At least one company's doubts about the reform effort have led to their departure from the new navigator program intended to assist the uninsured in obtaining health plans through the federal health exchange.
At least one company’s doubts about the reform effort have led to their departure from the new navigator program intended to assist the uninsured in obtaining health plans through the federal health exchange. Cardon Outreach, who has been helping to enroll Medicaid beneficiaries for years, will be returning more than $800,000 in federal grant money intended for hiring navigators.
“The emerging state and federal regulatory scrutiny surrounding the Navigator program requires us to allocate resources which we cannot spare and will distract us from fulfilling our obligations to our clients,” said the group in a recent statement.
Almost $70 million in federal navigator grants were recently issued to ensure consumers successfully enroll in the healthcare insurance exchanges. Navigators, of course, are the volunteers who will be entrusted with the task of guiding Americans through purchasing health plans in state and federal exchanges. The Texas-based organization was included in this latest batch of navigator grants.
While Cardon did not go on to list too many specifics, the requirementsof the navigator program raise many uncertainties. States like Wisconsin and Indiana, for instance, are asking navigators to pay for their training fees while others are charging for background checks. Grant recipients have been questioned about their budgets, training, and supervision, sometimes even being required to procure documentation. Consumers are also worried about the security of the health database being used; navigators will have access to buyers’ personal information including their income and immigration status.
“It is shameful and unprecedented for Congress to bully and intimidate private organizations that have legitimately received federal grant money to do nothing more than help people enroll in health coverage,” US Department of Health and Human Services spokeswoman Joanne Peters said.
Around the Web
Company Returns $800K ‘Navigator’ Grant as Obstacles to Implement Affordable Care Act Mount
Federal Grants to Assist Navigator Program [AJMC]
Tailored Dosing for MM Matters More Than Drug Count: Ajai Chari, MD
April 25th 2025When it comes to treating multiple myeloma (MM), Ajai Chari, MD, argued that more is not always better. More intense treatment regimens, or those with more drugs, don't necessarily guarantee better outcomes.
Read More
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
Listen
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
Listen
Contributor: For Complex Cases, Continuity in Acute Care Is Necessary
April 23rd 2025For patients with complex needs and social challenges like unstable housing, the hospital has become their de facto medical home—yet each visit is a fragmented restart, without continuity, context, or a clear path forward.
Read More
Tailored Dosing for MM Matters More Than Drug Count: Ajai Chari, MD
April 25th 2025When it comes to treating multiple myeloma (MM), Ajai Chari, MD, argued that more is not always better. More intense treatment regimens, or those with more drugs, don't necessarily guarantee better outcomes.
Read More
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
Listen
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
Listen
Contributor: For Complex Cases, Continuity in Acute Care Is Necessary
April 23rd 2025For patients with complex needs and social challenges like unstable housing, the hospital has become their de facto medical home—yet each visit is a fragmented restart, without continuity, context, or a clear path forward.
Read More
2 Commerce Drive
Cranbury, NJ 08512