Advocates: Carve out mental health for Medicaid
Manhattan Urgent Care Center Opens
With more physician entrepreneurs spotting a business opportunity in urgent care, a new site opened in Manhattan this month. Medrite Urgent Care Center launched on Manhattan's East Side at 919 Second Ave., near East 49th Street. Medrite Urgent Care is owned by Dr. Jeffrey Dick, based in Brooklyn; its medical director is Dr. Douglas Kaiden, who is board certified in emergency medicine. The center is located in a new building, "a great location with so many residential buildings," said Samuel Fisch, the center's administrator. He reports that patient volume has been surprisingly high. "We didn't expect to see so many patients in the beginning, but they are coming from the neighborhood and referrals from hotels." Mr. Fisch declined to provide financial details of the new urgent care center, whose website is www.medriteurgentcare.com.
Grant Targets Doc Shortage
As part of a federal commitment to boost the number of primary care doctors, the Institute for Family Health in Kingston has been awarded a training grant. The organization has been named a federal Teaching Health Center, a new designation The money, $600,000 for the academic year 2011-2012, will permit its Mid-Hudson Family Medicine Residency Program to expand to 30 residents from 18, adding the first four additional residents in July. IFH plans to train an additional 12 doctors over the next five years to address an acute shortage of primary care specialists in upstate New York. The award was announced by the federal Health Resources and Services Administration. IFH was one of 11 grantees nationally and the only one in New York.
Pace of Rising Health Care Costs Slows
The average per capita cost of health care for patients insured by commercial plans and traditional Medicare rose 6.06% over calendar 2010, but according to a Standard & Poor's report, that is the lowest annual growth rate since 2007. The pace was slower in Medicare, with hospital and professional services rising only 3.27% in 2010, while health care costs under commercial insurance rose 7.75%. The report is at www.healthcareindices.standardandpoors.com.
Pascack Valley Reopening?
On Friday, the New Jersey Department of Health and Senior Services announced it would accept certificate of need applications to open a hospital in Bergen County. Hackensack University Medical and its partner, LHP Hospital Group, called the move "an extremely important step in our long effort to obtain a license to reopen Pascack Valley Hospital."
The Medicaid Redesign Team meets twice this week, and behavioral health advocates are urging MRT members to embrace proposal 93 on their list, which calls for a managed behavioral health carve-out. A rival proposal, 91, accomplishes the opposite—moving behavioral health to general Medicaid managed care plans. It has the support of health plans (Pulse, Feb. 17, 18).
Advocates for a behavioral health carve-out argue that the model works well in Pennsylvania, Massachusetts and Michigan. Pennsylvania's Behavioral Health Choices program, for example, generated $4 billion in savings from 1997 to 2007, according to advocates.
The model, they say, takes advantage of specialty expertise within the behavioral health system. The carve-out proposal would move some Medicaid beneficiaries into designated specialty behavioral health organizations.
"The savings come from improved care coordination, which means fewer readmissions and emergency room visits," said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services in Albany. Mental health groups such as the Coalition of Behavioral Health Agencies also support the carve-out.
Rival proposal 91 "introduces HMOs to a whole other community, and presumes the HMOs will understand our people," added Mr. Rosenthal.
By that, he meant Medicaid's high-cost, high-needs enrollees with serious mental health, substance use and medical conditions.
WHO'S NEWS: Ross University School of Medicine named a new dean: Dr. Joseph Flaherty, currently dean of the University of Illinois College of Medicine. He starts on May 7. In a statement, Ross said his first task will be to "strengthen the clinical education program and engage with the national medical education community to raise awareness of the school and its reputation." Ross, which has its U.S. administrative office in North Brunswick, N.J., is located in Dominica, West Indies.
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