By Bill Zeeble, KERA 90.1 reporter
http://stream.publicbroadcasting.net/production/mp3/kera/local-kera-474037.mp3
North Texas Home Call-Center Agents Assist Chronically Ill
Dallas, TX –
Bill Zeeble, KERA 90.1 reporter: Like the rest of the nation, Texas has struggled to reverse growing health care costs. One bill from the 2003 legislative session was designed to do just that. It's called The Medicaid Enhanced Care Program.
Jennifer Harris, Spokesperson, Texas Health and Human Services Commission: The impetus for that came from data showing only a few clients with chronic diseases were incurring a disproportionate share of the costs of Medicaid.
Zeeble: Medicaid's the state run program providing medical benefits to poor Texans. Jennifer Harris, with the state's Health and Human Services Commission, the HHSC, says some 55,000 Medicaid enrollees were costing Texas at least $500 million a year. But if those members could be reached and helped by health care providers before they became emergency room statistics, Texas could save money. Work-at-home agents, like Kathleen Stipp, have taken on that task. Last week alone she called 900 Medicaid enrollees.
Kathleen Stipp, Work-at-Home Agent: This is Kathleen. I'm calling on behalf of Texas Medicaid, and we're calling to follow up on a mailing we sent you in regards to our new condition support program.
Zeeble: Kathleen Stipp is a 20-year insurance company veteran who lives in Houston. These days she supplements her income by calling Medicaid members as a contractor for Plano-based Working Solutions, a work-at-home company. Stipp spent several hours learning the basics of the program.
Stipp: We ask how they're feeling and doing. Some conditions: asthma, diabetes...these people do have medical situations. If it needs immediate help we can triage them to a nurse to talk to them and direct them to a nurses' line, too.
Zeeble: The nurses on Stipp's referral list work for McKesson Health Solutions, the business chosen to save Texas some Medicaid money. In fact, says the HHSC's Jennifer Harris, Texas may the only state to require guaranteed savings.
Harris: We anticipate saving $28.6 million the first year alone. If they don't reach that threshold - if they don't meet that $28.6 million or 5% - they have to pay the difference back to us.
Zeeble: McKesson Health Solutions is confident it'll save the state money and make money itself. Mike Modiz oversees McKesson's Operations and Strategic Projects.
Mike Modiz, Vice President of Operations and Strategic Projects, McKesson Health Solutions: Our service does pay for itself, which is why the state got into this program. We go through working with the state to identify people with chronic conditions - asthma, heart failure, diabetes - and reach out to them to enroll them in a program to manage their conditions and work with a doctor.
Zeeble: Texas is one of just eight states fully implementing anything like this plan, according to McKesson. The program's still a work in progress, and too young yet to evaluate. Less than a year old, the HHSC says 35,000 Medicaid recipients have been signed up so far. For KERA 90.1, I'm Bill Zeeble.
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