|
|
|
|
Health Authority convenes meeting of FQHCs and Medicaid QHPs
It was a breakthrough moment, of sorts. Every federally-qualified health center (FQHC) chief executive officer met with Detroit and Wayne County Medicaid qualified health plans at the Health Authority offices, June 20, to talk about directing more Medicaid HMO members to the health centers. Representatives from the Michigan Department of Community Health included Cheryl Bupp, Director of the Managed Care Plan Division, Medical Services Division; as well as Bill Hart and Bob Esdale, of the Bureau of Health Policy Planning and Access to Care.
Increasing the volume of Medicaid patients in FQHCs is critical to creating the financial infrastructure allowing the health centers to absorb more uninsured patients. The Health Authority has focused on increasing enrollment of Medicaid patients and directing them to FQHCs as an essential first step in providing more access points for the uninsured.
The FQHCs indicated that they would be able to accommodate 60,700 new Medicaid patients. QHP executives stated that they were willing to direct patients to FQHCs but that there are several obstacles, including: A sound framework would need to be created to begin an FQHC assignment system.
The group agreed that a framework for this effort would include criteria for quality, cost-effectiveness, access and care for the uninsured. The group will start by reviewing state criteria in these areas. Considerations such as geography and contracts should also be included in the criteria.
The group agreed to create a smaller workgroup to work between meetings and present recommendations for the next meeting. The group will meet next on Aug. 7.
|
Health Authority gears up for Walk/Rally
The Health Authority will sponsor a rally and walk on behalf of the uninsured and underinsured on Saturday, Aug. 9, in Detroit's New Center. "Walk for the Uninsured" will feature presentations from elected officials, health care safety net providers, and representatives of the uninsured.
The event will begin with presentations at 10 a.m., followed by a 3 mile walk in the Midtown/Wayne State University area. A shorter, 1.5 mile walk course will also be available. There is no fee for the event, but walkers are encouraged to raise money on behalf of the Health Authority's Community Education Fund, which supports community and health education projects.
"We want to put a face on the issue of the uninsured, and the best way to do that is live and in person," noted Chris Allen, Executive Director and CEO of the Health Authority. "Given that more people than ever are uninsured or under-insured, and the prominence that universal health care has assumed during this election year, we thought a rally/walk would be an excellent way of demonstrating our community's support for the uninsured."
There currently is an estimated 280,000 uninsured people in Wayne County, and a growing number of underinsured people, whose workplace health benefits are diminishing and co-pays increasing. The reduction in health insurance coverage for many workers has reduced access to medical care, pharmacy, medical equipment, and other health services, further compounding the issue.
In addition to the program and walk, the Health Authority will offer Medicaid enrollment assistance on site during the event. People who are uninsured are encouraged to speak with an outreach counselor who will determine if they are eligible for Medicaid or another insurance program.
|
New Center Community Mental Health Services/ Advantage Health Centers model mental health treatment at a primary care facility
Responding to the lack of mental health treatment in physical health care facilities as well as the social stigma attached to the receipt of such care, New Center Community Mental Health Services and Advantage Health Centers have embarked upon a pilot collaborative initiative to expand primary care service capacity and improve mental health service access for a vulnerable, high-risk population.
Serving Advantage Health facilities, a New Center CMHS co-located therapist addresses the untreated or inadequately treated mental health needs of consumers via mental health screening, psycho-education, and therapeutic services. The services of a psychiatrist are available to prescribe any necessary psychotropic medications as well as conduct psychiatric evaluations and follow-up.
This pilot program targets clinical outcomes which include:
- Reducing the stigma linked to the receipt of mental health services
- Increasing the service capacities of both New Center Community Mental Health Services and Advantage Health Centers
- Increasing the ability of primary care staff to manage mental health disorders in the physical health care setting
- Preventing mental health deterioration through early identification and direct, on-site treatment of at-risk consumers and their families, and
- Improving mental health through increased medication adherence via psychosocial interventions and the availability of psychiatric follow-up.
Based upon such groundwork, this model can serve as a blueprint for integrated treatment not only throughout Wayne County but the state of Michigan as well, according to New Center CMHS.
|
|
New Wayne County Medical Society President looks to support Health Authority
"We live in challenging times," notes Chris Bush, M.D., the newly elected president of the Wayne County Medical Society. "Michigan, especially the Detroit area, is in a crisis. Not only is it straining families day-to-day health care, it's affecting the hospitals." Dr. Bush, a member of the Health Authority's Provider Advisory Committee, says one of his goals as president of the medical society is "enhance our involvement with the Health Authority to promote better health care coverage of the population."
Dr. Bush is doing his part in helping meet the needs of the uninsured. As founder of Wyandotte Clinic for the Working Uninsured, he feels a need to "give something back to the people of this community." The struggle to maintain a profitable medical practice makes it difficult for Dr. Bush to accept people unable to pay for their care. However, together with volunteer physicians, nurses, podiatrists, and other health professionals, he sees uninsured patients on Wednesdays, 4 p.m. to 7 p.m. and on Saturdays during busy periods. The clinic is affiliated with Henry Ford Health System.
Dr. Bush, a graduate of the Wayne State University School of Medicine, is a past member of the Michigan State Medical Society Board of Directors, and currently serves as Secretary of the society.
|
Backgrounder
Expanding Medicaid: Less costly than covering more low-income uninsured than expanding private insurance
Average medical expenditures per person are lower under public programs such as Medicaid or the State Children's Health Insurance Program (SCHIP) than under private insurance, according to new research published by Health Affairs. The new research, by Leighton Ku of George Washington University and Matthew Broaddus of the Center on Budget and Policy Priorities, is consistent with previous work by researchers at the Urban Institute, according to the Center on budget and Policy Priorities.
There are two main reasons why overall medical expenditures per person are lower under Medicaid and SCHIP than under private insurance. First, the average cost that insurers pay per beneficiary is lower under public programs than under private insurance, probably because these programs reimburse health care providers at lower rates and have lower administrative costs. Second, the average out-of-pocket costs that individuals incur are substantially lower under public programs than private insurance because Medicaid and SCHIP limit cost-sharing for low income beneficiaries, the Center noted in its report.
Key findings of the study include:
Adults enrolled in Medicaid tend to be in poorer health - and require more health care - than low-income adults.
Adults enrolled in Medicaid are more likely than low-income adults with private coverage to be female, minority, and poor - three groups with higher medical costs.
If one fails to adjust for these health and demographic differences, medical expenditures are higher for Medicaid beneficiaries than for those in private practice.
After controlling for these health and demographic factors, medical expenditures are substantially higher under private insurance than under Medicaid.
Medical costs paid by insurance are higher under private coverage than under Medicaid.
Out-of-pocket costs are substantially higher under private coverage than under Medicaid.
Covering the uninsured through Medicaid would generally be less costly - in terms of total medical expenditures, costs paid by insurance and out-of-pocket costs per individual - than covering them through private insurance.
To access the actual article, "Public and Private Insurance: Stacking Up the Costs," visit http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.4.w318
|
The Detroit Wayne County Health Authority's mission is to coordinate efforts to meet the health needs of the uninsured and underinsured residents in Detroit and Wayne County by assuring access and improving the health status of all people.
"It's about access...for all."
| |
|
|
|
|
|
