Get ready for changes in health care coverage as the implementation date of the federal Affordable Healthcare Act approaches.
Changes in how health care will be covered were discussed by the Southern Humboldt Healthcare District governing board at their monthly meeting last Thursday, Aug. 29, which was held at the Civic Club in Garberville because of renovations to their usual meeting room at the hospital.
Anyone covered by the state Medi-Cal program needs to officially choose a primary health care provider by Oct. 1, the day the new Medi-Cal managed care program begins, administrator Harry Jasper said.
Persons who don’t choose a provider will have one selected for them by Medi-Cal, and they may not receive full benefits if they go to a different provider.
On the good side, next year the maximum income eligibility for Medi-Cal will be 138 percent of the federal poverty level, which is five percent higher than the current maximum of 133 percent.
Anyone who thinks he or she may become eligible for Medi-Cal during the new year should choose a provider now to be able to continue to go to that provider and receive benefits, Jasper explained.
Everyone who is not eligible for Medi-Cal or Medicare will be required to choose commercial health insurance from the newly-created “Insurance Marketplace,” which allows consumers to compare insurance rates and benefits from all companies and choose the plan that best suits them.
Additionally, persons whose household income falls below 400 percent of the federal poverty level will be eligible for subsidies from the federal government that will pay a portion of their health insurance premiums.
”Subsidies will make a significant difference for working class people,” SHCHD board president Barb Truitt said.
Medicare will not be affected by these changes but secondary insurance supplemental to Medicare, called “Medi-Gap,” may change. Medicare recipients with Medi-Gap coverage should receive information from their insurance companies to help them make choices.
Anyone without coverage after full implementation of the ACA is supposed to be penalized as an additional income tax item, but exactly what this entails is still being debated in Congress, Jasper said.
For more information and to choose your healthcare provider, call your primary care provider’s office.
The fourth annual Southern Humboldt Health Fair will be held on Friday, Sept. 20 from 11 a.m. to 4 p.m. in the Town Square and the new Chautauqua Natural Foods parking lot, Truitt reminded the board.
SHCHD will have a booth at the fair, as will other health care providers in SoHum, and many other groups with an interest in healing and healthy living will be there to talk to community members.
On that same day John Driscoll, who is Congressman Jared Huffman’s chief of staff in Eureka, and his assistant will visit SHCHD, tour the clinic and hospital, and discuss the district’s vision for the new facility the district plans to build and occupy by 2025 in compliance with California seismic standards.
To begin that effort, Jasper has received a proposal from the district’s consultants Eide-Bailly to design a process for the complex planning process. This will begin with a workshop to gather public input to make sure the facility meets community needs.
”We’re in our summer swing,” board member and finance committee chair Corinne Stromstad announced at the start of the financial reports. Clinic visits were higher than they have been for many years, and patient volumes increased in all departments.
With the help of contractors DSG Data Management, the average length of open accounts receivable (A/R) dropped from 134 days in May to 97 days in June between billing and payment. In July this number dropped to 87 days. The district’s goal is to bring the average to only 60 days.
Faster turnaround means better cash flow for SHCHD, especially since the amount insurance companies and other programs allow as payment for a particular service is usually less than the amount billed, a standard situation in health care finance.
Among the techniques used to reduce A/R, DSG employs a program called a “claim scrubber,” which electronically reviews all claims to make sure they are “clean” - that is, correctly billed -- and therefore will be paid promptly by insurers.
Progress continues toward selecting software for Electronic Health Records (EHR). SHCHD’s current software provider, Healthland, spent two days giving onsite presentations to all the departments as well as the selection committee, which includes Jasper, operations manager Kent Scown, patient services director Sarah Beach, and medical director Dr. Marcin Matuszkiewics.
The selection committee plans to travel to a facility in Tehachapi, California later in the year to observe the Healthland EHR system in real-life operation.
The board discussed establishing a second WiFi connection that board members can use for webinars and online education, and for the convenience of patients and their families. For security reasons, the current connection cannot be shared.
Jasper suggested that the district purchase two large flat-screen TVs that can be positioned in the clinic and emergency waiting rooms. These can be used to provide information to patients about services, the results of the patient satisfaction survey, and related matters.
The most recent results of the patient satisfaction survey, covering March 2013 through the present, shows continued high patient satisfaction, with all departments scoring a percentage point or two higher than at the last report, Jasper told the board.
In the meanwhile, time was extended for district staff to return the employee satisfaction survey in order to get at least 60 percent returns.
Employees’ confidentiality is protected because they can either do the survey through Survey Monkey, an online service, or they can mail a manually-completed, anonymous survey form to attorney Doug Ingold, who will compile the results for the board.
So far the majority of people responding have chosen to send their survey to Ingold.
Finally the board discussed a letter from Six Rivers Planned Parenthood inviting SHCHD to join the Humboldt County ProChoice Coalition.
Several board members expressed their opposition to the right to choose abortion, although they all said that otherwise they support Planned Parenthood’s commitment to providing health care for women. They declared they would abstain if this matter came to a vote.
Seeing that no one would make a motion, Truitt said, “We will not be taking any action on this item.”
The next open meeting of the SHCHD governing board is scheduled for Thursday, Sept. 26, beginning at 1 p.m. Unless another location is announced, the meeting will be held in the Dimmick meeting room at the Garberville hospital.