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Health Systems, Health Authority Announce Safety Net Initiatives
The leaders of health systems serving Wayne County have agreed to pursue initiatives that will help contain uncompensated care which has been an increasing fiscal burden and create systems that will more appropriately and cost-effectively meet the health and social needs of uninsured and underinsured people.
Chaired by Nancy Schlichting, president and CEO of Henry Ford Health System, the Uncompensated Care Committee of the Detroit Wayne County Health Authority focused its work in three areas:
Federally Qualified Health Center (FQHC)-Hospital Workgroup: Chaired by Jesse Thomas, president of Molina Healthcare of Michigan, this workgroup was specifically charged with creating more appropriate emergency department use and promote referrals to urgent care centers and community health centers. The workgroup was inclusive of emergency department physicians. A primary goal of the workgroup was to co-locate an FQHC and a hospital emergency department. The group also recognized that existing relationships between hospitals and FQHCs must be strengthened before this can occur.
Physician Workgroup: Chaired by Ken Matzick, president and CEO of Beaumont Hospitals, this workgroup was charged with examining ways of working with physicians to improve quality, cost, and access for safety net services. The primary goal of the workgroup was to improve access to specialty care for uninsured and underinsured patients. Essentially, under this model, several specialty physicians agree to treat uninsured patients on a limited basis throughout the year.
Finance Workgroup: Chaired by Jay Rising, executive vice president, Detroit Medical Center, this group was charged with estimating the uncompensated care burden experienced by health systems, assess coverage expansion options and alternate methods of leveraging federal matching funds; assess opportunities and current limitations on funding; and review federal requirements for funding and coverage expansion.
"I am pleased to have had an opportunity to chair this effort, primarily because the problem of uncompensated care is so acute in our community," said Schlichting. Health systems in Southeast Michigan provided more than $600 million in uncompensated care in 2008. "Clearly, there is a responsibility for providers to innovate in this area - to think differently about the challenges we all have for providing care for the uninsured and under insured. This has created a sense of urgency to really make a difference."
"Health systems represent a major component of the safety net. This initiative has shown how creativity and commitment by the provider community can result in innovative solutions," said Chris Allen, CEO of the Detroit Wayne County Health Authority. "Under the leadership of Nancy Schlichting and the collaboration of regional health systems, we have forged a plan that will ensure that many uninsured and underinsured people with urgent health problems have a medical home to treat them in a timely, appropriate manner. At the same time, emergency department volume will decrease, allowing providers to care for truly emergent patients and reduce uncompensated care costs for hospitals."
The Uncompensated Care Committee will be reorganized to implement these recommendations during 2010. Members of the committee include:
Dennis Herrick, senior vice-president & CEO, Beaumont Hospitals;
Kevin Seitz, executive vice-president, Health Care Value Enhancement, Blue Cross Blue
Shield of Michigan;
Dr. Paul LaCasse, president & CEO, Botsford Hospital;
Michael Duggan, president & CEO, Detroit Medical Center;
Jay Rising, executive vice president & CFO, Detroit Medical Center;
Gary Ley, president & CEO, Garden City Hospital;
James Connelly, senior vice president & CFO, Henry Ford Health System;
Spencer Johnson, president, Michigan Health and Hospital Association;
David Seaman, executive vice president, Michigan Health and Hospital Association;
Peter Schonfeld, senior vice president, Policy & Data Services, Michigan Health and
Hospital Association
Denise Holmes, associate dean for Government Relations and Outreach, Michigan State
University - Institute of Health Studies;
Brian Connolly, president & CEO, Oakwood Health;
Doug Welday, chief financial officer, Oakwood Health;
Bob Hobin, chief strategy officer, St. John Health;
Patrick McGuire, chief financial officer, St. John Health;
Stephen Fitton, acting bureau director, State of Michigan Medicaid Services
Administration;
Garry Faja, president of St. Joseph Health System, Trinity Health;
Adam Jablonowski, executive director, Wayne County Medical Society;
Robert Frank, M.D., executive vice dean, Wayne State University School of Medicine. Chris Allen, executive director & CEO, Detroit Wayne County Health
Authority
Janette Davis, chief financial officer, Detroit Wayne County Health Authority;
Dick Bohrer, co-chair of the Health Authority's primary Care Network Council and former
U.S. Assistant Surgeon General;
Neal Colburn, consultant, Michigan Primary Care Association;
Joslyn Pettway, director of Primary Care Initiatives, Detroit Wayne County Health
Authority.
Specific recommendations of the Uncompensated Committee include:
Hospital-FQHC Workgroup: Develop and distribute a contact list and access information about all FQHCs to appropriate hospital staff; integrate "point of care counseling" in emergency departments to support referrals; collaborate with existing FQHCs to help address existing capacity and system issues; and create a pilot co-location of a hospital emergency department and FQHC.
Physician Workgroup: Create a voluntary network of specialty physicians who agree to serve the uninsured; coordinate specialty outpatient clinics to provide physicians with an alternate practice site; create a network of physician consultants to help in the secondary care of the uninsured.
Finance Workgroup: Pursue approach to Medicaid coverage expansion in compliance with any early adopter providers in federal health reform; substantiate the rationale of private employers' benefit from Medicaid coverage expansion; and refine benefit costs and develop funding and management systems to support Medicaid coverage expansion.
For more information on the Uncompensated Care Committee and other initiatives of the Health Authority, contact Chris Allen, executive director & CEO, at 313-871-3751.
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'Future of the Safety Net Summit' set for February
Health insurance reform, should it occur, will extend access to many people through an expanded Medicaid program, among other changes. The Health Authority is inviting health and human service leaders to a "Future of the Safety Net Summit" in February. "The prospect of health care insurance reform offers both hope of new opportunities for the uninsured and underinsured and new challenges for health care safety net organizations," according to Chris Allen, CEO of the Health Authority. The two-0day summit will be facilitated by Nicole Boyer, who specializes in strategic foresight. The goal of the event is to identify a range of plausible scenarios and identify a collective preferred future.
"Initiatives such as the Primary Care Network Council, the Near East Side Planning Initiative, the Uncompensated Care Committee, and the Detroit Wayne county Integrated Behavioral Health Initiative have shown us that a broad spectrum of stakeholders acting in unison can achieve great things for the safety net population," Allen said. "We believe that the strength of the safety net depends on collective action around a shared vision."
For information on the summit, contact Andrew Pritchard at 313-871-3751.
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Advantage opens Waller Health Center in Midtown Detroit
Underscored by the Episcopal Diocese's commitment to the poor and disadvantaged and acknowledging the vision of one of Detroit pioneers of community health, Advantage Health Centers announced the establishment of the Waller Health Center in Midtown, Detroit. Named after John Waller, Dr.Ph, former chair of Community Medicine at Wayne State University, the health center will offer health care for underserved populations, including the homeless. It's located in a former school building adjacent to the Cathedral Church of St. Paul, on Woodward Avenue and Warren.
Advantage is the second oldest federally qualified homeless health center in the nation, according to Joseph Ferguson, executive director. The Waller center complements community health centers in Midtown, including Health Centers Detroit, Woodward Corridor Family Health Center, and the CHASS New Center location. |
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Joslyn Pettway joins Cabrini Health Center Board
Joslyn Pettway, director, Primary Care Services for the Health Authority, has joined the Board of Directors of St. Frances Cabrini Clinic, located in Corktown, Detroit. The Cabrini Clinic is the oldest free clinic in the nation. |
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Backgrounder
Michigan Unemployed Face Cold Reality of Health Insurance Costs
For Michigan's unemployed, coping with finding new employment has been difficult enough. Now they will begin to feel the cold reality of health insurance costs with the expiration of federal subsidies for COBRA insurance. Families USA noted that the average family premium for COBRA insurance will jump from $389 per month to $1,111. It's expected that health insurance costs will amount to about 83.4 percent of the average unemployment check, according to a report published by Families USA this month. When you add health insurance costs to mortgage/rent payment, utilities, food, and other living expenses, it will be tough for families of unemployed workers to maintain their health coverage.
The federal stimulus package included a provision to help laid-off workers pay for their health insurance through COBRA, which allows ex-workers to remain enrolled in their former employer's play by paying the full insurance cost themselves. The federal subsidy paid 65 percent of monthly insurance costs. Proposed legislation to extend the subsidies remains stalled in Washington.
"Unless Congress acts to provide this subsidy for longer than nine months, each month from now on, another group of people will confront a painful choice: find a way to pay significantly higher premiums or drop their family coverage," according to the Families USA report.
"While an immediate extension of the COBRA subsidy is needed to help families who are already unemployed and those who will lose their jobs in the coming months, this is only a temporary fix. Health reform, once it is fully implemented, will offer anew, permanent source of help. The health reform bills now pending in Congress would enable laid-off workers to obtain health coverage through a newly created marketplace, called an 'exchange,' and families with low incomes would receive tax credit subsidies to help pay the premiums." |
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."
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