Do We Need A Navigator?

What is a Navigator and What do they have to do with healthcare?

In the new legislated changes in healthcare, confusion is reigning! CMS has announced the creation and funding for Navigators.  What are they and how will they help us navigate the rapid changes not only in laws, but in billing and adjustments in physician reimbursement.

The Centers for Medicare & Medicaid Services (CMS) announced the availability of new funding to support Navigators in Federally-facilitated and State Partnership Marketplaces.

"Navigators are individuals and entities that will provide unbiased information to consumers about health insurance, the new Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program."

How are they going to help?

“Navigator” program will help consumers understand new coverage options as they enroll in new Marketplaces. (The marketplace meaning: mandated insurance coverage for all Americans.)

What's the problem?

According to CMS, Navigators will be a valuable resource funded with $54 million dollars! 

Wait a minute! Where did that money come from?  Weren't physicians reimbursements cut by 2%  beginning last week?...  That 2% cut will have a huge trickle down effect causing the physicians to make difficult decisions.

• There is huge potential for job loss because the physician will not be able to afford to keep all of his staff.
• The physician may not be able to pay for the benefit packages that his staff once enjoyed. They may have to choose insurance plans with higher deductibles and co-payments for their workers. 
• The physicians and their patients are going to be making a lot of  difficult choices in the days ahead. Some of those decisions will affect the quality of life especially for the aged and disabled, the poor and underemployed. 

Hmmm! How are the Navigators going to help clear up this confusion? Will they have solutions with the common good in mind? October is coming.   We will have to wait and see.  

Thanks for reading.

Donna McHugh, CMRS

Resources:

April 03, 2013 and April 09, 2013 Press Releases CMS Announcements

http://www.cms.gov/apps/media/press/release.asp?Counter=4576&intNumPerPage=10&checkDate=&checkKey=&srch