Area hospitals' aim? Drive down costs by serving uninsured patients

zmurdock@beaufortgazette.comSeptember 22, 2013 

Hospitals in Beaufort and Jasper counties are planning ways to help uninsured patients avoid emergency room visits to keep hospital costs down and low-income residents healthy.

Beaufort Memorial, Hilton Head Island and Coastal Carolina hospitals are preparing to participate in the state's healthy outcomes initiative, which launches Oct. 1.

Under the program, hospitals across the state partner with nonprofit agencies to work with uninsured, chronically ill patients who frequently use emergency room services.

The goal is to evaluate patients' needs and connect them with free or low-cost care from local providers.

To do that, the three hospitals will work with local organizations, such as Beaufort-Jasper-Hampton Comprehensive Health Services and Volunteers in Medicine, to educate uninsured patients about health issues and connect them with primary care providers.

South Carolina's nearly 60 hospitals were required to submit plans for implementing the initiative at the beginning of September, and the state will finalize those plans this week, said Colleen Mullis, spokeswoman for state Health and Human Services Department.

At Beaufort Memorial Hospital, AccessHealth Lowcountry has been providing a form of that service since April, said Debbie Slazyk, the program's director.

AccessHealth is one of 10 state hospital association networks created to help uninsured patients get care and manage medical needs. The program is a broader model for the healthy outcomes initiative, which focuses on patients who frequently use hospitals' emergency services, Slazyk said.

So far, the AccessHealth group has served about 60 people, Slazyk said.

"What I think is really terrific -- we have an opportunity to individualize the program," Slazyk said. "We're addressing each person's specific needs to the best of our ability."

Under the healthy outcomes initiative, the state's Medicaid agency gave each participating hospital a target number of uninsured patients to help between the program's launch in October and the end of June 2014.

At Beaufort Memorial, that target is 190 patients. Hilton Head Hospital has been tasked to serve 57 eligible patients, and Coastal Carolina Hospital has a target of 73 patients.

Although the initiative is described as voluntary, hospitals that don't participate put a portion of their state reimbursement for treating the uninsured at risk, according to The Associated Press.

The state Department of Health and Human Services expects to distribute $415 million to hospitals statewide in 2013-14 for treating the uninsured -- $17 million more than last year, according to Health and Human Services documents.

The agency has allocated an additional $20 million to fully cover the cost of uncompensated care at the state's 19 rural hospitals, said Coastal Carolina Hospital CEO Bradley Talbert in an email. All hospitals typically receive reimbursement for 60 percent of the cost of treating uninsured patients, according to The AP.

If the partnerships are successful at reaching patients in need, the program should reduce the number of costly emergency room visits that hospitals and the state have to pay for, Slazyk said.

"We're hoping that as this programs grows in the community, we'll get more providers willing to take these patients in for free care," Slazyk said. "If everybody takes a little piece, it goes a long way to addressing everybody's health care needs."

Follow reporter Zach Murdock at twitter.com/IPBG_Zach.

South Carolina Healthy Outcomes Initiative:

https://msp.scdhhs.gov/proviso/site-page/healthy-outcomes-plan-0

Projected initiative reimbursement by hospital https://msp.scdhhs.gov/proviso/sites/default/files/DSH%20%202014%20Projections_0.pdf

Initiative target populations by hospital https://msp.scdhhs.gov/proviso/sites/default/files/HOP%20Target%20Pop%20and%20Payment_0.pdf

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