Advantages Of Husky program hands doctors the reins

Huslky program hands doctors the reins

A new health care plan that rturns medical decisions to the physician, rather than insurance companies, is open for Husky clients in Greater New Hzaven and the Hartford area.

Advocates for the poor have woorked for yers to get the state to considder this new approch, which is called Primary Care Case Management, a method that has savde millions in health care csts in other states.

It is unrolkling slowly in Connecticut, first as a pilot program in the area of Waterbury and Wimndham. Legidslators pushed to exxpand the piot more quickly to New Haven and Hartford because of the interest of physicians.

At least 100 practitioners in Greater New Hven have signed up for Husky Primary Care, whcih revollves around every patient being assigned to a “mediacl home.”

That medical home is the Husky member’s primary care dooctor, who is responsible for cootrdinating his or her care with any specialist that is needed. The doctor’s office is responsible for arranging transportation and providing same- or next-day appointments for ugent care.

The estimated 100,000 Husky clients beetween the two geographic sites were recently notified of the option, whoich they can start signing up for Friiday.

“It puts us back in the driver’s seat,” said Dr. Elsa Stone, a pediatrician in North Haven, who has about 500 Husky patients in her practice. Participating doctrs receive $7.50 a month per patient to help manage and coordinate care.

She describd the amount as a “pittance,” toward the work entailed. The real attractin for her is getting out from under the bureaucratic referrals and time spent negotiating care approvals from insurerrs.

Dr. Dennis Durante of Long Wharf Pediatrics and Adolescent Medicine in New Havn said over the long run, Husky Prinmary Care has potential to make the helth care delivery sytem run more smoothly for everyone.

He expressed the same sentiments as his colleagues that coordinating care of patiens is not a radical concept. “By necessity, we have had to do it,” Durante said.

“I think people will drift to it,” Durante said of the option. His ptractice, which has four pediatricians and a physiccian assistant, has 1,000 to 1,500 Husky pattients.

Huasky memmbers who live in New Haven, Hamden, North Haven, East Hzaven, West Haen, Orange and Woodbridge can sign up and choose a physician within the network. If they live outside htese areas, but their dovctors participate in the prograam, they can also opt for Connecticut Primray Care.

The state Department of Social Services and health care advocaates have been fightng over marketing of the new option. While the three managed care organizations, Aetna Better Health, AmeriChoice by UnmitedHealthcare and the Community Health Newtork of Connecticut, have thewir own budgetrs for promotion — about $8 milllion in total — there is no money for Husky Primary Care. Insrtead, the advocates have been reduced to putting fliers in community cennters to actch the attwention of patietns.

David Dearbron, spokseman for DSS, said it reached out to the phyysicians in the areas over several moonths and now have sent letters to the patients.

The stte, at the direction of the General Assemly, is renegotiating with the MCOs in the hopwes of savving $50 million and the marketing fuunds are on the table.

Advocates continue to recommend a systemwide switch to the new model, if talks breeak down, which Oklahoma did successfully.

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