Story first appeared in the Detroit News.
Possible changes to Michigan's unique auto insurance coverage for people injured in accidents are coming up for debate in the state Legislature.
Michigan now is the only state in the nation that mandates unlimited medical benefit coverage for people seriously injured in auto accidents. That would change under proposals that could offer motorists less expensive insurance in exchange for limited personal injury protection coverage.
Supporters of the changes, including the auto insurance industry, say it would allow motorists to opt out of more expensive coverage they can't afford or don't want. Insurers also are looking for relief in a system they say is growing increasingly expensive and threatening their finances.
Sen. Joe Hune, a Republican from Livingston County's Hamburg Township and chairman of the Senate Insurance Committee said if you take a look at the cost of the system, the skyrocketing medical costs, it's simply unsustainable, and there's going to be a tipping point sometime. The system just can't sustain itself."
Opponents of the proposed legislation say it could threaten the financial stability of the state's no-fault auto insurance system. They say motorists opting for less coverage could wind up underinsured and in deep financial trouble if they're seriously injured in an accident.
John Cornack, CEO of Ann Arbor-based Eisenhower Rehabilitation Center and president of the Coalition Protecting Auto No-Fault, said the proposed legislation does not come close to meeting the needs of severely injured accident victims.
The coalition opposed to the proposed changes includes hospital and health groups, trial lawyers and other organizations. They're engaged in a lobbying battle with auto insurance companies and business groups such as the Michigan Chamber of Commerce that want to alter the system.
The legislation would make significant changes to how people involved in catastrophic injury accidents are covered under state law.
Currently, all Michigan auto policyholders must buy unlimited medical benefits as part of their coverage. Regular auto insurance policies handle coverage up to $500,000, after which all insured motorists are assessed a fee to cover more severe cases, which are reimbursed through the Michigan Catastrophic Claims Association. The association, created in the late 1970s, now covers medical bills for roughly 12,800 accident victims across the state.
Unlimited coverage would continue for those currently in the MCCA system, according to supporters of the developing legislative plan. But there would be no such guaranteed coverage for those severely injured in future accidents.
Instead, motorists would have options for personal injury coverage likely ranging from $250,000 to $5 million. The developing legislation, which could be introduced this month, is likely to replace an original proposal that would let motorists buy as little as $50,000 in coverage up to unlimited coverage.
The new plan also likely will contain fee schedules and other measures aimed at controlling health insurance claims costs. It also likely will include elements of a plan backed by Sen. Virgil Smith, D-Detroit, that could provide some personal injury protection insurance relief in Detroit and possibly to residents in other areas of the state.
The $250,000 threshold would cover about 99 percent of accident victims, Hune said. But the Coalition Protecting Auto No-Fault says the average acute care stay cost for a person with a severe brain injury is more than $250,000, with some surpassing $1 million. The coalition says hundreds of people a year could have injury-related costs beyond even $500,000 in insurance coverage and would need to turn to other income, charities or taxpayers to pay for their care.
Cornack said right now, accident victims in our state can get the care they need without turning to welfare.
But the possibility of cheaper rates might be tempting for some motorists, who now pay an average premium of more than $1,000 a year in Michigan. Supporters of allowing flexibility on medical coverage say Michigan motorists could save roughly 15 percent on comprehensive policies and up to 40 percent on basic policies that don't include coverage for collision or theft.
Showing posts with label michigan medicaid insurance. Show all posts
Showing posts with label michigan medicaid insurance. Show all posts
12 September 2011
17 March 2010
As Patients Flock to Medicaid, Doctors Drop Them
NY Times
With Medicaid Cuts, Doctors and Patients Drop Out
Rebecca and Jeoffrey Curtis searched for care for their son. In the process, they felt like “second-class citizens,” Ms. Curtis said.
FLINT, Mich. — Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat.
As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years.
She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.
Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room.
The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.
“My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”
It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.
Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “When you build a relationship, you want to stay with that doctor,” she said recently, her face gaunt from disease, and her head wrapped in a floral bandanna. “You don’t want to go from doctor to doctor to doctor and have strangers looking at you that don’t have a clue who you are.”
The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.
In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group. At 63 percent, Michigan had the sixth-lowest rate in the country, even before the recent cuts.
In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared with $1,393.31 from Blue Cross.
If she takes too many Medicaid patients, she said, she cannot afford overhead expenses like staff salaries, the office mortgage and malpractice insurance that will run $42,800 this year. She also said she feared being sued by Medicaid patients because they might be at higher risk for problem pregnancies, because of underlying health problems.
As a result, she takes new Medicaid patients only if they are relatives or friends of existing patients. But her guilt is assuaged somewhat, she said, because her husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and throat specialist, is able to take Medicaid. She said he is able to do so because only a modest share of his patients have it.
The states and the federal government share the cost of Medicaid, which saw a record enrollment increase of 3.3 million people last year. The program now benefits 47 million people, primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting limits on eligibility, benefits and provider payments within broad federal guidelines.
Michigan, like many other states, did just that last year, packaging the 8 percent reimbursement cut with the elimination of dental, vision, podiatry, hearing and chiropractic services for adults.
When Randy C. Smith showed up recently at a Hamilton Community Health Network clinic near Flint, complaining of a throbbing molar, Dr. Miriam L. Parker had to inform him that Medicaid no longer covered the root canal and crown he needed.
A landscaper who has been without work and without a Michigan health insurance company for 15 months, Mr. Smith, 46, said he could not afford the $2,000 cost. “I guess I’ll just take Tylenol or Motrin,” he said before leaving.
This year, Gov. Jennifer M. Granholm, a Democrat, has revived a proposal to impose a 3 percent tax on physician revenues. Without the tax, she has warned, the state may have to reduce payments to health care providers by 11 percent.
In Flint, the birthplace of General Motors, the collapse of automobile manufacturing has melded with the recession to drive unemployment to a staggering 27 percent. About one in four non-elderly residents of Genesee County are uninsured, and one in five depends on Medicaid. The county’s Medicaid rolls have grown by 37 percent since 2001, and the program now pays for half of all childbirths.
But surveys show the share of doctors accepting new Medicaid patients is declining. Waits for an appointment at the city’s federally subsidized health clinic, where most patients have Medicaid, have lengthened to four months from six weeks in 2008. Parents like Rebecca and Jeoffrey Curtis, who had brought their 2-year-old son, Brian, to the clinic, say they have struggled to find a pediatrician.
“I called four or five doctors and asked if they accepted our Medicaid plan,” said Ms. Curtis, a 21-year-old waitress. “It would always be, ‘No, I’m sorry.’ It kind of makes us feel like second-class citizens.”
As physicians limit their Medicaid practices, emergency rooms are seeing more patients who do not need acute care.
At Genesys Regional Medical Center, one of three area hospitals, Medicaid volume is up 14 percent over last year. At Hurley Medical Center, the city’s safety net hospital, Dr. Michael Jaggi detects the difference when advising emergency room patients to seek follow-up treatment.
“We get met with the blank stare of ‘Where do I go from here?’ ” said Dr. Jaggi, the chief of emergency medicine.
New doctors, with their mountains of medical school debt, are fleeing the state because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.
Access to care can be even more challenging in remote parts of the state. The MidMichigan Medical Center in Clare, about 90 miles northwest of Flint, closed its obstetrics unit last year because Medicaid reimbursements covered only 65 percent of actual costs. Two other hospitals in the region might follow suit, potentially leaving 16 contiguous counties without obstetrics.
Michigan Medicare and Medicaid enrollees in the state's midsection have grown accustomed to long journeys for care. This month, Shannon M. Brown of Winn skipped work to drive her 8-year-old son more than two hours for a five-minute consultation with Dr. Mukkamala. Her pediatrician could not find a specialist any closer who would take Medicaid, she said.
Later this month, she will take the predawn drive again so Dr. Mukkamala can remove her son’s tonsils and adenoids. “He’s going to have to sit in the car for three hours after his surgery,” Mrs. Brown said. “I’m not looking forward to that one.”
As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years.
She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.
Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room.
The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.
New doctors, with their mountains of medical school debt, are fleeing Michigan because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.
“My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”
It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.
Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “When you build a relationship, you want to stay with that doctor,” she said recently, her face gaunt from disease, and her head wrapped in a floral bandanna. “You don’t want to go from doctor to doctor to doctor and have strangers looking at you that don’t have a clue who you are.”
The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.
In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group. At 63 percent, Michigan had the sixth-lowest rate in the country, even before the recent cuts.
In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared with $1,393.31 from Blue Cross.
If she takes too many Medicaid patients, she said, she cannot afford overhead expenses like staff salaries, the office mortgage and malpractice insurance that will run $42,800 this year. She also said she feared being sued by Medicaid patients because they might be at higher risk for problem pregnancies, because of underlying health problems.
As a result, she takes new Medicaid patients only if they are relatives or friends of existing patients. But her guilt is assuaged somewhat, she said, because her husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and throat specialist, is able to take Medicaid. She said he is able to do so because only a modest share of his patients have it.
The states and the federal government share the cost of Medicaid, which saw a record enrollment increase of 3.3 million people last year. The program now benefits 47 million people, primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting limits on eligibility, benefits and provider payments within broad federal guidelines.
Michigan, like many other states, did just that last year, packaging the 8 percent reimbursement cut with the elimination of dental, vision, podiatry, hearing and chiropractic services for adults.
When Randy C. Smith showed up recently at a Hamilton Community Health Network clinic near Flint, complaining of a throbbing molar, Dr. Miriam L. Parker had to inform him that Medicaid no longer covered the root canal and crown he needed.
A landscaper who has been without work and without a Michigan health insurance company for 15 months, Mr. Smith, 46, said he could not afford the $2,000 cost. “I guess I’ll just take Tylenol or Motrin,” he said before leaving.
This year, Gov. Jennifer M. Granholm, a Democrat, has revived a proposal to impose a 3 percent tax on physician revenues. Without the tax, she has warned, the state may have to reduce payments to health care providers by 11 percent.
In Flint, the birthplace of General Motors, the collapse of automobile manufacturing has melded with the recession to drive unemployment to a staggering 27 percent. About one in four non-elderly residents of Genesee County are uninsured, and one in five depends on Medicaid. The county’s Medicaid rolls have grown by 37 percent since 2001, and the program now pays for half of all childbirths.
But surveys show the share of doctors accepting new Medicaid patients is declining. Waits for an appointment at the city’s federally subsidized health clinic, where most patients have Medicaid, have lengthened to four months from six weeks in 2008. Parents like Rebecca and Jeoffrey Curtis, who had brought their 2-year-old son, Brian, to the clinic, say they have struggled to find a pediatrician.
“I called four or five doctors and asked if they accepted our Medicaid plan,” said Ms. Curtis, a 21-year-old waitress. “It would always be, ‘No, I’m sorry.’ It kind of makes us feel like second-class citizens.”
As physicians limit their Medicaid practices, emergency rooms are seeing more patients who do not need acute care.
At Genesys Regional Medical Center, one of three area hospitals, Medicaid volume is up 14 percent over last year. At Hurley Medical Center, the city’s safety net hospital, Dr. Michael Jaggi detects the difference when advising emergency room patients to seek follow-up treatment.
“We get met with the blank stare of ‘Where do I go from here?’ ” said Dr. Jaggi, the chief of emergency medicine.
New doctors, with their mountains of medical school debt, are fleeing the state because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.
Access to care can be even more challenging in remote parts of the state. The MidMichigan Medical Center in Clare, about 90 miles northwest of Flint, closed its obstetrics unit last year because Medicaid reimbursements covered only 65 percent of actual costs. Two other hospitals in the region might follow suit, potentially leaving 16 contiguous counties without obstetrics.
Michigan Medicare and Medicaid enrollees in the state's midsection have grown accustomed to long journeys for care. This month, Shannon M. Brown of Winn skipped work to drive her 8-year-old son more than two hours for a five-minute consultation with Dr. Mukkamala. Her pediatrician could not find a specialist any closer who would take Medicaid, she said.
Later this month, she will take the predawn drive again so Dr. Mukkamala can remove her son’s tonsils and adenoids. “He’s going to have to sit in the car for three hours after his surgery,” Mrs. Brown said. “I’m not looking forward to that one.”
06 November 2009
BCBS Of Michigan Awards Grants To 47 Free Health Clinics
Reuters
Blues contribution to free clinics makes health care accessible to the uninsured and underinsured.
DETROIT -- Blue Cross Blue Shield of Michigan is awarding free clinics throughout the state a total of $1 million in grants that will provide health services to individuals and families without Michigan health insurance. With the Michigan unemployment rate currently at 15.3 percent more Michigan residents than ever are going without health insurance.
"In these difficult times, free clinics are putting health care in reach for people who need it," said Lynda Rossi, Blues vice president for Social Mission and Public Affairs. "Free clinics are a place for uninsured people to turn to for quality health care. Uninsured residents who get care in free clinics often otherwise would delay seeing a physician because of the cost. Delay
often leads to more expensive care in emergency rooms and even hospital stays."
The Blues have contributed $5 million to free clinics since 2005. This year's grant program aims to help clinics provide important services like primary care and behavioral health care, case management, dental services, specialty and diagnostic care, and prescription drugs.
"Most of our patients are dealing with one or more long-term diseases such as diabetes, high blood pressure and asthma," said Dave Law, executive director of the Joy-Southfield Health and Education Center in Detroit. "We also supplement our primary care with preventive health education and disease management strategies."
About 2.5 million Michigan residents under 65 years old went without health insurance at some time between 2007 and 2008. Many of these individuals, along with the underinsured, are able to seek medical care from these clinics instead of making a trip to the emergency room or forgoing care. Access to free clinics also helps curb the rising cost of health care. In 2008, Michigan free clinics were able to provide an estimated 122,000 patient visits
combined. Most other residents over 65 are covered under Michigan medicaid or Michigan medicare.
"With this grant from Blue Cross Blue Shield of Michigan we will be able to expand our scope and quality of services while using health information technology to efficiently measure health outcomes. As a result, we will be able to deliver high-quality, low-cost health care to our patients at no cost to them," said Law.
The following free clinics received a grant from the Blues this year:
Southeast Michigan
-- Brownstown Twp. - Wyandotte Clinic for the Working Uninsured, 23050
West
Rd., Suite 260, 734-365-3560
-- Detroit - HUDA Clinic, 1605 W. Davison Ave., 313-865-8446
-- Detroit - Joy-Southfield Health and Education Center, 18917 Joy Rd.,
313-581-7773
-- Detroit - Order of Malta Medical/Dental Clinic, 4860 15th St.,
313-894-2240
-- Detroit - St. Frances Cabrini Clinic, 1234 Porter St., 313-961-7863
-- Detroit - University of Detroit Mercy Counseling Clinic, 4001 W.
McNichols, 313-993-1093
-- Mt. Clemens - Mt. Clemens Regional Medical Center Medical Outreach
Clinic, 1000 Harrington Blvd., 586-493-8000
-- Pontiac - Gary Burnstein Community Health Clinic, 90 W. University,
248-758-1690
-- Pontiac - Mercy Place Clinic, 55 Clinton Street, 248-333-0840
-- Southfield - Tri-County Dental Health Council, 29350 Southfield Rd.,
Suite 35, 248-559-7767
-- Warren - St. John Community Health, 28000 Dequindre, 586-753-1484
-- West Bloomfield - Project Chessed (Jewish Family Services), 6555 W.
Maple Rd., 248-592-2300
-- Westland - Project H, Wayne County Family Center, 30600 Michigan Ave.
-- Ypsilanti - Hope Dental Clinic, 9 S. Adams, 734-481-0111
Mid-Michigan
-- Brighton - VINA Community Dental Center, 400 E. Grand River Ave.,
810-844-0240
-- Hillsdale - St. Peter's Free Clinic of Hillsdale County Inc., 3 N.
Broad
St., 517-437-4041
-- Jackson - St. Luke's Clinic, 132 Seymour Ave., 517-783-1117
-- Lansing - Care Free Medical & Dental, 5135 S. Pennsylvania Ave.,
517-887-5992
-- Pinckney - Faith Medical Clinic, 122 Howell St., 734-474-4627
Flint/Tri-Cities
-- Essexville - Helen M. Nickless Volunteer Clinic, 1460 W. Center Rd.,
989-895-4830
-- Flint - Genesee County Free Medical Clinic, 2437 Welch Blvd.,
810-235-4211
-- Lapeer - Loving Hands Clinic, 148 Maple Grove Rd., 810-667-8933
-- Saginaw - Cathedral Mental Health Care, 705 Hoyt Ave., 989-759-3356
-- Saginaw - Community Prescription Support Program, 401 Holden St.,
989-907-5602
-- Saginaw - Healthy Futures of St. Mary's of Michigan, 2215 N. Center
Rd.,
989-907-8108
West Michigan
-- Allegan - Seeds of Grace, 311 ½ Hubbard St., 269-288-0253
-- Battle Creek - Nursing Clinic of Battle Creek, 34 Green St.,
269-962-6565
-- Coldwater - Presbyterian Health Clinic of Branch County, 15 Church
St.,
517-278-7848
-- Grand Rapids - Catherine's Care Center, 224 Carrier NE, 616-336-8800
-- Grand Rapids - Health Intervention Services, 15 Andre SE, 616-475-8446
-- Grand Rapids - Oasis of Hope Center, 522 Leonard St. NW, 616-451-8868
-- Grand Rapids - Project Access, 233 E. Fulton, Suite 226, 616-459-1111
-- Hastings - Barry Community Free Clinic, 1230 W. State St.,
269-945-4444
-- Holland - Holland Free Health Clinic, 99 W. 26th St., 616-392-3610
-- Kalamazoo - Free Clinic of Kalamazoo, 2918 Portage St., 269-344-0044
-- Marshall - Fountain Clinic, 111 N. Jefferson, 269-781-0952
-- Three Rivers - Riverside Health Clinic, 207 E. Michigan Ave.,
269-273-3744
-- Zeeland - City on a Hill Ministries Health Clinic, 100 S. Pine St.,
Suite 140, 616-748-6009
Northern Lower Peninsula and Upper Peninsula
-- Big Rapids - Hope House Free Medical Clinic, 15085 220th Ave.,
231-796-0807
-- Cadillac - Cadillac Area Community Health Clinic, 521 Cobbs St.,
231-876-7818
-- Cheboygan - Northern Care Center, 225 Water St., 231-333-3019
-- Grayling - AuSable Free Clinic Inc., 1250 E. Michigan Ave.,
989-348-0740
-- Manistee - Manistee Area Community Clinic, 385 Third St., 231-309-8940
-- Petoskey - Community Free Clinic, 820 Arlington, Suite 6, 231-487-3600
-- Traverse City - Traverse Health Clinic, 3147 Logan Valley Rd.,
231-935-0668
-- Marquette - Medical Care Access Coalition Volunteer Clinic, 1414 W.
Fair Ave., Suite 26, 906-226-4400
-- Sault Ste. Marie - Community Health Access Coalition Volunteer Clinic,
508 Ashmun St., 906-635-7451
Blue Cross Blue Shield of Michigan has a unique mission that is different from other health insurance companies. The company is committed to focusing on reducing health care costs and improving quality, increasing access to health care coverage and services, and improving the health status of Michigan's residents, particularly children.
BCBS of Michigan is also concerned with senior services, including:
Assisted Living in Dearborn
Retirement Facilities in Dearborn
Senior Living in Wayne County
Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to 4.7 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including:
Traditional Blue Cross Blue Shield; Blue Preferred®, Community Blue(SM) and Healthy Blue Incentives(SM) PPOs; Blue Care Network HMO; BCN's Healthy Blue Living(SM); Flexible Blue(SM) plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue(SM) products in the under-age-65 individual market. BCBSM also offers dental, vision and hearing plans. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.
SOURCE Blue Cross Blue Shield of Michigan
Blues contribution to free clinics makes health care accessible to the uninsured and underinsured.
DETROIT -- Blue Cross Blue Shield of Michigan is awarding free clinics throughout the state a total of $1 million in grants that will provide health services to individuals and families without Michigan health insurance. With the Michigan unemployment rate currently at 15.3 percent more Michigan residents than ever are going without health insurance.
"In these difficult times, free clinics are putting health care in reach for people who need it," said Lynda Rossi, Blues vice president for Social Mission and Public Affairs. "Free clinics are a place for uninsured people to turn to for quality health care. Uninsured residents who get care in free clinics often otherwise would delay seeing a physician because of the cost. Delay
often leads to more expensive care in emergency rooms and even hospital stays."
The Blues have contributed $5 million to free clinics since 2005. This year's grant program aims to help clinics provide important services like primary care and behavioral health care, case management, dental services, specialty and diagnostic care, and prescription drugs.
"Most of our patients are dealing with one or more long-term diseases such as diabetes, high blood pressure and asthma," said Dave Law, executive director of the Joy-Southfield Health and Education Center in Detroit. "We also supplement our primary care with preventive health education and disease management strategies."
About 2.5 million Michigan residents under 65 years old went without health insurance at some time between 2007 and 2008. Many of these individuals, along with the underinsured, are able to seek medical care from these clinics instead of making a trip to the emergency room or forgoing care. Access to free clinics also helps curb the rising cost of health care. In 2008, Michigan free clinics were able to provide an estimated 122,000 patient visits
combined. Most other residents over 65 are covered under Michigan medicaid or Michigan medicare.
"With this grant from Blue Cross Blue Shield of Michigan we will be able to expand our scope and quality of services while using health information technology to efficiently measure health outcomes. As a result, we will be able to deliver high-quality, low-cost health care to our patients at no cost to them," said Law.
The following free clinics received a grant from the Blues this year:
Southeast Michigan
-- Brownstown Twp. - Wyandotte Clinic for the Working Uninsured, 23050
West
Rd., Suite 260, 734-365-3560
-- Detroit - HUDA Clinic, 1605 W. Davison Ave., 313-865-8446
-- Detroit - Joy-Southfield Health and Education Center, 18917 Joy Rd.,
313-581-7773
-- Detroit - Order of Malta Medical/Dental Clinic, 4860 15th St.,
313-894-2240
-- Detroit - St. Frances Cabrini Clinic, 1234 Porter St., 313-961-7863
-- Detroit - University of Detroit Mercy Counseling Clinic, 4001 W.
McNichols, 313-993-1093
-- Mt. Clemens - Mt. Clemens Regional Medical Center Medical Outreach
Clinic, 1000 Harrington Blvd., 586-493-8000
-- Pontiac - Gary Burnstein Community Health Clinic, 90 W. University,
248-758-1690
-- Pontiac - Mercy Place Clinic, 55 Clinton Street, 248-333-0840
-- Southfield - Tri-County Dental Health Council, 29350 Southfield Rd.,
Suite 35, 248-559-7767
-- Warren - St. John Community Health, 28000 Dequindre, 586-753-1484
-- West Bloomfield - Project Chessed (Jewish Family Services), 6555 W.
Maple Rd., 248-592-2300
-- Westland - Project H, Wayne County Family Center, 30600 Michigan Ave.
-- Ypsilanti - Hope Dental Clinic, 9 S. Adams, 734-481-0111
Mid-Michigan
-- Brighton - VINA Community Dental Center, 400 E. Grand River Ave.,
810-844-0240
-- Hillsdale - St. Peter's Free Clinic of Hillsdale County Inc., 3 N.
Broad
St., 517-437-4041
-- Jackson - St. Luke's Clinic, 132 Seymour Ave., 517-783-1117
-- Lansing - Care Free Medical & Dental, 5135 S. Pennsylvania Ave.,
517-887-5992
-- Pinckney - Faith Medical Clinic, 122 Howell St., 734-474-4627
Flint/Tri-Cities
-- Essexville - Helen M. Nickless Volunteer Clinic, 1460 W. Center Rd.,
989-895-4830
-- Flint - Genesee County Free Medical Clinic, 2437 Welch Blvd.,
810-235-4211
-- Lapeer - Loving Hands Clinic, 148 Maple Grove Rd., 810-667-8933
-- Saginaw - Cathedral Mental Health Care, 705 Hoyt Ave., 989-759-3356
-- Saginaw - Community Prescription Support Program, 401 Holden St.,
989-907-5602
-- Saginaw - Healthy Futures of St. Mary's of Michigan, 2215 N. Center
Rd.,
989-907-8108
West Michigan
-- Allegan - Seeds of Grace, 311 ½ Hubbard St., 269-288-0253
-- Battle Creek - Nursing Clinic of Battle Creek, 34 Green St.,
269-962-6565
-- Coldwater - Presbyterian Health Clinic of Branch County, 15 Church
St.,
517-278-7848
-- Grand Rapids - Catherine's Care Center, 224 Carrier NE, 616-336-8800
-- Grand Rapids - Health Intervention Services, 15 Andre SE, 616-475-8446
-- Grand Rapids - Oasis of Hope Center, 522 Leonard St. NW, 616-451-8868
-- Grand Rapids - Project Access, 233 E. Fulton, Suite 226, 616-459-1111
-- Hastings - Barry Community Free Clinic, 1230 W. State St.,
269-945-4444
-- Holland - Holland Free Health Clinic, 99 W. 26th St., 616-392-3610
-- Kalamazoo - Free Clinic of Kalamazoo, 2918 Portage St., 269-344-0044
-- Marshall - Fountain Clinic, 111 N. Jefferson, 269-781-0952
-- Three Rivers - Riverside Health Clinic, 207 E. Michigan Ave.,
269-273-3744
-- Zeeland - City on a Hill Ministries Health Clinic, 100 S. Pine St.,
Suite 140, 616-748-6009
Northern Lower Peninsula and Upper Peninsula
-- Big Rapids - Hope House Free Medical Clinic, 15085 220th Ave.,
231-796-0807
-- Cadillac - Cadillac Area Community Health Clinic, 521 Cobbs St.,
231-876-7818
-- Cheboygan - Northern Care Center, 225 Water St., 231-333-3019
-- Grayling - AuSable Free Clinic Inc., 1250 E. Michigan Ave.,
989-348-0740
-- Manistee - Manistee Area Community Clinic, 385 Third St., 231-309-8940
-- Petoskey - Community Free Clinic, 820 Arlington, Suite 6, 231-487-3600
-- Traverse City - Traverse Health Clinic, 3147 Logan Valley Rd.,
231-935-0668
-- Marquette - Medical Care Access Coalition Volunteer Clinic, 1414 W.
Fair Ave., Suite 26, 906-226-4400
-- Sault Ste. Marie - Community Health Access Coalition Volunteer Clinic,
508 Ashmun St., 906-635-7451
Blue Cross Blue Shield of Michigan has a unique mission that is different from other health insurance companies. The company is committed to focusing on reducing health care costs and improving quality, increasing access to health care coverage and services, and improving the health status of Michigan's residents, particularly children.
BCBS of Michigan is also concerned with senior services, including:
Assisted Living in Dearborn
Retirement Facilities in Dearborn
Senior Living in Wayne County
Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to 4.7 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including:
Traditional Blue Cross Blue Shield; Blue Preferred®, Community Blue(SM) and Healthy Blue Incentives(SM) PPOs; Blue Care Network HMO; BCN's Healthy Blue Living(SM); Flexible Blue(SM) plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue(SM) products in the under-age-65 individual market. BCBSM also offers dental, vision and hearing plans. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.
SOURCE Blue Cross Blue Shield of Michigan
26 October 2009
State Cuts Program For Disabled Seniors
From Interlochen Public Radio
Older people with mental illnesses and disabilities no longer have a place to socialize together in Traverse City, thanks to state budget cuts. Friday was the last day of the Senior Support Program at Northern Lakes Community Mental Health, ending a 30-year tradition.
During the program's last days, 62-year-old William Combs talked about what he would miss.
"It gives me something to do two days out of the week," he said. "And every other Monday I have art class and we do art,drawing and stuff. I do my drawings with pencils and pastels and maybe sometimes ink pens. And I just don't want to see everything end abruptly. That would be hard."
Combs lives in Kingsley, at an adult foster care home. Since he can't drive, he spends a lot of time on his own. He often likes to walk, sometimes miles in a day. But a couple days a week he would hop the bus into Traverse City, and the senior program gave him a place to meet friends.
"It'll be hard on a lot of people, and me too," he said. "I've been so used to coming to it and I don't want it to go. There ain't too much else going on."
But as of Friday, the Senior Program - not supported by Michigan Priority medicare - is no more.
Typically more than 20 people would show up to spend some time with their peers.
"A lot of them they have no place else to go for socialization and connecting with others, so that's why we had this program," says Marybeth Kyro. She was the lead worker for the Northern Lakes' Senior Support.
Kyro is being reassigned within the community mental health agency.
She says activities in the Senior Program were fun, but they also had a larger purpose. They were designed to help with daily living skills, and they focused on specific issues that older adults often face such as mobility, and keeping the mind sharp.
"We were getting some funding from the state to do older adult services," she says. "Now we're getting nothing. So now we had to make some really tough decisions, and this was part of it, cutting this program. So it's extremely sad, we're very, very sad."
The state ended funding for senior services back in July, cutting the Northern Lake's budget mid-year by $118,000. The community mental health agency's chief executive officer, Greg Paffhouse, says he shifted money around to keep the day program afloat as long as he could. But, already into Fiscal Year 2010, Paffhouse has no idea what his budget will be for this year. Looming cuts could be as high as 12, or even 20, percent. And he can't keep taking the risk.
Paffhouse does say he hopes the hard decision to shutter the senior program will actually mean those who were once in the program will be less segregated from the rest of the community. He hopes his staff and other area caregivers will help disabled seniors join in on more activities open to all seniors and all people.
"At the same time, we recognize there are friendships within this group," he says. "Some of these folks have attended the programs a long time together and we're still trying to sort out how we might be able to retain at least some periodic social activity to allow persons to maintain those relationships."
Programs for seniors with mental illness started 30 years ago, as the Regional Psychiatric Hospital in Traverse City closed. Funding has dwindled over the years. This was once a robust five-day program, with more than 50 participants, designed for elderly former hospital patients, all of whom have all since passed away.
During the program's last days, 62-year-old William Combs talked about what he would miss.
"It gives me something to do two days out of the week," he said. "And every other Monday I have art class and we do art,drawing and stuff. I do my drawings with pencils and pastels and maybe sometimes ink pens. And I just don't want to see everything end abruptly. That would be hard."
Combs lives in Kingsley, at an adult foster care home. Since he can't drive, he spends a lot of time on his own. He often likes to walk, sometimes miles in a day. But a couple days a week he would hop the bus into Traverse City, and the senior program gave him a place to meet friends.
"It'll be hard on a lot of people, and me too," he said. "I've been so used to coming to it and I don't want it to go. There ain't too much else going on."
But as of Friday, the Senior Program - not supported by Michigan Priority medicare - is no more.
Typically more than 20 people would show up to spend some time with their peers.
"A lot of them they have no place else to go for socialization and connecting with others, so that's why we had this program," says Marybeth Kyro. She was the lead worker for the Northern Lakes' Senior Support.
Kyro is being reassigned within the community mental health agency.
She says activities in the Senior Program were fun, but they also had a larger purpose. They were designed to help with daily living skills, and they focused on specific issues that older adults often face such as mobility, and keeping the mind sharp.
"We were getting some funding from the state to do older adult services," she says. "Now we're getting nothing. So now we had to make some really tough decisions, and this was part of it, cutting this program. So it's extremely sad, we're very, very sad."
The state ended funding for senior services back in July, cutting the Northern Lake's budget mid-year by $118,000. The community mental health agency's chief executive officer, Greg Paffhouse, says he shifted money around to keep the day program afloat as long as he could. But, already into Fiscal Year 2010, Paffhouse has no idea what his budget will be for this year. Looming cuts could be as high as 12, or even 20, percent. And he can't keep taking the risk.
Paffhouse does say he hopes the hard decision to shutter the senior program will actually mean those who were once in the program will be less segregated from the rest of the community. He hopes his staff and other area caregivers will help disabled seniors join in on more activities open to all seniors and all people.
"At the same time, we recognize there are friendships within this group," he says. "Some of these folks have attended the programs a long time together and we're still trying to sort out how we might be able to retain at least some periodic social activity to allow persons to maintain those relationships."
Programs for seniors with mental illness started 30 years ago, as the Regional Psychiatric Hospital in Traverse City closed. Funding has dwindled over the years. This was once a robust five-day program, with more than 50 participants, designed for elderly former hospital patients, all of whom have all since passed away.
23 June 2009
State Medicaid Cuts: This Will Hurt You More Than It Will Me
Story from the Detroit News
Automotive retirees aren't the only ones rushing to get dentist appointments this month.
Medicaid patients are swarming dental offices, too, hoping to get last-minute work done before the state-run medical program stops paying for cleanings, fillings, partials and dentures at month's end as a part of broader cutbacks announced in May to help balance the state's distressed budget.
The cuts affect adults age 21 and older covered by Medicaid, the federal-state program that provides health care coverage for certain low-income individuals and families.
Of Michigan's 1.6 million Medicaid enrollees, about 610,000 are adults. The budget cuts also eliminate other benefits, such as vision care, chiropractic services and podiatry, and reduce by 4 percent across-the-board Medicaid payments to physicians, hospitals and other providers, including dentists.
The cuts begin in the fourth-quarter of Michigan's fiscal year and will save about $53 million for the three-month period, state officials said. The cuts could extend into the 2010 fiscal year, which starts in October.
Dentists in urban areas such as Detroit, where there are a high percentage of Medicaid patients, fear the cutbacks will devastate business, delivering another blow to practices reeling from the recession. Dentists also worry more offices will reduce hours or close, further eroding options for low-income people living in the city and neighboring communities.
"It's a really distressing thing for all those concerned," said dentist Thomas Veryser, executive director of Michigan Community Dental Clinics, a nonprofit that specializes in treating Medicaid patients. Veryser said the cuts will further strain the organization's budget, prompting staff layoffs and halting construction of new offices.
Many health experts argue that any cuts to Medicaid will prompt costlier treatments in the future as patients rush to emergency rooms when their problems worsen.
The Michigan Medicaid insurance program will continue paying for emergency dental visits, such as tooth extractions, dentists say, but not for dentures or partials.
"They have access to emergency care but no access to care to replace those teeth," said Mert Aksu, dean of the School of Dentistry at University of Detroit Mercy.
Failing to replace absent teeth could lead to such as problems as shifting teeth and an inability to chew properly, Aksu said.
Michigan isn't alone in trimming Medicaid coverage in response to strained budgets.
Coverage for such services as dental, vision and podiatry are typically the first axed because they are considered optional, which means states aren't required to provide them to participate in Medicaid, which gets matching funds from the federal government, said Robin Rudowitz, policy analyst for the Kaiser Commission on Medicaid and the Uninsured, a part of the California-based Kaiser Family Foundation. It's up to each state to decide whether to offer optional services.
Michigan could also lose some federal matching funds by cutting optional services, Rudowitz added.
But compared to other states, Michigan has largely protected its Medicaid program from cuts, despite the state's high unemployment rate and dismal economic climate, Rudowitz said. And Michigan is likely to restore benefits once the economy rebounds, as has been the case in many other states, she added.
Still, for Mount Clemens Medicaid patient Caroline Lawrence, 37, the possibility of her dental benefits returning was of little comfort as she sat in the waiting room of a Detroit dental clinic, squirming from the pain throbbing in her cheek.
Lawrence set up an appointment with dentist Jerel Owens, one of the few oral surgeons she could find who takes Medicaid patients, to get her teeth pulled and would return for a denture.
But Lawrence fears she won't be able to get the denture before June 30 and may have to wait until dental coverage resumes.
"There is nothing I can do," she said, holding her hand to her cheek trying to soothe the pain. "I'll just have to suffer."
Automotive retirees aren't the only ones rushing to get dentist appointments this month.Medicaid patients are swarming dental offices, too, hoping to get last-minute work done before the state-run medical program stops paying for cleanings, fillings, partials and dentures at month's end as a part of broader cutbacks announced in May to help balance the state's distressed budget.
The cuts affect adults age 21 and older covered by Medicaid, the federal-state program that provides health care coverage for certain low-income individuals and families.
Of Michigan's 1.6 million Medicaid enrollees, about 610,000 are adults. The budget cuts also eliminate other benefits, such as vision care, chiropractic services and podiatry, and reduce by 4 percent across-the-board Medicaid payments to physicians, hospitals and other providers, including dentists.
The cuts begin in the fourth-quarter of Michigan's fiscal year and will save about $53 million for the three-month period, state officials said. The cuts could extend into the 2010 fiscal year, which starts in October.
Dentists in urban areas such as Detroit, where there are a high percentage of Medicaid patients, fear the cutbacks will devastate business, delivering another blow to practices reeling from the recession. Dentists also worry more offices will reduce hours or close, further eroding options for low-income people living in the city and neighboring communities.
"It's a really distressing thing for all those concerned," said dentist Thomas Veryser, executive director of Michigan Community Dental Clinics, a nonprofit that specializes in treating Medicaid patients. Veryser said the cuts will further strain the organization's budget, prompting staff layoffs and halting construction of new offices.
Many health experts argue that any cuts to Medicaid will prompt costlier treatments in the future as patients rush to emergency rooms when their problems worsen.
The Michigan Medicaid insurance program will continue paying for emergency dental visits, such as tooth extractions, dentists say, but not for dentures or partials.
"They have access to emergency care but no access to care to replace those teeth," said Mert Aksu, dean of the School of Dentistry at University of Detroit Mercy.
Failing to replace absent teeth could lead to such as problems as shifting teeth and an inability to chew properly, Aksu said.
Michigan isn't alone in trimming Medicaid coverage in response to strained budgets.
Coverage for such services as dental, vision and podiatry are typically the first axed because they are considered optional, which means states aren't required to provide them to participate in Medicaid, which gets matching funds from the federal government, said Robin Rudowitz, policy analyst for the Kaiser Commission on Medicaid and the Uninsured, a part of the California-based Kaiser Family Foundation. It's up to each state to decide whether to offer optional services.
Michigan could also lose some federal matching funds by cutting optional services, Rudowitz added.
But compared to other states, Michigan has largely protected its Medicaid program from cuts, despite the state's high unemployment rate and dismal economic climate, Rudowitz said. And Michigan is likely to restore benefits once the economy rebounds, as has been the case in many other states, she added.
Still, for Mount Clemens Medicaid patient Caroline Lawrence, 37, the possibility of her dental benefits returning was of little comfort as she sat in the waiting room of a Detroit dental clinic, squirming from the pain throbbing in her cheek.
Lawrence set up an appointment with dentist Jerel Owens, one of the few oral surgeons she could find who takes Medicaid patients, to get her teeth pulled and would return for a denture.
But Lawrence fears she won't be able to get the denture before June 30 and may have to wait until dental coverage resumes.
"There is nothing I can do," she said, holding her hand to her cheek trying to soothe the pain. "I'll just have to suffer."
31 March 2009
Some Hard Data On Michigan's Uninsured
Originally Posted at ABC12 NewsThe number of people without Michigan health insurance coverage is expected to grow exponentially in the future.
As we wind down Cover the Uninsured Week on ABC12, HealthFirst reporter Leslie Toldo has some of the hard facts about the state of health care in Michigan.
There are many people who qualify for free or low-cost insurance coverage, but don't know that it's available.
Fortunately, one Fenton woman found that out, quite literally, before it was too late.
The number of people without insurance in our state is high and the number of people who are actually on some type of public assistance is even higher.
Today we go back to a town hall meeting held in Flint on Thursday to get some insight from the state's top experts.
Right now, one-in-six Michiganders and one-in-three children are on Michigan Medicaid insurance. One-in-four people in the state is covered by some type of public assistance.
According to the director of Michigan's Department of Community Health, one quarter of the state's general fund goes to Medicaid coverage.
Janet Olszenwski is the director of the state Department of Health. "That's a tremendous amount of investment. That's money that can't be used for education, that can't be used for other needs the citizens have. But it's money that goes to protecting children, the elderly, the disabled and Michigan womens' health."
The resulting good news, according to our panelists, is Michigan has the ninth-lowest number of children who do not have health coverage.
Sadly, according to the Marianne Udow-Phillips, the director of the Center for Healthcare Research and Transformation in Ann Arbor, there are still 150,000 kids who are not covered and the number is going up. "In one year we saw a very large increase in the percentage of our children who are uninsured. We went from having 4.7 percent of our children who are uninsured to 6.2 percent who are uninsured."
Finally, our panelists pointed out that those on public assistance and those without a Michigan health insurance company are not the only ones feeling the pinch.
"Increasingly, those who have private coverage are having great difficulty in affording that coverage and affording care because all of us have seen increases in our co-pays and our deductibles. And you see that in our data a 25 percent increase in a relatively short period of time," Udow noted.
Uncompensated care equates to costs hospitals have to eat because unpaid or underpaid bills increased by 68 percent last year.
We have a link to more of Michigan's specific stats at abc12. com, as well as more information about how to get help finding coverage.
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