Traverse City Record-Eagle

October 30, 2013

Health model aims to lower costs

Traverse City Record-Eagle

---- — TRAVERSE CITY— A proposed state initiative seeks to improve patient care and lower costs by providing a way for health professionals to work together and share information, while asking insurance companies to streamline their payment system.

A high-ranking state official said the Michigan Department of Public Health is putting together a plan for a “community integrated health system.”

Melanie Brim presented the proposed State Innovation Model to about 35 area health professionals gathered Tuesday at Munson Medical Center and asked for input.

In April the state of Michigan was awarded a $1.7 million federal grant to design the health model, still in the planning stages, said Brim, a public health deputy director with the Michigan Department of Community Health.

“This is a six-month planning grant to come up with a new delivery and payment model, get agreement, produce it and get the governor to sign off on it. I used to look a lot, lot younger,” Brim joked.

If the plan is approved and funded, community hubs would be established for professionals to work collaboratively to improve patient outcomes, she said.

“So when you’re working with a patient and have a social determinant, you can turn to the community hub with pathways on how to deal with the issue,” she said. “If they hear consistently that people can’t get to appointments because there is no transportation, that becomes something this collaborative would try to address.”

The plan also seeks to streamline payment and reimbursements for providers and reduce costs.

Health care professionals at Tuesday’s presentation came from a wide range of backgrounds, including substance abuse treatment, hospital care, and public health departments. Attendees gave a warm reception to the complex plan.

Paul Winkler of Old Town Psychological Services said easier access to medical records would be helpful, for example, when he’s treating someone with depression.

Brim said the SIM advisory team engaged Medicaid, Medicare, Blue Cross/Blue Shield, and Priority Health, among others. The state expects to put together a proposal in the next three weeks on how to simplify billing and pay for the new plan.

“Once you describe the system, you have to pay for it,” she said. “… If you can use the same metrics for all the payers, it would be really great. You could simplify life. We’ll ask payers how to do that.”

Brim made presentations throughout the state to get input on the concept before the plan is finalized by year end.

Twenty-five states are in the planning or testing phase of how best to deliver care and pay for it. The effort is funded through the Centers for Medicare and Medicaid Services, which will review Michigan’s plan and determine if it merits funding, she said.

The state expects to pilot elements of the plan in October of 2014, even if funding is denied, she said.