Association for Community Affiliated Plans
Encyclopedia
The Association for Community Affiliated Plans (ACAP) is a national trade association representing 57 Medicaid
-focused health plans in 27 states
in the United States
. ACAP’s mission statement is To represent and strengthen not-for-profit, safety net health plans as they work with providers and caregivers in their communities to improve the health and well being of vulnerable populations in a cost-effective manner. ACAP’s principles include:
Advocacy
Care
Access
Public Good
ACAP members are nonprofit, community-based plans that serve public insurance programs and the safety net
. ACAP actively promotes strengthening critical public health coverage programs. ACAP also provides technical assistance to health plans with an emphasis on quality. Collectively, ACAP plans serve 8 million enrollees, over 50 percent of individuals enrolled in Medicaid-focused health plans.
expanded across the county, safety net providers, such as Community Health Center
s (CHCs) and public hospitals, viewed it with great trepidation. They feared that managed care
would reduce reimbursements for Medicaid-eligible services, making it harder for them to provide care to the un- and under-insured, and then result in a loss of Medicaid volume as beneficiaries would chose to see other providers once given a choice.
In response to these concerns, community health centers in at least 16 states banded together to establish their own managed care organizations. Often CHCs were the only sponsors, but in other cases, they joined with hospitals or other safety net providers to sponsor a health plan. These organizations were established to support both the financial viability of the CHCs and other sponsors, as well as to support the mission of care for the underserved.
CHC Plans Brought Together – In 2000 seventeen CHC-affiliated plans came together with the help of the US Health Resources and Services Agency to form the Association for Health Center Affiliated Health Plans (AHCAHP). The Board incorporated and met several times to develop bylaws and decide to hire an Executive Director.
CHC Plans Form an Active Association – In May 2001 the Board hired Meg Murray as its Executive Director. In June 2001 the AHCAHP Board met in Portland, OR to develop a strategic plan to guide the work of the association over the next two years. AHCAHP’s vision as developed during that meeting was to improve the health of medically underserved populations through the development, survival, promotion and growth of CHC-affiliated health plans. The Association’s goals were to: Advocate and promote the development, survival and growth of CHC-affiliated health plans and programs for vulnerable populations to enhance access and improve health status; Support and promote best practices related to services, internal quality and operational management; and Increase the visibility of AHCAHP plans and AHCAHP via its role in advocacy and promotion of best practices.
AHCAHP Expands to Include Other Community-Affiliated Plans -- In October 2003, the Board agreed to expand full membership to like-minded, community-affiliated health plans that had a majority of members from public insurance programs and shared the same outlook as the AHCAHP plans. The name change to the Association for Community Affiliated Plans (ACAP) reflected the new mission and membership.
In 2007 the plans expanded their mission of ACAP to include work on Medicare Special Needs Plan
s (SNPs.)
In 2010, ACAP had 52 Board members, 54 health plans, one Associate member and one Incubator Plan among 26 states. Collectively the plans cover over 7 million lives in Medicaid, Medicare and CHIP. Twenty-two of the ACAP members also run Medicare SNPs.
California: Alameda Alliance for Health, CalOptima, CenCal Health, Central California Alliance for Health, Community Health Group, Contra Costa Health Plan, Gold Coast Health Plan,Health Plan of San Mateo, Inland Empire Health Plan, L.A. Care Health Plan, Partnership HealthPlan of California, Santa Clara Family Health Plan, San Francisco Health Plan
Colorado: Colorado Access, Denver Health
Connecticut: Community Health Network of CT
DC: Health Services for Children with Special Needs Plan
Florida: Prestige Health Choice
Hawaii: AlohaCare
Illinois: Family Health Network
Indiana: MDwise
Kansas: Children's Mercy Family Health Partners
Kentucky: Passport Health Plan
Maine: Maine Primary Care Association
Maryland: Priority Partners, Maryland Community Health System
Massachusetts: BMC HealthNet Plan, Commonwealth Care ALliance, Neighborhood Health Plan, Network Health
Michigan: CareSource MI
Minnesota: Metropolitan Health Plan
Missouri: Children's Mercy Family Health Partners
New Jersey: Horizon NJ Health
New York: Affinity Health Plan, Amida Care, Elderplan & Homefirst, Health Plus, Hudson Health Plan, Monroe Plan for Medical Care, Total Care, Univera Community Health, VNS CHOICE
Ohio: CareSource
Oregon: CareOregon
Pennsylvania: AmeriHealth Mercy, UPMC for You
Rhode Island: Neighborhood Health Plan of RI
Texas: Community Health Choice, Cook Children's Health Plan, Driscoll Children's Health Plan, El Paso First Health Plans, Texas Children's Health Plan
Virginia: VA Premier
Washington: Community Health Plan
Wisconsin: Children's Community Health Plan
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
-focused health plans in 27 states
U.S. state
A U.S. state is any one of the 50 federated states of the United States of America that share sovereignty with the federal government. Because of this shared sovereignty, an American is a citizen both of the federal entity and of his or her state of domicile. Four states use the official title of...
in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
. ACAP’s mission statement is To represent and strengthen not-for-profit, safety net health plans as they work with providers and caregivers in their communities to improve the health and well being of vulnerable populations in a cost-effective manner. ACAP’s principles include:
Advocacy
- For beneficiaries
- For publicly-sponsored programs
- For providers who serve vulnerable populations
Care
- Through high quality delivery systems
- Through efficient use of scarce resources
Access
- To universal health care
- To high quality providers
Public Good
- For all truly consumer-focused managed care models
ACAP members are nonprofit, community-based plans that serve public insurance programs and the safety net
Safety net
A safety net is in most cases a net to protect people from injury after falling by limiting the distance they fall. It may also be a device to arrest falling or flying objects for the safety of people beyond the net....
. ACAP actively promotes strengthening critical public health coverage programs. ACAP also provides technical assistance to health plans with an emphasis on quality. Collectively, ACAP plans serve 8 million enrollees, over 50 percent of individuals enrolled in Medicaid-focused health plans.
History
Beginning in the 1980s, as Medicaid managed careMedicaid managed care
Medicaid managed care provides for the delivery of Medicaid health benefits and additional services in the United States through an arrangement between a state Medicaid agency and managed care organizations that accept a set payment – “capitation” – for these services...
expanded across the county, safety net providers, such as Community Health Center
Community health centers in the United States
A Community health center in the United States is a Community health center in the United States.Community Health Centers are unique in that at least 51 percent of all Governing Board Members must be patients at the CHC. Access to care is improved by decreasing the cost of care with a sliding fee...
s (CHCs) and public hospitals, viewed it with great trepidation. They feared that managed care
Managed care
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on...
would reduce reimbursements for Medicaid-eligible services, making it harder for them to provide care to the un- and under-insured, and then result in a loss of Medicaid volume as beneficiaries would chose to see other providers once given a choice.
In response to these concerns, community health centers in at least 16 states banded together to establish their own managed care organizations. Often CHCs were the only sponsors, but in other cases, they joined with hospitals or other safety net providers to sponsor a health plan. These organizations were established to support both the financial viability of the CHCs and other sponsors, as well as to support the mission of care for the underserved.
CHC Plans Brought Together – In 2000 seventeen CHC-affiliated plans came together with the help of the US Health Resources and Services Agency to form the Association for Health Center Affiliated Health Plans (AHCAHP). The Board incorporated and met several times to develop bylaws and decide to hire an Executive Director.
CHC Plans Form an Active Association – In May 2001 the Board hired Meg Murray as its Executive Director. In June 2001 the AHCAHP Board met in Portland, OR to develop a strategic plan to guide the work of the association over the next two years. AHCAHP’s vision as developed during that meeting was to improve the health of medically underserved populations through the development, survival, promotion and growth of CHC-affiliated health plans. The Association’s goals were to: Advocate and promote the development, survival and growth of CHC-affiliated health plans and programs for vulnerable populations to enhance access and improve health status; Support and promote best practices related to services, internal quality and operational management; and Increase the visibility of AHCAHP plans and AHCAHP via its role in advocacy and promotion of best practices.
AHCAHP Expands to Include Other Community-Affiliated Plans -- In October 2003, the Board agreed to expand full membership to like-minded, community-affiliated health plans that had a majority of members from public insurance programs and shared the same outlook as the AHCAHP plans. The name change to the Association for Community Affiliated Plans (ACAP) reflected the new mission and membership.
In 2007 the plans expanded their mission of ACAP to include work on Medicare Special Needs Plan
Special Needs Plan
A Special Needs Plan is a category of Medicare Advantage plan designed to attract and enroll Medicare beneficiaries who fall into a certain special needs demographic. There are two types of SNPs. The exclusive SNP enrolls only those beneficiaries who fall into the special needs demographic. The...
s (SNPs.)
In 2010, ACAP had 52 Board members, 54 health plans, one Associate member and one Incubator Plan among 26 states. Collectively the plans cover over 7 million lives in Medicaid, Medicare and CHIP. Twenty-two of the ACAP members also run Medicare SNPs.
ACAP Members
Arizona: University Physicians Health PlansCalifornia: Alameda Alliance for Health, CalOptima, CenCal Health, Central California Alliance for Health, Community Health Group, Contra Costa Health Plan, Gold Coast Health Plan,Health Plan of San Mateo, Inland Empire Health Plan, L.A. Care Health Plan, Partnership HealthPlan of California, Santa Clara Family Health Plan, San Francisco Health Plan
Colorado: Colorado Access, Denver Health
Connecticut: Community Health Network of CT
DC: Health Services for Children with Special Needs Plan
Florida: Prestige Health Choice
Hawaii: AlohaCare
Illinois: Family Health Network
Indiana: MDwise
Kansas: Children's Mercy Family Health Partners
Kentucky: Passport Health Plan
Maine: Maine Primary Care Association
Maryland: Priority Partners, Maryland Community Health System
Massachusetts: BMC HealthNet Plan, Commonwealth Care ALliance, Neighborhood Health Plan, Network Health
Michigan: CareSource MI
Minnesota: Metropolitan Health Plan
Missouri: Children's Mercy Family Health Partners
New Jersey: Horizon NJ Health
New York: Affinity Health Plan, Amida Care, Elderplan & Homefirst, Health Plus, Hudson Health Plan, Monroe Plan for Medical Care, Total Care, Univera Community Health, VNS CHOICE
Ohio: CareSource
Oregon: CareOregon
Pennsylvania: AmeriHealth Mercy, UPMC for You
Rhode Island: Neighborhood Health Plan of RI
Texas: Community Health Choice, Cook Children's Health Plan, Driscoll Children's Health Plan, El Paso First Health Plans, Texas Children's Health Plan
Virginia: VA Premier
Washington: Community Health Plan
Wisconsin: Children's Community Health Plan