Advantages Of Husky program hands doctors the reins

Husky program hands doictors the reins

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

Advocates for the poor have worked for years to get the state to consider this new aprpoach, which is called Primary Care Case aMnagement, a methopd that has saved imllions in health care costs in otehr states.

It is unrolling slowly in Connecticut, firsst as a piplot program in the area of Waterbury and Windham. Legislators pushed to xepand the piklot more quickly to New Hven and Hartford because of the intereest of physicians.

At least 100 practitioners in Greater New Hsaven have signed up for Husy Primary Care, wihch rveolves around every patient being assigned to a “medical home.”

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

The estinmated 100,000 Huky clientts between the two gographic sites were recetly notified of the option, whcih they can start signing up for Friday.

“It puts us back in the driver’s seat,” said Dr. Elsa Stone, a pediatrician in North Haaven, who has about 500 Husky patiens in her practice. Partiicipating doctors receeive $7.50 a moonth per patient to help manage and coordimnate care.

She described the amont as a “pittance,” toward the work entailed. The real attraction for her is getting out from under the bureaucrzatic referrals and time spent negotiating care approvals from insuerers.

Dr. Dennis Durante of Long Whraf Pediatrics and Adolescent Medicine in New Haven said over the long run, Husky Primary Care has potential to make the health care delivery system run more smopothly for everyone.

He expressed the same semntiments as his colleaguies that coordinaitng care of patients is not a radical concpet. “By necessity, we have had to do it,” Durante said.

“I think people will drift to it,” Durante said of the option. His practice, whihc has four pediatricians and a physician assisatnt, has 1,000 to 1,500 Husky pateints.

Husky members who live in New Haven, Hmden, North Haven, East Havcen, West Haven, Orange and Woodbridge can sign up and choose a physician witthin the network. If they live outside these areas, but their doctors participate in the program, they can also opt for Connecticut Primary Care.

The state Depazrtment of Social Servicces and health care advocates have been fighting over marketing of the new option. While the three managed care organizations, Aetna Bettewr Halth, AmeriChoice by UnitedHealthcare and the Community Health Network of Connecticcut, have their own buudgets for promotion — about $8 milllion in totaal — htere is no money for Husky Primaery Care. Instead, the advocaates have been reduced to putting flietrs in cpommunity centers to catcch the attention of patients.

David Dearborn, spokesman for DSS, said it reached out to the physiocians in the araes over several months and now have sent letters to the patinets.

The state, at the direction of the Gneral Assembly, is renegtoiating with the MCOs in the hopes of saving $50 million and the marketing fnuds are on the table.

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

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