Easing Health Care Costs

Easing Health Care Costs

Grant to aid uninsured and underinsured.

Less than 90 days after Inova Health System (IHS) filed for dismissal of a federal class action law suit against it for charging higher rates to uninsured patients for the same medical procedures administered to insured patients, Inova Alexandria Hospital was named a recipient of a 2004 Healthy Communities Access Program grant. It was one of only 35 organizations nationwide selected.

Provided by Health Resources and Services Administration (HRSA), the grants "help local safety-net health care providers develop coordinated health care networks to serve uninsured and underinsured residents." IAH will receive $939,913 for fiscal year 2004, according to an IHS announcement. IHS received a similar grant in 2000 to undertake a similar program in Fairfax County.

"The program has been a real success, currently serving more than 45,000 uninsured and underinsured residents. As the largest safety net provider in Northern Virginia, Inova has focused a great many resources on caring for the uninsured and underinsured," said Elita Christiansen, vice president, Community Health and Cultural Competence, IHS.

Ironically, it was fees totaling more than $29,000 charged to an uninsured patient for a 21-hour stay at Inova Fairfax Hospital to perform a heart catheterization procedure that triggered the law suit. Attorneys for patient Paul Shipman of Herndon maintained that the procedure should have cost far less and that the reason the bill was so high was because Shipman was uninsured.

IHS and the IHS Foundation, along with the American Hospital Association, all defendants in the case, filed for dismissal on Sept. 24 in U.S. District Court in Alexandria, on the grounds "Each count of the complaint must be dismissed for failure to state a claim." Before judge Gerald B. Lee, could render a ruling, Shipman's attorneys withdrew the suit.

Had Lee ruled against the dismissal, the IHS suit would have become part of a national class action suit, on the same subject, filed against 50 healthcare providers in 23 states. However, an attempt by plaintiff attorneys to have all suits combined into a single class action was denied in Philadelphia federal court this past fall. Cases must now be argued in each individual jurisdiction if they go forward.

HRSA'S GRANT will enable the City of Alexandria to develop a partnership similar to that in Fairfax County. It will be called the Alexandria Coalition for Coordinated Health Care (ACCHC).

ACCHC will coordinate the services of IAH, Alexandria Health

Department, Arlandria Health Center, Alexandria City Departments of Human Services, Mental Health, and Mental Retardation and Substance Abuse, Access to Health Care for Children Partnership, private providers and the three shelters located with the city, according to the grant announcement.

ACCHC will develop an integrated and comprehensive health care delivery system that will improve the effectiveness, efficiency, and coordination of services for uninsured and underinsured residents, resulting in higher quality care at less cost, according to Beth Visioli, spokesperson, IAH.

Specific goals of the ACCHC include:

* Increasing enrollment in Medicaid/FAMIS by 10 percent

* Reducing the use of the hospital emergency department for primary care visits

* Increasing the number of specialists serving the indigent care population by 10 percent

* Increasing patient satisfaction by 15 percent

* Developing a chronic care initiative by creating a registry to track patients

ALEXANDRIA HAS an estimated 23,700 uninsured residents and Medicaid recipients, according to IHS statistics. In a study completed by Alexandria United Way in 2001, 41 percent of the city's working poor indicated they had no health insurance.

"We've seen the success in reaching out to residents in Fairfax County and we know we can achieve the same results here," said Kenneth Kozloff, administrator IAH, and IHS vice president who is serving as co-chair of ACCHC.

"Our community groups have a good working relationship and this coalition will make the processes even more efficient so that we can better serve the residents of our community." Serving with Kozloff as the other ACCHC co-chair is Dr. Charles Konigsberg, director, Alexandria Health Department.