A Conversation with... Ellen Rabinowitz

The following is a convesation with Ellen Rabinowitz, Executive Director of the Washtenaw Health Plan.  The WHP has recently made some organizational changes that will benefit both clients and staff alike.

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I know you have some exciting changes taking place at the WHP but, first of all, can you give some background on the Washtenaw Health Plan, and who participates?
The WHP is a collaboration of a number of provider partners that include the County, the two major health systems – University of Michigan and Saint Joseph Mercy, along with the community’s ‘safety net’ clinics and independent providers who offer health care services. The WHP was created to provide health care for individuals who do not have insurance and have few, if any, other options for services.

So, the WHP is not health insurance?
Yes, that is one thing to remember: the WHP is not health insurance. Even though it looks like insurance and, for our members, having that card with them should feel no different from having a Blue Cross/Blue Shield card in your wallet. We intentionally designed the program to make sure that our clients are treated just like the person who is covered by Blue Cross – to avoid that stigma that can develop around being uninsured or being in a government program.

The WHP seems to be receiving more recognition these days, more signage references at local pharmacies and mentions in the media. Why is that?
Demand for services through the WHP is skyrocketing. We’ve been moving along, growing incrementally at a fairly steady pace of 15% each year. In this past year, our enrollment has grown by 40%.

To me, that’s a sign of the downturn in the economy. In fact, we’re seeing a whole lot more of what you might call “middle class” individuals applying for the program and we’ve added an “assets test” to make sure that the people receiving care through the WHP are those who need it most – who just have no other options. And this is another way in which our new enrollment process will be helpful.

How has the enrollment process changed?
The changes are being made to enhance customer service. We’re moving from an enrollment that was largely a paper application process to comprehensive, face-to face and interactive assessments to help us understand our clients’ eligibility for a number of programs – not just the Washtenaw Health Plan. We believe that many of our members are eligible for other programs – food stamps, pregnant women who should be diverted to Medicaid to cover the care they need during their pregnancies, immigrants who may be eligible for ESO (Emergency Only) Medicaid - and many more – but people just don’t know about them, or how to access them.

The WHP is, for all intents and purposes, the health care provider of last resort. We want to make sure that if someone is Medicaid eligible that they know how to access those services.  These enhancements to the program have been in the planning for the last six to eight months, and we’ve already piloted this new face-to-face enrollment process. And we’re all pretty excited about this opportunity for a greater, more constructive connection to our customers.

As a member, or prospective member, what will be different?
Now, in this new comprehensive process, they meet with a WHP customer service specialist – we have both walk-in hours and we schedule appointments. Those 30 to 60 minutes also offer an opportunity to educate our clients, or would-be clients, on how to navigate the health care system.

Many of the folks who enroll in the program have been uninsured for a long time; maybe they’re immigrants who come from places where delivery of health care services is very different. So, we’re now able to let them know, right from the beginning, what services are available and how to access them. We can help them understand how important it is to have a strong relationship with their primary care provider, not go to the Emergency Room unless it’s a true emergency, and more. It’s a great way to provide upfront member education.

You mentioned that you’re seeing more “middle class’ people who are uninsured and looking for answers. Will the new enrollment process be helpful to them, too?
People who have been laid off and who don’t understand their options can be as unsure and frightened as anyone else. This new focus on the customer in our enrollment - finding the best way to help each individual person – will ultimately identify the best path to health care in every case – whether or not the person enrolls with WHP.

Are there any other changes for WHP?
Well, yes.  All of our present members should have received a new card, and a new prescription card during the month of December as we have changed vendors for the administrative functions of the Plan. It’s an important enhancement to the Plan but, other than the new cards and new toll-free phone numbers for member or provider services, this change will be largely seamless.

We’re moving our administrative functions from the Washtenaw Community Health Organization (WCHO), to the Ingham County Health Department’s Bureau of Health Plan Management Services. They will be doing all the claims management, much of the provider relations functions, data management services and they will be the call center for WHP. This organization provides these services for at least 16 other County health plans operating in 54 counties across the state. We felt that, rather than recreate that expertise locally, it made more sense to avail ourselves of a proven entity like the Ingham County system.

Calling the toll free numbers will put a provider or a member in touch with a person who has all the files and facts for Washtenaw Health Plan. There will be no noticeable impact on the delivery of services. And, of course, we will still have liaisons at the hospital systems who will help manage care, and we continue to have case managers who work directly with our members who might need assistance to better access their care.

It sounds like the WHP is attempting new efficiencies to help with the growing needs.
Exactly. It all goes to the mission set out by the Washtenaw Health Plan Board: to expand access to health care and improve the health status of low-income uninsured County residents by developing programs in partnership with local health care organizations. These changes are going to move us further along toward achieving that mission.