Shawnee Christian Health Care and many social services agencies,
have trained members of their staffs to assist with ACA related issues.
The goals of the committee are to enroll 50% of Jefferson County
residents who qualify to purchase insurance through Qualified
Health Plans by the end of the first open enrollment period ending
March 31, 2014 and to enroll 60% of those who qualify under expanded Medicaid by the end of the fiscal year on June 30, 2014. The
combined goal is to enroll more than 55,000 previously uninsured
Jefferson County residents by June 30, 2014.
Through January 2, 2014 a total of 19,929 Jefferson County residents had enrolled - 14,185 under Medicaid and 5,744 under a
private Qualified Health Plan.
Education and Health Literacy
Many of the newly insured will never have had health insurance
before and will be unfamiliar with how to navigate the system. They
will need assistance in finding a medical home. Reaching out to the
newly insured is also an excellent opportunity to encourage them
to get age-appropriate medical screenings such as colonoscopies,
Pap smears and mammograms - especially now that there will be
no co-pays for many of these services. As always, we also need to
stress the importance of healthy lifestyle choices – eating nutritiously, being more active and avoiding tobacco, illicit drug use
and excessive alcohol use.
We also need to educate people on the appropriate use of the health
care system. For years we who have advocated for universal access
to health insurance have reasoned that if everyone had coverage,
emergency room usage would be limited to what it was intended
for – medical emergencies – and costs would be contained. Now we
need to make sure that that is what actually happens! But a recent
study from Oregon points to the fact that emergency room use
may not automatically decrease as more people become insured.
The study of about 25,000 low-income adults randomly selected
in 2008 to enroll in the state’s Medicaid program found that the
newly insured actually increased their visits to emergency rooms.
Over an 18-month period, about 42 percent of the new Medicaid
enrollees visited the emergency department. In the same period,
about 35 percent of those who did not receive Medicaid visited the
emergency department.
While the results of this study may not necessarily be predictive of
how the many more people enrolled under the Affordable Care Act
will use emergency rooms across the country, it does illustrate that
we need to help the newly insured recognize those life-threatening
conditions for which hospital emergency rooms were designed, and
which other conditions are more appropriately handled by a visit
to a primary care physician or an urgent care center.
As a start, the Education and Health Literacy Committee has
printed English language and Spanish language brochures which
list the area’s federally qualified health centers, community health
centers, community mental health resources, and hospital primary
care resources as sources of information on finding a medical home.
list of other conditions for which someone should go to a primary
care provider or an urgent treatment center. So far, 31,550 English
language brochures and 2,850 Spanish language brochures have
been distributed through twenty five community partners.
For the second phase of its outreach campaign, the Education and
Health Literacy Committee plans to broaden its outreach through
the news and social media to reinforce messages about using the
healthcare system responsibly.
Workforce Capacity
With the potential of more than 100,000 newly insured patients
entering the Louisville health care system over time, there is an obvious need to measure the capacity of our local workforce to meet this
need. The Workforce Capacity Committee is charged with systematically evaluating this capacity and to make recommendations about
how to improve capacity and workforce readiness. A 2013 Deloitte
study indicated that Kentucky has an estimated shortage of 183 to
256 primary care physicians. The Workforce Capacity committee
is considering working with the state to do further analysis of the
Deloitte data to make health care workforce capacity projections
specifically for Metro Louisville.
While Federally Qualified Health Centers such as Family Health
Centers and Park DuValle Community Health Center may be able
to meet a portion of the increased demand brought about by Medicaid expansion, private practices will also need to shoulde