Cost containment is something that’s nearly unheard of in Medicaid circles. Medicaid recipients receive very little if any guidance or education on holistic health nor are they really encouraged to make smart shopping decisions when it comes to healthcare.
It shows. Total federal, state and local expenditures on the healthcare program grew from $329 billion in 2015 to what is an estimated $344 billion for this budget year, a jump of 5% in just one year alone. At the turn of the century, Medicaid’s total outlays were “only” $206 billion.
Compare that to private insurance plans purchased on the marketplace or provided by an employer. In those scenarios, the insured are strongly encouraged and in some cases forced to overhaul their diets and behaviors. Examples of the countless programs and practices that both cut costs and improve overall health are workplace wellness programs, mandatory annual physicals, smoking cessation and penalization, high deductible plans, utilization of urgent care facilities, and procurement of a primary physician.
It would be good to see those same principles applied to Medicaid before costs further spiral out of control and the health of its recipients do the same, especially when every single one of us has a vested interested in the outcomes: 1 full percentage point of our sales taxes and more than half of our county property taxes are earmarked for Medicaid.
A local health organization is uniquely leading that charge.
Niagara Falls Memorial Medical Center (NFMMC) is the only hospital in Western New York undertaking such an endeavor. Through their Health Home program, director Vicki Landes leads a crew of 40 staff members – and growing – who become fully involved in the nuances of health care management (at the micro and macro levels) for nearly 2,000 families who receive Medicaid.
Under this truly unique program, Medicaid enrollees are assigned case managers who can meet with them at the hospital or their workplace and home (how’s that for service!). Those case managers coordinate all facets the patient's care and encourages them to do the aforementioned things that we do under private insurance plans – they promote patient wellness and encourage wise choices in dietary behaviors and healthcare decisions.
The Health Home team also understands the impacts of environment and socioeconomic factors on their clients and connects individuals to social services and community support partners – more than 60 such local organizations have aligned themselves with NFMMCs goals. By doing so, they can help improve the enrollees’ standing by finding them the resources, education, and jobs they need…which makes them healthier physically, mentally, emotionally and economically. This, in turn, leads them down a path that takes them off of Medicaid.
Feeding off the success of this program, NFMMC officially launched their Children’s Health Home program this month. Similar to the more adult-oriented Health Home, this one does virtually the same for at-risk kids, while providing them the tender loving care and special attention that’s required for their demographic. They become so involved with the kids’ well-being that they can even direct them to paths of education and trades that will lead to good careers and healthy lives. In just its first two years alone, the Children’s Health Home program is expected to serve 2,000 children.
NFMMC’s efforts seem counterintuitive to the standard business plan and economic ideals of any hospital – they are using a cost center to temper health issues at the root cause, which significantly cuts down their potential long term revenues that could be gleaned from future surgeries and treatments.
That’s what makes NFMMC unique. CEO Joe Ruffolo, his board and management team clearly understand that a healthy economy creates healthy people and vice versa. God knows Niagara Falls needs such an understanding and commitment more than most urban areas do.
US healthcare spending, across all public and private provisions, will surpass $3.2 trillion this year. It’s up to all of us – consumers of healthcare and providers of healthcare – to mitigate costs. It’s good to see an organization like Niagara Falls Memorial holding up their end of the bargain far better than most. Because of the hospital’s efforts, Niagara County residents will be saved millions of dollars over the coming years and, at the same time, many of our friends and neighbors will be enjoying far better health.
From the 12 December 2016 Greater Niagara Newspapers
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