Washtenaw health care collaborative plans for influx of insured patients in 2014

Originally posted on Crain’s Detroit Business by Jay Greene on July 07, 2011 1:53 PM  Modified: July 07, 2011 3:10 PM

Washtenaw health care collaborative plans for influx of insured patients in 2014

The Washtenaw County Health Initiative, a newly formed collaborative, is working with 40 local health organizations to identify service gaps and increase access to health care services as the nation moves toward expanding the availability of insurance under health care reform in 2014.

In a telephone press conference today, members of the nonprofit health initiative discussed their report, which concluded that closer coordination of services is required because more than 50,000 people in Washtenaw County will become eligible for Medicaid or purchase private insurance starting in 2014.

The collaborative may be the only such organization in Michigan and the nation seeking to coordinate health care resources among providers to prepare for the full implementation of the Affordable Care Act of 2010, said Marianne Udow-Phillips, director of the Ann Arbor-based Center for Healthcare Research & Transformation and one of the initiative’s members.

“We know that Washtenaw County’s current health care delivery systems and community services, while providing excellent care, don’t fully meet the needs of these individuals today and won’t be sufficient in 2014,” Robert Guenzel, a retired Washtenaw County administrator and a co-chair of the initiative, said in a statement.

“There is a lot that can and needs to be done now to improve our citizens’ health, regardless of what happens with health care reform,” he said.

This year, the group will issue recommendations to expand access, increase the number of providers and coordinate care more efficiently, the officials said.

Besides a greater number of doctors and nurses, Udow-Phillips said more mental health, substance abuse and dental care providers are required to meet demand in the county. Health care reform provides some funds to increase providers, but more are needed, she said.

Said Norman Herbert, a retired University of Michigan treasurer and another member of the initiative: “We have lots of emergency room care, but we need to redirect that” into ambulatory settings. “We can save dollars that way.

Udow-Phillips said most hospital-based systems, including the University of Michigan Health System andSt. Joseph Mercy Health System, are taking steps to expand services to accommodate the influx of insured patients from 2014 to 2019. The two Ann Arbor-based health systems are co-sponsors of the group.

“A lot of agencies are responding, but they are hanging on by a thread because currently the funding is inadequate, especially under Medicaid,” said Robert Laverty, retired CEO of St. Joseph Mercy Health System and an initiative member. “Where will they get working capital to address increased demand?

“It is difficult to do meaningful planning without understanding where the health care reform debate is going. This shows the importance of getting the agencies together to help them respond to the challenges.”

In its report, the group also found the following:

• The Medicaid enrollment system is under stress, with 42 eligibility categories, more than 55,000 total public assistance cases in progress and only 59 workers to process them.

• About 54,000 additional primary-care visits may occur annually when the newly insured begin to seek care in 2014. The current primary-care work force may be unable to absorb these additional visits.

• About 27,000 county residents, or 10 percent of all adults, reported poor mental health for 10 or more days during one month in 2005. But only 25 percent reported being seen by a mental health professional. More services are needed.

• Only 15 percent of community dentists surveyed in 2007 reported accepting Medicaid insurance, and just 8 percent said they were accepting new Medicaid patients. Restrictions on who can receive care at such clinics further limit dental care options for these individuals, particularly low-income adults.

For more information, visit WashtenawHealthInitiative.org.