Health Homes

Earlier this fall, the New York State Department of Health (DOH) announced a new Health Homes initiative, which will provide services for Medicaid eligible individuals with chronic medical conditions. The program, which will take effect in January 2012 for some counties and by June for all of New York State, was designed as a way to improve health care efficiency and quality by improving communication between the patient and his or her various care providers. To bridge this gap, each enrolled individual will be assigned a care manager to be responsible for the overall management and coordination of the patient’s care.

Health Home were developed both as a way to decrease New York State Medicaid costs and in response to the President Obama’s Patient Protection and Affordable Care Act, the U.S. health care statute that was signed into law on March 2010. Currently, New York’s Medicaid program serves over 5 million enrollees throughout the state, each with very different services and needs.

However, Medicaid recipients with complex and chronic health conditions, albeit just a small percentage of the total, the account for a large percentage of New York state health care costs. Often, the services they require are in-patient appointments that transcend various different medical fields. The result is piles of paperwork, scheduling difficulties, and unclear health care goals.

This lack of communication between facilities or physicians makes it especially difficult for patients to smoothly traverse the current system. As a part of the Health Homes implementation, the installation of Health Information Technology (HIT) will allow an individual’s health care providers to communicate easily and effectively so that all the patient’s needs are met. Either electronically or on paper, doctors will have easy access to their patients’ better-consolidated medical records so that no services are duplicated or forgotten. The personal care manager will help the individual navigate the services that he or she really needs and choose the best healthcare options while minimizing the number of procedures or appointments they must undergo.

In our most optimistic momments, we can see that this strategy could improve service for people who have complex needs and open an new chapter on care. The cautionary flip side is concern that in re-packaging, people loose out on needed services to additional bureaucratic layers.
 
More information is available through the department of health
http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/

Recession Over? Poverty at Record Breaking Levels!

The headlines are screaming poverty!!! The U.S. Census Bureau reports the official poverty rate for the nation for 2010 was 15.1%, up from 14.3% for 2009, with 46.2 million people in poverty, an increase of 2.6 million since 2009. Here in mid 2011, from all observations, it is most likely still rising. Record numbers are seeking assistance for their most basic needs – healthcare, food, housing.

Although the “Great Recession” officially ended in June 2009, the ranks of the poor is growing. Close to 104 million people or more than one in three were either poor or “near poor” (defined as a three person family with less than $35,000 in income in 2010). Continuing high levels of joblessness, and reduced wages hit low- and moderate-income people especially hard in 2010, with unemployment highest for those with little education, for people of color, and for woman-led households.

Poverty remains disproportionate and high for children. “We know that persistent and deep poverty threatens children’s opportunities fro a healthy productive life”, said Deborah Weinstein, Executive Director of the Coalition on Human Needs. Even with Unemployment Insurance, the Earned Income Tax Credit, and SNAP/Food Stamps working to lessen the affects of living poor, more and more people continue to barely get by.

We cannot allow members of Congress who wish to reduce the federal deficit by slashing Medicaid, food stamps, and low-income tax credits to be successful. These supports have prevented some of the worst effects of living on no, or low wages. Efforts to reform should rely on supports to assist people to live and work as independently as they can, not remove supports that improved the lives of so many people in our city, region, and country.

- Dave L.