U of L plays key role in thriving Medicaid program
August 7th, 2006
By Kevin Hyde
Think of Medicaid and the description “well-managed” may not come to mind automatically.
Passport Health Plan is changing that locally and beyond. A collaboration among the University of Louisville Medical School Practice Association, University Hospital, and partners like Jewish Hospital, Norton Healthcare, Federally Qualified Health Centers and the local Association of Primary Care Physicians, Passport is considered to be one of the best-managed and most-successful Medicaid programs in the nation.
In 1997, the U of L Medical School Practice Association and University Hospital formed a Medicaid program they called University Health Care Inc. (UHC) to contain costs and improve patient care and access to services.
Doing business as Passport Health Care, UHC now provides a sole-source, Medicaid-managed care plan that serves more than 137,000 members in Louisville and 15 surrounding Kentucky counties. The vast majority of Passport health care providers in Louisville are affiliated with the U of L medical, dental or nursing schools.
“The Medicaid population is important to the U of L Health Sciences Center’s mission of teaching doctors, nurses and dentists to practice in a diverse community because from it students learn to be sensitive professionals and gain an understanding of challenges that low-income patients may experience that contribute to health disparities,” said Larry Cook, U of L executive vice president for health affairs, Passport chairman of the board and one of the driving forces behind its creation.
As other Medicaid programs around the state and country struggle, Passport thrives—and not just in terms of the numbers.
It is “among the highest-performing Medicaid managed-care demonstrations in the country,” said Scott McClellan, Centers for Medicare and Medicaid Services (CMS), when CMS announced extension of Passport’s federal waiver in October 2005.
Passport offers its members major medical, vision and dental care and prescription medications. It provides several health education and outreach programs targeted at special needs clients, prenatal care, diabetes and asthma management and a comprehensive pediatric screening program for members under 21. It also has introduced innovative pilot projects to address the problem of childhood obesity, a palliative care program with early interventions and end-of-life hospice care.
Cook said one area Passport’s success can be best seen is in the “outstanding levels” of provider and member satisfaction.
“Somebody cares about you and makes sure you’re OK,” said one member who asked to be referred to as Anna.
Another strong measure of success, said Cook, has been two consecutive highest-level certifications from the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to measuring the quality of America’s health care. A health plan must meet rigorous requirements for consumer protection and quality improvement to receive NCQA’s “Excellent Accreditation.”
Passport ranked at #18 when NCQA partnered with U.S. News and World Report in 2005 on a national survey rating the top Medicaid programs in the country. The rankings are based on clinical performance, member satisfaction and NCQA accreditation. Also, the recent America’s Health Insurance Plans (AHIP) report “Innovations in Medicaid Managed Care” lauded Passport for effectively achieving improvements in health care while offering taxpayer value to Kentucky citizens.
According to independent consultants, Passport has saved the state $191 million since its inception.
“We have worked hard to improve the health and quality of life for our members by offering innovative programs in disease management, pharmacy management, case management and member education,” Cook said. “Obviously, these programs are working.”
“A provider-owned plan pays attention to the needs of those delivering services in ways that commercial managed-care plans don’t,” said Jim Taylor, president of University Hospital and CEO of its parent organization.
Passport “has demonstrated above all that management of Medicaid and the delivery of quality care with strong access are not incompatible,” Cook said.