AL providers struggle to create their own MCO
Birmingham, AL-An effort by local health providers to improve the quality of medical care to uninsured patients who visit local emergency departments (EDs) in droves has proven more difficult than at first believed. Local officials blame the slow bureaucratic process for hindering the development of the county's first integrated managed care organization (MCO) designed to enroll working residents who are near the federal poverty guidelines yet don't qualify for Medicaid.
For more than two years, the Jefferson County Department of Health has been leading a public-private partnership to create the MCO, which will include hospitals and physicians and would deliver better access to primary care for many of the county's 220,000 uninsured.
The effort has the support of the 4,500-member Jefferson County Medical Society, the Health Department, and the local hospital association. Some $35 million in funding for the project comes from the county's Indigent Care Fund.
But the wheels of progress turn slowly, according to Max Michael, MD, chief executive officer of 110-bed Cooper Green Hospital, the county's public facility. For one, the county is undergoing the lengthy process of a Medicaid waiver that would allow for the creation of the managed care plan.
Some 70% of Cooper Green's patients are uninsured, which means that more than half of the its 34,000 annual ED visits are charity cases. Officials fear those numbers will rise as local hospitals follow a growing regional trend of being bought by for-profit chains and eventually cut back on charity care.
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