and credit history. The Identity Theft
Protection service is available to eligible HAP members free of
charge as the result of an expanded partnership between HAP
and Assist America.
stolen, retrieving the information is fast and the process of
cancelling or replacing the cards can begin immediately.
Since 2011, HAP has partnered with Assist America to provide
emergency travel assistance to HAP members if they become
ill or injured while traveling away from home or in another
country. This expanded partnership offers HAP members an
added layer of protection to help guard against identity theft.
HAP is the only insurer in Michigan to offer this program.
24/7 Fraud Support – HAP members can call any time, day
or night, if they think they have fallen victim to identity theft. A
Fair Credit Reporting Act-certified caseworker will start working
immediately to notify any companies that maintain accounts
affected by fraud and will help cancel and reissue credit cards.
The caseworker will also file disputes regarding any wrong
information in a credit report with the appropriate agencies,
alert the U.S. Postal Service if someone thinks a thief has filed
a change of address or used the mail system to commit
crimes, contact banks if checks have been stolen or forged,
and notify the Social Security Administration if fraudulent use of
a Social Security number is suspected.
The Identity Theft Protection service includes:
Lost and Stolen Assistance – HAP members will be able to
protect themselves by proactively storing their credit/debit
cards, bank cards and other important documents in one
centralized location. If any of these items become lost or
Internet Fraud Monitoring – HAP members can register their
credit/debit card information on the secure Assist America
website. Real-time web-crawling technology monitors any
signs of the cards on underground chat rooms, websites, etc.,
and alerts the member if their information is found.
Matthew Walsh Named HAP Chief Operating Officer
Matthew Walsh was appointed to the Health Alliance Plan
(HAP) senior leadership team as Senior Vice President and
Chief Operating Officer.
Walsh, 42, has ten years of combined operational, clinical and
administrative expertise within Henry Ford Health System, the
Henry Ford Medical Group and HAP.
Prior to becoming HAP COO, Matt served as the Chief Access
Officer for the Henry Ford Medical Group (HFMG) and was
responsible for improving patient access across 26 ambulatory
clinics and call centers. Key outcomes achieved include a
reduction in appointment lead times, significantly improved call
center performance metrics, and the highest PressGaney
patient satisfaction scores for access ever achieved by HFMG.
Walsh also served as HFHS Vice President of Clinical Transformation and IT Integration, a role in which he co-led the complex implementation of Epic’s electronic medical record and
billing system across seven hospitals, the Henry Ford Medical
Group, and independent physician practices. This effort
created one patient medical record across nearly all HFHS
sites of care and enabled significant System integration.
While serving as HAP’s Associate Vice President, Purchaser
Initiatives in 2010, Walsh developed innovative models of care
517. 3 7 1. 3 18 1
delivery in partnership with
providers and automotive
manufacturers that significantly improved the quality
and efficiency of care delivery
and reduced health care
costs. Walsh pioneered
ePrescribing and eVisits in
Michigan, and prepared HAP
to support the UAW Medical
Benefits Trust. He implemented a primary care clinic
at Chrysler World Headquarters, and developed the
Chronic Care Excellence Initiative for patients with chronic
conditions.
Walsh left HAP in 2010 to become the Chief Operating Officer
of the Henry Ford Physician Network, which includes the Henry
Ford Medical Group, hospital-employed physicians, and more
than 600 private practice physicians.
He received his Bachelors of Business Administration from the
University of Michigan and his Masters of Healthcare Administration from the University of Phoenix.
M A H P F A L L 2 0 14
insights
7
Health Plan Updates
Haveman Steps Down as Director of the Department of
Community Health to Focus on His Health
Deputy Nick Lyon appointed as next director, ensures seamless transition
Gov. Rick Snyder announced that he has accepted the resignation of Michigan Department of Community Health (MDCH)
Director Jim Haveman effective Sept. 12. While Haveman had
intended to stay into 2015, he decided to step down after recently
experiencing a mild stroke.
“Director Haveman’s leadership has been instrumental as
we’ve navigated an ambitious health and wellness agenda that
has led to inclusive, bipartisan support to implement a number of
key health initiatives that are making a real difference in Michiganders’ lives,” said Snyder. “Jim’s commitment to the health
and wellness of our residents has been evident in all that we’ve
accomplished and I am grateful for his work. I understand and
respect his decision to focus on his health and wish him and his
family all the best. I know that Nick Lyon will be able to step in
and continue the tremendous work and progress underway.”
Haveman was appointed director of MDCH in 2012, and has
served as the group executive of the People Group since the beginning of 2014. Previously, Haveman served as the MDCH director from 1996 to 2003 and Department of Mental Health director from 1991 to 1996.
“It had always been my intention to stay in the position of
director through 2015 but with the minor stroke I experienced on
Memorial Day, Barb and I have decided it is best to re-evaluate
that time table,” said Haveman. “This has been a difficult decision because I truly love my work. I am humbled by all that we’ve
accomplished and have come to greatly admire the dedication of
this governor and administration, our management team and the
employees at the department.”
During his recent tenure as director, Haveman has led the
state on a number of key health initiatives including the governor’s 4 x 4 Plan, the recommendations of the bipartisan Mental
Health and Wellness Commission, and most recently, the successful launch of the Healthy Michigan Plan. Through these
efforts, Michigan has moved from the fifth to the tenth most
obese state in the nation, the movement toward better integrated
mental health and substance abuse treatment into the health
care delivery system has continued, and more than 375,000 residents are already enrolled in the Healthy Michigan Plan after
only five months.
Gov. Snyder has named MDCH Chief Deputy Director
Nick Lyon as the new director. Lyon served as deputy director of
the MDCH Operations Administration from 2010 to 2011 and
as deputy director of the Health Policy and Regulation Administration from 2003 to 2008. Prior to joining the MDCH, he served
8
as the director of the Office of Budget Development and General Government within the State Budget Office and as the finance officer for the Department of Attorney General. Lyon
earned a bachelor’s degree in economics and political science
from Yale University.
Haveman praised Snyder’s commitment to the health and
wellness of Michigan residents, and Lyon’s appointment as the
next director.
“Gov. Snyder’s steadfast commitment to doing what is right
and doing what is best for the people of the state has made serving in his Cabinet a truly rewarding experience,” Haveman continued. “It is the faith that I have in Nick Lyon as my successor
that I feel comfortable stepping away in September. Nick and I
have worked extremely well together over the past two years and
I know he will be an outstanding and dedicated director of the
Michigan Department of Community Health.”
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g
Health Plan Updates
HealthPlus Appoints Chris Milback, M.D., M.B.A., New Senior
Plan Medical Director
Dr. Milback brings extensive clinical, teaching and leadership experience to new role
HealthPlus announced the appointment of Chris Milback, M.D., M.B.A., to
senior plan medical director. Dr.
Milback assumes the role from Steve
Shapiro, D.O., who retired. Michael
Genord, M.D., chief medical officer at
HealthPlus, made the announcement.
As senior plan medical director, Dr.
Milback is focused on delivering better
member care and clinical outcomes
through medical and case management, health care services utilization
and behavioral health management.
Additionally, Dr. Milback will collaborate with contracted health systems,
physician groups and community
health organizations around common
goals while fostering effective communication and partnerships.
From his prior role as a leader in
primary care at Beaumont Health
System, Dr. Milback understands care,
quality and value. Most recently, he
served as vice chair of clinical operations for the department of family
medicine and community health for
Beaumont Health System, and chief of
family medicine and community health
at Beaumont Hospital, Troy.
Additionally, Dr. Milback was an
associate professor of family medicine
at Oakland University William Beaumont School of Medicine, in Rochester, Mich., and still serves as an
assistant clinical professor of family
medicine at Wayne State University
School of Medicine, in Detroit.
from Oakland University in Rochester,
Mich., and has membership in:
Dr. Milback completed his residency at
Albany Medical Center in Albany, N.Y.,
and is board certified by the American
Board of Family Medicine. He holds a
Master of Business Administration
•Oakland County Medical Society,
Board of Directors
•American Academy of Family
Physicians
•Michigan State Medical Society
HealthPlus extends title sponsorship of iconic Crim races through 2016
Michigan’s leading health-focused insurer supports hometown
footrace to provide accessible wellness options to residents
throughout the region
HealthPlus announced that it will serve as title sponsor of the HealthPlus Crim Festival of Races and the HealthPlus Tour De Crim for 2015
and 2016. HealthPlus President and CEO Bruce Hill made
the announcement at a news conference at the company’s
Flint headquarters.
HealthPlus has been the title sponsor of the HealthPlus Crim
Festival of Races since 2013. Prior to that, the company was the
Crim’s presenting sponsor and, before that, provided a variety of
funding support through the years. HealthPlus employees have a
30-year tradition of staffing the water station at the race’s mid-point in
famed Bradley Hills.
10
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g
Health Plan Updates
HealthPlus names new vice president to lead company’s rapidly
expanding provider network
New VP responsible for creating value-added relationships and ensuring member access to quality care
HealthPlus announced the appointment of Antoinette Geyer to vice
president, provider network and
contracting. Ms. Geyer joins HealthPlus as it continues its rapid growth in
commercial, individual and government programs, and expands its
service area in Southeast Michigan.
Bruce Hill, president and CEO, made
the announcement.
In addition to fostering the company’s
mission and vision of healthier communities, Ms. Geyer is charged with:
•Developing dynamic business
arrangements
•Fostering collaboration among
HealthPlus, its providers and
health systems
•Identifying strategies to spur growth,
increase provider access and
manage costs
•Analyzing and measuring care
costs, member population health
status and provider-network value
•Monitoring provider performance
and ensuring compliance with all
contracts, regulations, and local,
state and federal laws
Ms. Geyer comes to HealthPlus from
Gateway Health Plan, located in
Pittsburgh, Penn., where she last
served as director of provider contracting, network development and provider data quality. In that role, Ms.
Geyer negotiated contracts, expanded
services areas, managed plan networks, enhanced information technology to streamline processes and
boost functionality, and collaborated
with clinical peers on quality improvement activities.
Ms. Geyer holds a master’s degree in
finance from Duquesne University,
located in Pittsburgh. She resides in
Grand Blanc, Mich.
Health Alliance Plan Names Dawn Geisert Chief Compliance Officer
Health Alliance Plan (HAP) announced
that Dawn Geisert has joined the
company as Chief Compliance Officer.
In this newly created role, Geisert and
her team will implement a coordinated
regulatory compliance program,
oversee regulatory submissions and
reporting activities, assess compliance
risk and develop training programs to
address compliance. A robust compliance program ensures that the
company upholds its core values of
service excellence and integrity while
adhering to state and federal requirements. Geisert will also interface with
the Audit and Compliance Committee
of the HAP board of directors.
517. 3 7 1. 3 18 1
Prior to being appointed Chief Compliance Officer, she served in the Office
of the General Counsel at Blue Cross
Blue Shield of Michigan, where she
was Principal Counsel leading the
government programs practice group
legal team.
Geisert holds a Juris Doctorate from
Michigan State University College of
Law, a Master of Science in general
administration from Central Michigan
University and a Bachelor of Arts in
psychology from the University of
Michigan. She is also an alumnus of
the Michigan Chamber Foundation’s
Leadership Michigan program.
M A H P F A L L 2 0 14
insights
A lifelong Michigan resident, Geisert
resides in Troy with her husband and
two children.
11
Health Plan Updates
Molina Healthcare of Michigan Recognizes Unsung Heroes at its
Eight Annual Community Champions Awards Ceremony
Molina Healthcare of Michigan recently celebrated the good deeds of six
community heroes at its eighth annual
Community Champions Awards, held at
The Rattlesnake Club.
This year’s winners included Grenae
Dudley, Ph.D., from The Youth Connection, Katherine Emmanuel from Franklin Wright Settlements, Charles Keith
from Gleaners Community Food Bank,
Janet McAuliffe of Alternatives for Girls,
Connie Navarro of Latinos Working for
the Future and Maggie Varney from Wigs
4 Girls.
The Community Champions program
celebrates the vision of Dr. C. David MoPhoto ID (left to right): Heidi McGlinnen from Molina Healthcare of Michigan; Terry Bayer from
Molina Healthcare, Inc.; Katherine Emmanuel of Franklin Wright Settlements; Charles Keith from
lina, the founder of Molina Healthcare, as
Gleaners Community Food Bank;Connie Navarro of Latinos Working for the Future; Dr. Grenae
well as community partners who work toDudley from The Youth Connection; Maggie Varney from Wigs 4 Girls; Janet McAuliffe of Alternagether to care for society’s most vulneratives for Girls; Stephen Harris, president of Molina Healthcare of Michigan.
ble individuals. Each community champion was nominated by a community-based organization and received a $1,000 grant to give to a deserving nonprofit organization of
his/her choice.
The event included an invocation by Pastor Solomon W. Kinloch, Jr. of Triumph Church and musical entertainment by Cass Technical High School Chorale Ensemble.
THE 2014 COMMUNITY CHAMPIONS AWARD WINNERS:
• Grenae Dudley, Ph.D., serves as President and CEO of The Youth Connection,
a Detroit non-profit committed to providing high quality programs, advocacy and
support services to vulnerable youth.
Over the past decade, Dr. Dudley has
helped hundreds of youth who have experienced trouble with law enforcement get
back on their feet by finding legal aid
support, helping with court appearances
and getting them enrolled in diversion
programs so they will not have a permanent record. Dr. Dudley works tirelessly
to help young people get suits for interviews, assist in helping them locate job
training programs, and has traveled annually with a bus full of 18-year-olds to go
on a college tour. Over the last several
years, she has assisted more than 50 students gain entrance to state universities.
12
• Katherine Emmanuel has been a regular
fixture at Franklin Wright Settlements for
the past sixteen years. Franklin Wright
Settlements is a non-profit dedicated to
assisting individuals, families, groups
and the Detroit community with basic
life, family and social needs. Since 1999,
Emmanuel has dedicated four days a
week to the senior citizens at Franklin
Wright, where she provides fellowship
and companionship for the other seniors
in the program. In addition to serving
food and coffee each day, she goes above
and beyond her duties as a volunteer by
taking seniors to the drug store to pick up
their medications. Emmanuel also provides financial support to the seniors
when they do not have enough money to
afford their basic necessities.
M A H P F A L L 2 0 14
insights
• Charles Keith has been a dedicated volunteer and steadfast supporter of Gleaners Community Food Bank since 1995.
He has consistently logged 10-20 hours
of volunteer time each week at Gleaners,
with the daily mission of getting food to
those who struggle with hunger. He has
helped to direct the work of up to 150 volunteers each week as they inspected,
sorted and packed salvaged food for people in the community. As a member of the
Speakers Bureau, Keith spreads the word
about Gleaners’ work in the community.
In addition to all of these efforts, he also
serves as a table captain at Gleaners fundraising events.
• Janet McAuliffe has devoted the past several years to volunteering at the Detroit
non-profit Alternatives for Girls where
she helps empower homeless and at-risk
w w w. m a h p . o r g
Health Plan Updates
girls to lead productive and fulfilling
lives. McAuliffe volunteers 20-40 hours
a week supporting girls and young women
by helping them explore and access resources and opportunities necessary to
be safe, to grow strong and make positive
choices in their lives. As an advisor on
the Board of Directors, she is always
looking to launch new initiatives. McAuliffe is responsible for teaching the girls
how to work in the fruit and vegetable
garden she developed. Additionally, she
instructs sewing classes—making hats,
scarves, and other items— providing a
safe and relaxing activity and skill for the
girls and women. McAuliffe has gone
above and beyond by soliciting donations
and paying out of her own pocket to support Alternatives for Girls’ programs.
• Connie Navarro is known as an exceptional role model and proud Latina in the
Muskegon community. In 1991, Navarro
and her husband co-founded the organi-
zation Latinos Working for the Future, a
non-profit dedicated to preserving the
Latino culture through education and
cultural programming. Navarro has
played an active role since its inception
and continues to assist the group in the
creation of innovative programming. This
includes launching the Muskegon community’s first Latino health fair, Fiesta de
Salud, a public event that invited low-income community members to receive free
mammograms and health screenings.
Navarro also helped launch the first Latino College Fair, hosting over 100 Spanish-speaking students and families along
with 15 Michigan universities. Navarro
has also served on numerous boards including the NAACP, the Police Review
Board, Mediation Restorative Justice,
Greater Muskegon Woman’s Club and the
Kutsche Office of Local History.
•Maggie Varney, founder and CEO of
Wigs 4 Kids, is a visionary with a heart
for children who struggle with debilitating diseases. More than a decade ago,
Varney, a successful cosmetologist and
entrepreneur, had a chance encounter
with a young teen named Emily who was
dealing with the loss of her hair due to
cancer treatment. Through this bond with
Emily, the idea for “Wigs 4 Kids” was
born. The organization provides wigs and
support services to children in need – at
no charge – and has changed the lives of
more than 1,200 youth statewide that
have lost their hair to cancer and other
diseases. Varney has worked tirelessly
over the past 10 years, dedicating hours a
week to achieve the vision, mission and
values of Wigs 4 Kids. In 2013 alone, she
donated more than 2,200 hours of volunteer service. She is a true advocate for
children, with the goal of helping to raise
the self-esteem of kids who have been
given such large obstacles to overcome in
their young lives.
Over 250 Participate in “Rock Your Workout” at Hart Plaza
Molina Healthcare Brings Free Fitness Class, Rip Stix and Raffle Prizes to Detroit Resident
Molina Healthcare recently hosted a free POUND
fitness class for all ages at Hart Plaza. Attendance
was estimated at over 250 people including more than
150 youth from community organizations including
Adams Butzel Recreation Center, Cody High School,
Franklin Wright Settlements and The Youth Connection. POUND combines easy to follow cardio moves
with strength training and drumming (using lightly
weighted neon green drumsticks, called Ripstix). This
combo works the entire body, raises the heart rate to a
fat-burning zone and forces each move to be as
precise as a basic beat.
All attendees received a free pair of Rip Stix and were
able to enter a raffle that included prizes valued at
over $500. Molina Healthcare also donated $2,000 in
grants to Adams Butzel Recreation Center, Cody High
School, Franklin Wright Settlements and The Youth
Connection to support their health and fitness programs
Molina Healthcare held the event to offer a healthy activity for
local families and to show the community that you don’t need
517. 3 7 1. 3 18 1
an expensive gym membership or hours of free time to improve
your fitness and clear your mind. In addition to being a great
form of exercise, aerobic activity like POUND can reduce
stress, manage chronic health conditions, raise self-confidence
and improve concentration.
M A H P F A L L 2 0 14
insights
13
Health Plan Updates
Michigan Association of Health Plans Appoints New Deputy Director
Lansing, Michigan — The Michigan
Association of Health Plans (MAHP)
announced that Dominick J. Pallone
will become its new deputy director
effective Monday, June 16.
In his new capacity as deputy director,
Pallone will work closely with MAHP
members on policy, regulatory and
budget concerns impacting health
plans in Michigan. His duties will also
provide for collaboration with MAHP
committee chairs and members in
carrying out the association’s mission,
strategic plan and related interaction
with state executive and legislative
agencies in regard to industry matters.
Pallone most recently served as a
partner with Midwest Strategy Group,
working on health policy, information
services and appropriations matters,
among other issues. Prior to that he
worked for key lawmakers in the
Michigan House and Senate, serving
in critical staffing positions. His
experience in the Legislature and
as a successful partner with Midwest
Strategy Group will enhance the
MAHP’s policy and legislative agenda,
since health insurance and Medicaid
issues will continue to be the major
health care agenda for Michigan and
the rest of the country for the foreseeable future.
“We are very excited about our
opportunity to bring Dominick Pallone
on board here at MAHP. His talents
and experience will provide us with
valuable expertise as MAHP charts
its course over the next several years,”
said Richard Murdock, MAHP executive director.
Pallone, who lives in Lansing, received
his B.A. from the James Madison
College at Michigan State University
in 2003.
Molina Healthcare of Michigan Donates More Than $7,000 to Detroit
Rescue Mission Ministries
Molina Healthcare of Michigan recently presented a
check for $7,436 to Detroit Rescue Mission Ministries
with the charitable contribution coming from corporate
matching funds based on the amount contributed by
employees who voluntarily donated to Molina Healthcare of Michigan’s political action committee (PAC).
Founded over 104 years ago, Detroit Rescue Mission
Ministries is one of the largest rescue missions in the
nation, and serves over 1,800 men, women, and
children in the Cities of Detroit and Highland Park each
day, by providing emergency shelter, housing and
substance abuse treatment to those in need.
Photo ID: (left to right) Barbara Willis, chief operating officer of Detroit Rescue
Mission Ministries; Dr. Chad Audi, president of Detroit Rescue Mission
Ministries; Stephen Harris, president of Molina Healthcare of Michigan
14
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g
MAHP PAC Awards
MAHP PAC Awards
The MAHP PAC Award ceremony, which took place during the annual MAHP Summer Conference, is intended to recognize member plans for their outstanding leadership and commitment to legislative advocacy to promote and support high quality, affordable, accessible health care for the citizens of Michigan. MAHP annual PAC Awards are based on three levels of contribution. The Gold level is
awarded to plans contributing $10,000 or more. The Sliver level awards go to those contributing $7,500 or more. The Bronze level
awarded to plans contributing $5000 or more. MAHP is proud to present 2013 Awards to McLaren Health Plan, Molina Healthcare of
Michigan, Upper Peninsula Health Plan, Total Health Care, Health Alliance Plan, HealthPlus of Michigan and Priority Health.
Dennis Smith from the Upper Peninsula Health Plan receives the Bronze
Rory Lafferty from the Health Alliance Plan receives the Gold award from
award from MAHP’s Christine Shearer.
MAHP’s Christine Shearer.
Stephen Harris from Molina HealthCare of Michigan receives the Bronze
Dave Bilardello from Priority Health receives the Gold award from MAHP’s
award from MAHP’s Christine Shearer.
Christine Shearer.
Bruce Hill from the HealthPlus of Michigan receives the Gold award from
MAHP’s Christine Shearer.
517. 3 7 1. 3 18 1
M A H P F A L L 2 0 14
insights
15
Summer Conference
Summer Conference
Michigan Association of Health Plans Recognizes Health Care Leaders at
Annual Conference
16
LANSING, Mich. — Sens. Roger Kahn and Rebekah Warren, Rep. Mike Shirkey and Dennis H. Smith, president and
CEO of the Upper Peninsula Health Plan, along with the Health
Care Association of Michigan, were recognized today for their
contributions to health care issues during the Michigan
Association of Health Plans’ Annual Conference at Grand
Traverse Resort.
Rep. Mike Shirkey and Sen. Rebekah Warren received
Legislator of the Year awards. Rep. Shirkey played a key role
in passing the Healthy Michigan Plan, expanding access to
affordable health insurance to hundreds of thousands of low
income families. Sen. Warren is a longtime advocate for women’s health care and is crucial to Michigan’s implementation of
the federal Affordable Care Act.
Senator Roger Kahn, a Republican representing Saginaw
and Gratiot counties, received the Eugene Farnum Award,
established in the name of the long-time past MAHP executive
director, to honor those who reflect his values of collaboration, a
sense of balance, fairness and integrity, in moving toward
his vision of access to quality, affordable health care for
Michigan citizens.
MAHP Executive Director Rick Murdock noted that Kahn
has been instrumental in the passage of numerous reforms that
advocate to protect Michigan seniors, children and families
while encouraging physicians to always put their patients first.
“Senator Kahn has worked for years to help provide quality
health care for our state. His experience as a medical doctor has
made him the perfect candidate to empower other physicians to
join in his efforts,” said Murdock.
MAHP’s most prestigious award, the Ellis J. Bonner Outstanding Achievement Award, was given to Dennis H. Smith.
Murdock who makes the final choice of a recipient for the award,
said “Smith is the voice of one of the nation’s best Medicaid
health plans and a recognized leader throughout Michigan’s
Upper Peninsula. He has also been a valuable resource for me
as the association has moved forward on key issues over
the years.”
The Bonner award recognizes a MAHP member who has
been nominated by colleagues based upon exemplary service,
leadership and contributions to the managed care industry and
community. The late Ellis Bonner was a father of the health
maintenance organization movement in Michigan, a mentor to
many and a tireless promoter of creation of a just and accessible
health care system for Michigan citizens. The award recognizes
a MAHP member who has been nominated by colleagues based
upon exemplary service, leadership and contributions to the
managed care industry and community.
Dave LaLumia, CEP of Health Care Association of Michigan, accepted the MAHP President’s Recognition Award
on behalf of the Health Care Assocaition of Michigan. The
discretionary award recognizes an individual or organization
showing an outstanding commitment to the advancement and
improvement of health care.
Senator Rebekah Warren receives Legislator of the year award from
David LaLumia, CEO of Health Care Association of Michigan, receives the
Rick Murdock.
MAHP President Award from Bruce Hill, MAHP President.
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g
Summer Conference
Representative Mike Shirkey receives the
Senator Roger Kahn receives the Eugene
Dennis Smith, CEO of UPHP, receives the
Legislator of the Year Award from Stephan Harris.
Farnum Award from Jon Cotton.
Bonner Award from Rick Murdock.
Rick Murdock, Mark Zaleski, Senator Rebekah Warren, and Tim Codd
Senator and Mrs. Roger Kahn with Rick Murdock.
Rep. Mike Shirkey and Sen. Roger Kahn
MAHP President Bruce Hill
DIFS Director, Ann Flood
Legislative Panel
Legislative Panel
Farah Haney, Elizabeth Hertel and Bill Burke
517. 3 7 1. 3 18 1
M A H P F A L L 2 0 14
insights
17
Summer Conference
18
Kenneth Barratte, Dusty Fancher, Terri Morante and Bruce Hill.
Dennis Sirosky, Judy Hooyenga, Rep. Kate Segal and Mike Segal.
Paul Valenti, Kathy Kendall and Carol Solomon
Dominick Pallone, MAHP Deputy Director
Steve Fitton, Medicaid Director and Jeff Brownlee, State Purchasing Director
Catherine Pearson, Keynote Speaker, Avalere Health
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g
Summer Conference
Kathy Stiffler and Steve Fitton, Medicaid Director
Steve Fitton, Medicaid Director, and Janet Olszewski
Ani Turner, Altrarum Institute and Rick Murdock
Jan Getty, Late Breaking New Session
Joe Aoun, Late Breaking News Session
Chris Priest, Governor’s Office and Steve
Exhibit Hall
Karen Horgan, Senator Jim Marleau and
Fitton, Medicaid Director
517. 3 7 1. 3 18 1
Senator Jim Ananich
M A H P F A L L 2 0 14
insights
19
PRESORT STANDARD
US POSTAGE
PAID
Michigan Association of Health Plans
327 Seymour, Lansing, Michigan 48933
LANSING, MI
PERMIT NO. 664
MAHP 2015
Upcoming Events:
Wednesday, February 11, 2015
Best Practices
English Inn, Eaton Rapids
Tuesday, April 21, 2015
Legislative Reception
Troppo, Lansing
Wednesday, July 15–July 18, 2015
MAHP Summer Conference 30th Anniversary
Grand Traverse Resort & Spa, Acme
Tuesday, September 15, 2015
Pinnacle Awards
TBD
517. 3 7 1. 3 18 1
M A H P F A L L 2 0 14
insights
w w w. m a h p . o r g