Innovative programs help Medicaid recipients thrive

Not long ago, I was talking with a family friend, Jamie, a young, single mom and then Medicaid recipient. We were discussing our families and I had mentioned how busy I was driving my children to and from their many extracurricular activities and social events.

Jamie said that she didn't have a car and that she relied on her Medicaid caseworker to drive her and her children to and from their scheduled doctor visits. "It's so nice not having to worry about how to get to there," she said.

I started to realize how much I took having a dependable vehicle for granted. Fortunately, her Medicaid health plan understood that before Jamie could make healthcare a priority, it had to provide her a ride to her physician.

One plan that is doing just that is Ion Health, Pennsylvania's newest Medicaid health plan. I had the opportunity to sit down and speak with its founder and CEO, Anthony Horbal, the co-subject of this month's Executive Profile (see page 18). Horbal explains how Ion Health is able to pull this vulnerable population into the system of care by tailoring programs and using enhanced community outreach services. "We're constantly working at helping this population gain access to the healthcare system in an appropriate and consistent way," Horbal says. And, not all of Ion Health's efforts are specifically directed at Ion Health members.

"It requires lots of hand-to-hand contact, telephone calls and community outreach. For instance, we've just opened a community outreach center in Johnstown [Pa.], where non-profit organizations can work with their members. We've also provided flu shots and school immunization shots to people, regardless of whether they were Ion Health members," Horbal says.

"We've made it a point of pride to work to benefit the communities we serve, and if we do that effectively, we'll be able to attract more members to our roster. In my book, that's a win-win situation," he says.

"The key is connecting with these people regularly," agrees Ion Health President and Director Mike Nelson, Horbal's counterpart in this month's cover story. "When we welcome new members into our plan, we realize that some may have changed homes and phone numbers. We have to be clever about reaching them."

One of Ion Health's creative outreach programs is "Sleep Safe," an innovative education program aimed at expectant mothers. Women who successfully complete the "Sleep Safe" prenatal education program are given a crib and baby monitor at no cost, to help them better ensure their newborn's safety.

Other ways that plans can reach out to Medicaid members include providing free crutches to patients after hip replacements, launching baby shower gift programs, and purchasing and distributing easy-to-read, self-help healthcare books.

Providing outreach and case management services or community linkages in the hospital ER and at the bedside, as well as partnering with community family centers, faith-based organizations, schools and libraries, are other ways to reach out to members.

The Medicaid ranks are expected to continue their growth in upcoming years. If we want good healthcare consumers, we must first ensure that the programs we offer are designed to encourage participation by meeting specific needs. Then we have to make sure that people can actually get to their providers. The first step toward reaching that goal might not be a step at all. It might simply be making sure that people like Jamie and her kids have a ride to their doctor, and that when they get there, they'll get the services and care that they truly need.