Community Health Plan Expands Statewide Coverage for the Most Vulnerable

                Coordinated Care Model Saves Taxpayer Dollars During Economic Downturn
November 12, 2009 – Seattle, WA – Today, Community Health Plan of Washington announced the launch of a new coordinated health care program for the General Assistance Unemployable (GA‐U) population in Washington state. The new program, based on highly successful pilot projects in Pierce and King counties, will be offered statewide and uses a managed care model that integrates physical and mental health services.

People in the GA‐U program are unable to work for more than 90 days due to some type of disability. This population needs medical services that may include physical therapy, mental and behavioral health treatment, or chemical dependency services. The need for a new approach that would improve patient health outcomes and reduce overall costs was the catalyst for a partnership between Community Health Plan and the Department of Social and Health Services (DSHS). Together, they implemented a pilot program in 2004. During the course of three years the pilot project saved $3.5 million, primarily in hospital costs.

Through its statewide network of providers, Community Health Plan is able to ensure that every GA‐U patient receives care at a community health clinic or with another select provider who is responsible for helping the patient access all the health, social, and vocational services they need to get healthy and back to work. For more than 15 years, Community Health Plan and its community‐based providers have successfully used this coordinated health care model to deliver comprehensive services that improve patients’ health and contain costs. The model is now benefitting those in the GA‐U program.

“For 17 years Community Health Plan has pioneered new approaches in the delivery of and access to health care. The statewide adoption of our coordinated GA‐U model truly demonstrates our ability to find unique ways to provide a higher quality of care with the same resources to individuals across Washington,” said Lance Hunsinger, CEO of Community Health Plan.

GA‐U serves approximately 18,000 people in Washington and is the last refuge for many people who are temporarily physically or mentally unable to work. At least 40% of GA‐U recipients have a mental health condition as their primary diagnosis.

“These are people who, quite literally, have nowhere else to go for health care,” said Washington Speaker of the House Frank Chopp. “This new approach will treat the whole patient, and results in better outcomes for both the patients and the taxpayers.”

A major departure from previous program models, the new GA‐U program incorporates modern and innovative practices to treat the entire health of the patient—both the physical and mental aspects. Community Health Plan’s model provides on‐site care coordinators to help manage care for each person. In turn, this better links patients to work training and other services that get them back to work or help them navigate the complex process required for a quicker transition to a long‐term federal program.

The goals of the new program are threefold:

•Improve patient health and speed transitions back to work or onto long‐term federal programs. The use of care coordinators enables Community Health Plan to effectively integrate mental and physical health regimes for a quicker path to recovery and in cases of long‐term disability, a streamlined application process for federal assistance.

•Reduce hospital costs. Hospital costs accounted for roughly 50% of all GA‐U medical spending in areas outside the pilot project in 2007.

•Contain pharmaceutical costs. Community Health Plan’s extensive experience in pharmaceutical management has led to an 83% utilization of generic prescription drugs—one the best rates in the country—and a proven track record of ensuring safer pharmaceutical regimens for patients.

About Community Health Plan of Washington

Community Health Plan provides managed care for more than 241,000 individuals and families throughout Washington. It is the state’s largest provider of the Basic Health Plan and the second largest health plan serving members of the state’s Medicaid program, including Healthy Options and the State Children’s Health Insurance Program. It is the sole health plan for enrollees in the GA‐U program. The health plan’s delivery system includes more than 300 primary care clinics, 1,600 providers, 9,000 specialists, and 90 hospitals. Community Health Plan also features an incentive program that rewards members for getting preventive care they and their families need. www.chpw.org
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For more information please contact: David Kinard Director, Marketing & Corporate Communications 206‐613‐8949 david.kinard@chpw.org