From The Plain Dealer
By Ellen Kleinerman
CLEVELAND, Ohio -- Up to 30,000 uninsured adults in Cuyahoga County can now get free health care under MetroHealth System's new Medicaid waiver program.
The MetroHealth Care Plus program went into effect Tuesday, the same day it received federal approval. It's the first program of its kind in Ohio.
"This is about closing the gap for very poor adults," said John Corlett, vice president of government relations and community affairs at MetroHealth.
Corlett explained that the program covers uninsured adults who earn $14,856 or less (133 percent of the federal poverty level) and who are not eligible for regular Medicaid or Medicare.
To pay for the Care Plus program, MetroHealth is using $36 million that it gets each year from county taxpayers to qualify for $64 million in federal Medicaid matching funds. No state money is being used for this expansion program.
Primary care will be provided by MetroHealth, Neighborhood Family Practice and Care Alliance all of which have been adding staff in the last several months in anticipation of this program and the state's proposed Medicaid expansion in 2014.
Last year, MetroHealth with help from state regulators, submitted its plan for Care Plus to the U.S. Centers for Medicare & Medicaid in an effort to take advantage of a waiver provision in the Affordable Care Act to expand coverage, Corlett said.
The Care Plus waiver expansion program will expire at the end of this year, said Phyllis Marino, a MetroHealth spokeswoman.
Gov. John Kasich has proposed an expansion of the state's Medicaid program beginning in January in his two-year budget, which must be approved by state lawmakers. The state expansion could cover the same people who qualify for Care Plus this year.
Corlett said money for the Care Plus program will pay for some of the services MetroHealth now provides at a discount or for free.
MetroHealth had $130 million in uncompensated care in 2012 for an estimated 60,000 uninsured patients, Marino said. Care Plus only has enough money to cover up to 30,000 people who qualify.
Officials from the safety-net hospital said easily accessible preventive care and case management should reduce the high cost of emergency care.
Free medication is among the long list of service in the new program that could have a big impact on helping the homeless, unemployed and those in need of mental health services, officials said.
"It's going to be a great benefit for the working poor who struggle so much to get access to medication and care," said Jean Polster, executive director of Neighborhood Family Practice. As many as 2,000 of her agency's patients should qualify for MetroHealth's new program, she said.
Care Alliance CEO Francis Afram-Gyening said MetroHealth is being proactive in reaching out to these patients and he applauds its leadership. The program will be a "cushion of care" for the homeless and poor who don't have a medical home, he said.
"This is a big deal," U.S. Sen. Sherrod Brown said in a phone interview. "I think this program will be a model for serving people who don't have insurance." It will increase access to care and reduce costs to taxpayers and businesses in Ohio, he added.
MetroHealth also will partner with community agencies such as Recovery Resources, Murtis Taylor Human Services System, Catholic Charities Services and Stella Maris for specialized programs.
Those eligible to enroll will be assigned to a primary care provider who will coordinate health care. Medical Mutual of Ohio Inc., the third-party administrator, will process claims.
Services will include preventive exams, doctor visits, prescription medications, hospital care, dental care, mental health services, alcohol and drug abuse services and more.
Once the program gets into motion, Corlett said, it could end up being the single largest reduction of the uninsured in Cuyahoga County so far.
How to sign up:
Call 216-957-2325 or go to metrohealth.org and click “Patients: Need Financial Help” or get an application at any of the 17 MetroHealth locations. For more information go to MetroHealth's website.