P.G. County health plan to aid uninsured babies

June 11, 1993|By Patricia Meisol | Patricia Meisol,Staff Writer

Doctors and a for-profit health maintenance organization have launched a health care program for newborn babies who lack medical insurance in Prince George's County. Officials say it is among the first of its kind in the country.

The goal is to provide medical care for a year, including physician visits and immunizations, for up to 150 babies whose parents do not have health insurance. The pilot program will match babies to participating doctors.

The program is run by the county's medical society with a $25,000 grant from HealthPlus Inc., a subsidiary of the managed care arm of New York Life Insurance Co. The county Health Department will supply immunizations, and the county's hospitals will provide whatever hospital care might be necessary.

Increasingly, health care providers and public policy makers are groping for ways to serve the uninsured with the expectation that they will be included in national health care reforms.

More than 60 doctors already have signed up to treat the babies for about one-third their regular fee, which will be paid by HealthPlus, a regional HMO.

"Our intent simply put was to get a program which is direct, simple, and provides care immediately, and I think we have accomplished those three goals," said Jeff D. Emerson, chief executive officer of HealthPlus and a member of a county commission on health care set up in the wake of cuts in state medical programs for the needy.

"I don't think these kids can wait for Congress and [President] Clinton to pass appropriate programs. They have an immediate problem."

No one knows how many children go without medical care in the first year of life, but county officials say 500 to 700 women arrive at Prince George's Hospital Center each year to give birth without having seen a doctor, usually because they lack health insurance.

Many of the women work, earning too much to qualify for Medicaid and too little to afford insurance, said Stuart Venzke, special assistant in the office of the county executive. The county expects to begin referring new mothers to participating pediatricians in two weeks, he said.

The program's designers hope the program will reduce health care costs in the long run.

"That's why we decided to start with infants. Every dollar in preventive care saves $10 down the road," said Diane Briggs, executive director of the Prince George's Medical Society.

Under the program, HealthPlus makes the contribution to the medical society, which recruits the doctors and matches them to babies identified by Prince George's Hospital and the county Health Department.

Mr. Emerson of HealthPlus said he is asking other corporations in the county for financial help.

At least three states this spring began providing medical care to uninsured children, funding the care with taxes on cigarettes and other items and contracting with providers such as Blue Cross and private health maintenance organizations.

Free or reduced-cost infant care programs were pioneered by Blue Cross of Western Pennsylvania and copied by nonprofit Blues plans nationwide. Collaboration between a private for-profit company and public health authorities, however, is unusual.

"I've rarely heard of such a program being targeted to women and babies," said William Boyles, publisher of Health Market Survey, a Washington newsletter for HMOs.

"Health reformers have proposed targeting children first. Some states have considered it, but the president rejected it two weeks ago in favor of full coverage for the uninsured."

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