The Children's Healthcare Access Program Shows Encouraging Results; Receives Awards for Collaboration
As the nation debates healthcare reform, a community partnership in Kent County is ensuring more children have access to quality healthcare by shifting resources to focus on prevention and early intervention. The Children's Healthcare Access Program, an initiative of First Steps, began as a one-year pilot project in August 2008. Thanks to positive preliminary results, Priority Health, the Helen DeVos Children's Hospital, Cherry Street Health Services and other partners have all signed on for a second year of the program.
The continued support of the program comes on the heels of statewide recognition for innovation and collaboration in serving the community. Healthy Kent 2010 recently awarded it the Douglas A. Mack Award for Community Collaboration. The Michigan Association of Health Plans also honored the Children's Healthcare Access Program with its statewide Pinnacle Award for Community Collaborative Health Initiative.
The program involves 15,000 Kent County children, birth through 17, who are enrolled in Priority Health Medicaid. There are two primary goals: to improve the health of our community's children by connecting them to a quality medical home and, ultimately, to reduce costs by lowering emergency room usage and hospitalization rates.
The early results show it is working. Visits to the emergency department have decreased approximately six percent among children at the clinics and pediatric offices participating in the program. Hospital admissions are also down six percent.
"We're very encouraged by the first year of the program," said program manager Maureen Kirkwood. "There's still a lot of work to do, but we're beginning to show that by redirecting our existing healthcare dollars to emphasize prevention, we can get better outcomes for children."
The Children's Healthcare Access Program takes a comprehensive approach to improving access to quality healthcare. In the first year of the project:
- Thousands of families received support services such as intensive asthma education, home-based health education from a nurse or community health worker, free transportation, and connections to community resources.
- 1000 new openings were created in private practices for children with Medicaid.
- Clinics expanded their evening hours and offered more same-day appointments for sick children.
To create the additional openings, Priority Health, the largest Medicaid managed care provider in Kent County, increased the Medicaid reimbursement for sick child office visits. In exchange the physicians agreed to accept additional Medicaid patients. Priority Health is continuing this commitment even as the state decreases its payments to Medicaid providers.
"The Children's Healthcare Access Program is an example of the power of partnerships," said Tom Peterson, M.D., medical director of the Children's Healthcare Access Program and Helen DeVos Children's Hospital pediatrician. "This program brings healthcare providers together and enables our community to focus on the health and well-being of children in a coordinated, efficient and business wise model. Everybody wins."
A guiding principle of The Children's Healthcare Access Program is that all children should have a consistent medical home-a doctor's office or clinic where they can always go for regular checkups, immunizations and treatment when they are sick. The medical home concept is based on family-centered, coordinated care, with a strong emphasis on prevention. It is gaining momentum nationally as an effective approach to deliver better healthcare at a lower cost.
"Priority Health collaborates with and supports primary care physicians statewide in their efforts to develop medical homes for their patients," said Jim Byrne, M.D., chief medical officer, Priority Health. "We believe that primary care is the backbone of our delivery systems; a strong, effective primary care base is critical to achieving our goals of improving health, improving patient experience and controlling costs. Priority Health is honored to be a part of this important community initiative. The first year results are very impressive and a testimony to the hard work of many talented professionals."
The Children's Healthcare Access Program comes in response to significant community needs. Approximately 35 percent of children in Kent County are currently enrolled in Medicaid-a number that grows every year. A study commissioned by First Steps found children with Medicaid have poorer health outcomes than children with private insurance and are nearly twice as likely to be hospitalized.
All of the 15,000 children in the program are clients at one of the participating primary care providers: Cherry Street Health Services, Helen DeVos General Pediatrics Clinic, ABC Pediatrics, Alger Pediatrics, Forest Hills Pediatrics, and Kent Pediatrics. An additional clinic, the Grand Valley State University Family Health Center, has joined for the second year of the program. Based on the promising results of the first year, First Steps and its community partners hope to expand the Children's Healthcare Access Program to include additional health plans, primary care providers and children.
First Steps is a non-profit organization leading a community initiative to develop a system of support services for young children and their families in Kent County . First Steps works in partnership with the Great Start Collaborative, county government, parents, health systems, education systems, human service agencies, foundations and other child advocates. Our community vision is that every young child will be ready to succeed in school and in life. Visit www.firststepskent.org to learn more.
Priority Health is a nationally recognized health benefits company based in Michigan. It serves nearly a half million members with a broad portfolio of products including commercial and government health plans. A nonprofit dedicated to providing all people access to affordable health care, Priority Health continues to be recognized as one of America's Best Health Plans by U.S. News & World Report and NCQA. Priority Health has offices in Grand Rapids, Farmington Hills, Holland, Jackson, Kalamazoo and Traverse City.
Helen DeVos Children's Hospital is a Grand Rapids-based hospital serving children throughout Michigan. A teaching hospital, it includes more than 150 pediatric specialty physicians with specialized training in providing medical and surgical care to children in more than 40 pediatric specialties. We care for 7,600 children on an inpatient basis and 190,000 children at outpatient sites annually. The staff at Helen DeVos Children's Hospital is committed to caring for children and families with compassion, excellence and innovation.