MAXIMUS on Health Reform

Health reform legislation must include mechanisms to find the uninsured, inform them about their health care choices and enroll them in their chosen program, independent of profit or other motives.

Expanding access to the nearly 50 million uninsured Americans is a critical goal of health care reform. The majority of the uninsured population has income below 200% of the federal poverty level and may face multiple barriers to accessing health insurance coverage.

Efforts to expand access must be efficient and unbiased; an independent process for finding and enrolling uninsured individuals ensures that companies contracted to administer these important functions are not profiting from the investment in health care reform. Many states have improved access to Medicaid and the Children's Health Insurance Program (CHIP) through partnerships with independent companies like MAXIMUS.

Legislation must provide for independent efforts to find eligible individuals, inform them about their health care options, and help them enroll in the plan that is best for them and their families.

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Health reform legislation must help consumers make informed decisions among health insurance plans.

Health reform is expected to create mechanisms for expanded insurance coverage.

Health reform investments must include improving communication efforts to help consumers better understand their health care options. This empowers the individual to make choices that will improve their own health and the health of their family members. In doing so, policies should encourage partnerships with specialized providers that have proven success in helping government effectively and efficiently help this population access quality health care. MAXIMUS is the nation's leading company partnering with state governments as diverse as California, Iowa, Michigan and Texas to provide independent information on health insurance plan choices so that consumers make the best health plan choice for their families' health care needs.

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Health consumers, whether enrolling in public or private plans, need an effective appeals process when a health insurance provider denies their claim.

Independent, evidence-based reviews are essential for health consumers accessing government programs such as Medicare Parts A, C, and D. Beneficiaries need assistance to navigate and understand the often complex and confusing appeals process. The Medicare Part D program, for example, provides a wide range of provider choices. These plans have broad discretion in the implementation of prescription drug coverage, making the appeals process even more complex.

Independent providers such as MAXIMUS manage appeals for government and private insurance programs, ensuring a fair, effective and efficient process.

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Developing culturally competent approaches to health delivery through tailored health communication and literacy efforts will help combat health disparities.

Racial and ethnic minority populations suffer from higher rates of chronic disease and have poorer health outcomes, creating significant health disparities. Additionally, these populations suffer from health care disparities; that is, less access to services and providers.

A major component of health care reform will address these inequities through increased access, but improving the way we provide health information to diverse communities is a critical part of increasing access to health services. Research shows tailored communication approaches are more effective in helping people understand their own health and make the necessary lifestyle changes.

MAXIMUS understands how to communicate effectively with culturally and linguistically diverse populations and can develop health communication materials in virtually any language.