During 2016, its first year, the 11 members of the Manatee County Healthcare Advisory Board talked among themselves a lot, heard from plenty of experts and got ideas from numerous concerned citizens about how to provide heath care for Manatee’s uninsured and under-insured.
But perhaps it wasn’t until the first meeting of 2017, which was Wednesday on the ninth floor of the county administration building, that the light at the end of the tunnel really became brighter for the board members.
“I feel like I will leave here tonight with a little spring to my step,” said Stephen Hall, chairman of the Healthcare Advisory Board, after a highly productive 5-7 p.m. meeting.
I think we will have a problem telling the commissioners and the public that you are going to do this at the 200 percent poverty level. They have already figured out that forty or fifty percent of the community is at that level. Those are some big numbers.
Ernest “Sandy” Marshall, Manatee Healthcare Advisory Board
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Part of the reason for Hall’s optimism was a long and comprehensive presentation titled, “Population Health Management. Why?” given to the advisory board by Joshua Barnett, the county’s health care services manager.
In his presentation, Barnett, integrating data from last year’s health care consultant’s report, reports from subcommittees that the advisory board formed and his own research, argued that if the county created an entity — as yet nebulous — where Manatee’s medically needy could go to have their health care managed in a structured way, it would ultimately keep them out of the emergency rooms and save the county money.
The board member’s key responsibility is to make recommendations to the Board of County Commissioners, and they will have their first chance at 9 a.m. Feb. 7.
Based on their reaction to Barnett’s presentation, it appeared Wednesday as if part of that recommendation would be population health management in some form.
For decades, Manatee County could draw from an indigent care health fund that came from the sale of Manatee Memorial Hospital, which paid for services for the county’s medically needy. But that fund has been exhausted, and Manatee taxpayers are now paying millions to hospitals and doctors and agencies for indigent care.
“It would be a drastic shift,” Barnett said. “It moves us from being a payer of services rendered to a funded health promotion entity. What that means is that what we do now is we pay for providers of indigent health care based on service utilized. What this would do instead is allow us to proactively identify uninsured folks and support them to accessing preventative and health home management services, avoiding unnecessary emergency care services due to long term health neglect and financial burden.”
But what would this entity look like? Would the county run it? How much staff would it require? Who would qualify for it?
All those questions are still up in the air, Barnett said.
Board member Phil Brown said it felt like the right direction to him. Hall said if dollars were going out the door for an population management entity, he would lean toward the county running it, rather than giving it off to an existing health care agency.
Board member Ernest “Sandy” Marshall told Barnett that the idea will not advance if it becomes too generous.
“I think we will have a problem telling the commissioners and the public that you are going to do this at the 200 percent poverty level,” Marshall said. “They have already figured out that 40 or 50 percent of the community is at that level. Those are some big numbers.”
James McCloud, one of three members of the public who attended, told the board that dental care had to be a top priority.
“It’s the cost of dental care that is the barrier more than anything else,” said McCloud, founder, president and chief executive officer of Genesis Health Services in Bradenton and Nokomis.
Board member Lori Dengler, who agreed with McCloud that dental care must be a top priority, requested that Barnett research other communities that have population health management programs and how much did they cost and save.
Barnett proposed the creation of a pilot program on a small scale to see how it could work.
A pilot program could be set up by looking at the services currently available and making a creative system, said Cheri Coryea of the county’s neighborhood and community services departments.
The next advisory board meeting is 5-7 p.m. Feb. 22.