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Insuring the Uninsured

The federal Affordable Care Act (ACA), signed into law in March 2010, contains a huge number of mandates and a long list of deadlines which states and territories must comply with or potentially lose federal health care dollars.

In the Virgin Islands we are on the way toward reaching many of the benchmarks set by the new law. Shortly after the federal law was signed, Governor John deJongh established a local Health Care Implementation Task Force (HCITF) and named representatives from key Virgin Islands Departments and agencies to organize and oversee the work to get our health care delivery system in line with the new requirements.

See Also: How Insurance Exchanges Will Work

Taetia Phillips-Dorsett took the helm in early 2011 following Barbara Jackson’s departure and has already made significant headway. In November and December of 2011 she and Insurance and Banking Commissioner, John McDonald conducted over 25 public town hall meetings with various stakeholder groups throughout the territory as part of their Stakeholder Engagement. The team has also developed an extensive survey instrument to measure stakeholder preferences concerning whether the territory should develop a health care exchange or expand the current Medicaid program to incorporate the over 28,000 working individuals who are unable to afford health insurance.

This January the HCITF issued a Request for Proposals (RFP) for research on the VI’s health insurance Private Market Analysis. This study will compile detailed analysis on all 27 of the health insurance carriers who are already operating in the Virgin Islands. The work will also include a review of the two companies who are the only ones still writing renewal policies for their existing customers.

A second RFP is expected to be released next month. This RFP will look for a company whose work will focus on analyzing health care sector gaps specific to the health information technology area. This proposal’s work encompasses taking a hard look at infrastructure available in the VI Medical Assistance Program (Medicaid) as well as the entire Department of Health. It will also evaluate each office’s capacity, what is missing, what needs to be upgraded plus what amount of funding will be required to achieve the ACA goals. These consultants will also explore the potential of each office’s deliverables as related to the ACA requirements. The proposal will also look at the federal requirements related to establishing a local health insurance Exchange.

Work has also been progressing in the private sector and at both hospitals. Another committee working with the Task Force is the Health Information Exchange (HIE) committee. This committee meets regularly focusing on the infrastructure necessary to enable physicians’ offices, laboratories, pharmacies and other allied health organizations to more effectively communicate with one another. In order to accomplish this, patient records must make the leap from paper to electronic records. This means that doctors and their staffs must all change how they conduct the business of health care. Patients too, must be brought up to date on what to expect from the new technology. And, of course, security is of primary concern for everyone.

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