Pioneering Hennepin County reform is delivering results.
For Eddie Johnson, a 48-year-old client of Hennepin County’s pioneering medical program for low-income adults, the path to good health doesn’t end at the doctor’s office. It includes visits to Rise Inc., a metro nonprofit that helps those with disabilities or behavioral health issues find a job and housing and achieve self-sufficiency.
Johnson, who suffered a traumatic brain injury when he was younger and also has extensive arthritis, now has a job at an industrial bakery. With help from Rise staffer Pat Meacham, whose organization provides contracted services to Hennepin Health enrollees, Johnson is hoping to end a long span of homelessness and rent an apartment.
Johnson, who dropped out of grammar school but eventually earned a GED, is optimistic because he has his medical challenges under control and receives encouragement from Rise staffers. For the first time in a long time, “I’m in positive situation,’’ he said. After the housing “barrier” is crossed, “the sky’s the limit.’’
The expansive, not-limited-to-the-doctor’s-office approach taken to improve Johnson’s health is a key reason why the Hennepin Health program is among the nation’s most innovative health reform efforts. Now in its third year, the county-led program, which serves some of the metro’s poorest and sickest patients, keeps delivering impressive results.
The latest data released by the program underscored why it continues to accrue accolades and should be looked to as a national model. It’s also a reminder that the private sector doesn’t have a monopoly on health care innovation.
From 2012 to 2013, emergency treatment among enrollees fell more than 9 percent, according to the county. Inpatient hospital admissions also dropped by 3.2 percent. At the same time, the percentage of patients getting “optimal care” for asthma, diabetes and vascular conditions increased. So did enrollees’ satisfaction.
Even more impressive statistics came from Hennepin Health’s visionary work to address the root causes of its clients’ health challenges — joblessness and homelessness.
About 8,800 low-income adults without children are now enrolled. The program is a partnership between Hennepin County Medical Center, Hennepin County Human Services and Public Health, the county-owned and operated Metropolitan Health Plan, and NorthPoint Health and Wellness Center. NorthPoint is a federally qualified health center.
It’s this partnership that allows Hennepin Health to weave social services into patient care and gives the program new financial flexibility to innovate and focus on prevention. The program is paid a set amount by the state’s Medical Assistance program to care for each patient. Assuming the financial risk of overages allows Hennepin Health to plow the savings it finds back into the program and use the money in broader ways to improve patients’ health.
That’s how Rise’s contract to provide job assistance to clients like Johnson came to be. Recognizing poverty’s link to illness and emergency room visits, Hennepin Health staff began addressing joblessness and homelessness to improve health and reduce dependency on government programs. While the number of patients using its services was small in the contract’s first year, the results were promising.
Costs for patients who were placed in jobs dropped 60.3 percent (measured on a per-member-per-month basis). Costs for those who went through Rise’s intake but weren’t placed in a job fell 18 percent.
Hennepin Health’s focus on housing also paid off. The program worked to provide “supportive housing” for 112 enrollees classified as medically complex.
Among that group, emergency room use dropped 55 percent, hospital admissions fell 28.8 percent and hospital costs declined 72 percent, according to the county.
One data point in particular is an eye-opener: Keeping one patient out of a hospital bed for one day is enough to cover a month’s housing for a Hennepin Health enrollee getting housing assistance.
Programs like Hennepin Health should be championed loudly by Republicans and Democrats in the coming election season. The program’s bipartisan appeal is clear. It aids the most vulnerable and provides quality, life-changing care. At the same time, it’s spending public dollars more efficiently while putting those who are able on a pathway out of poverty.
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