Check your addition when counting up uninsured

Apparently somebody forgot to carry the one. The U.S. Census Bureau recently revised its 2005 data on the uninsured and now reports that the initial numbers were off by 1.8 million people. New totals show 44.8 million people were uninsured in 2005, not the 46.6 million previously reported.

The National Center for Policy Analysis criticizes the Census Bureau and calls its numbers "misleading at best and essentially meaningless at worst." I have no way of knowing whether the Census Bureau is a blue-ribbon organization with otherwise flawless performance or whether it's no smarter than a fifth-grader with an abacus, but the glitch was blamed on software problems. In August, when it releases the 2006 numbers, the bureau will also release revised numbers dating back to 1995.

The truth is, even at a low estimate of 20 million people, and even if you subtract all those who voluntarily opt out or qualify for public programs, there's still plenty of uninsured people who would benefit from some decent healthcare coverage.

WHERE TO NOW?

Creativity abounds to solve big problems in healthcare these days. I give a lot of credit to the CapitalCare Collaborative in Wake County, N.C., which is a partnership of eight local stakeholders who are trying to redirect the uninsured (who are frequent users of emergency rooms for non-urgent care). A key facet of the partnership will consolidate uninsured patients' financial data and select medical data online where the groups can access it. They anticipate that they should be able to identify the ER users and steer them toward applicable public programs and, of course, more cost-effective care.

The average Wake County ER visit costs $1,000-and it's always chalked up as charity care among the uninsured-while the average appointment in a Raleigh clinic costs $80. WakeMed Health & Hospitals delivered $66.1 million in charity care in 2006, and no doubt those costs were absorbed by the insured in one way or another.

The CapitalCare Collaborative has essentially developed a network of uninsured. In July, it will also begin to sign people up for patient assistance programs offered by drug companies to help the uninsured afford needed medications, and by next year, the network will go live with a database of care that patients have received in its facilities in an effort to avoid duplicate tests.

There's no estimate yet of the potential costs that will be avoided thanks to this network, but once the totals are in, I'm sure everyone will be diligent enough to check their addition.

Julie Miller is editor-in-chief of MANAGED HEALTHCARE EXECUTIVE. She can be reached at juliemiller@advanstar.com