Healthcare project targets those with greatest need

Hennepin County this month introduced a “patient-centered” pilot healthcare program designed to integrate medical, behavioral health, and human services for low-income individuals. Reduced healthcare costs are just one of the hoped-for outcomes.

“It is really based on some previous work that has been done, trying to string together some systems in Hennepin County,” Area Director Jennifer DeCubellis told the MSR last week about the pilot program called Hennepin Health.

Individuals aged 18 to 64 with no dependent children at home who live in Hennepin County, whose incomes are at or below 75 percent of the federal poverty rate, and who qualify for Medical Assistance, are the target population of the one-year funded program.

Key elements of the program include: an integrated system of providers offering comprehensive care such as emergency, inpatient and outpatient services; accessible electronic health records to both the patient and members of his or her healthcare team; and a personalized care plan and designated healthcare team that includes medical, behavioral health, and human services professionals based on each patient’s unique needs.

Hennepin Health’s approach to meeting the needs of the county’s safety net population has not been tried before elsewhere. “We are doing this on a smaller scale,” said DeCubellis, predicting that if successful the program could help reduce healthcare costs.

Nearly 50 percent of Hennepin County’s target population for receiving medical assistance is Black. “Sixty percent of the [target] population has at least one of these [characteristics]” such as chemical dependency, mental health needs and chronic pain management, explained DeCubellis, an 18-year health professional who joined the County last year.

“We have more individuals needing public assistance today than in previous years. One of the things we have identified is that there is a population at the low-end poverty level whose needs aren’t being met by our healthcare system… Until we meet the basic needs, we won’t be able to impact their health care.

“So if our first priority is that the individual’s basic needs are met, then we can better address their health care. This will bring down overall costs. This is an opportunity to stop putting people in this healthcare box,” believes DeCubellis, adding that another aspect of the program is working with community agencies.

“We are doing services in homeless shelters and in conjunction with community providers. We are looking at individuals and communities, their needs, and how we can be creative to make sure we are meeting their needs.”

She adds, “Hennepin County Medical Center has had a successful program for the past year and a half when they have taken folks that have been in the hospital greater than three times in a year and put them in a coordinated care clinic. The coordinated care clinic has brought down hospitalizations by greater than 50 percent.

“It’s not keeping the individual out of the hospital altogether, but at $2,000 a day, you free up some substantial dollars that could  go to somebody else’s preventive health care or go to fund these social services that are so critical to the population.”

The program now becomes a fourth healthcare option for qualified individuals: “They have a choice of traditional plans currently at Hennepin County — Medica, UCare and HealthPartners already provide coverage for Medicaid Expansion populations, and the fourth option has been added, which is Hennepin Health.”

Although Hennepin Health is funded for one year, “We are hopeful that we will at least be able to use this pilot through December 2013. And if we are successful, we would like the opportunity to expand it to other populations, even to folk who have under-coverage,” DeCubellis said.

“I think this is an excellent time to make some significant improvements, and it is important that we work together as a community to ensure that all healthcare providers are cooperating and heading in the right direction. This will improve the lives of everyone in our area.”

For more information on Hennepin Health, call Jennifer DeCubellis at 612-596-9416 or email her at Jennifer.decubellis@co.hennepin.mn.us.

Charles Hallman

Charles Hallman writes regularly for the Minnesota Spokesman-Recorder and blogs at Another View.