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June 15, 2012 - Patient Care Network Program Being Implemented for Mobile, Washington Counties

Last year, the Alabama Medicaid Agency created the Patient Care Networks program, which consists of independent, nonprofit patient-centered health networks that provide coordinated care to Medicaid recipients.

Initially piloted in three areas – East Alabama, West Alabama, and North Alabama – the program has demonstrated a 7.7 percent decrease in the total cost of providing care to Medicaid patients in these areas. A statewide rollout of the networks has begun, and beginning July 1, 2012, Mobile and Washington counties will be associated with the Gulf Coast Patient Care Network, Inc.

Laura O’Connor (pictured at right), executive director of the new Gulf Coast Patient Care Network (GCPCN), said the network provides a system of care coordination, including care management and pharmacy services, to serve Medicaid patients in our area with chronic disease and/or mental illness.

“We are developing a patient-centered network that facilitates access to and coordination of the full array of community-based health care services in partnership with local providers,” said O’Connor, who is responsible for overall operations of the network and serves as liaison between the network and the Alabama Medicaid agency.

With this network, members of the health care team work together to provide a high level of coordinated care that accomplishes the simultaneous goals of higher quality, greater patient access and lower costs.

“In a time of tightening budgets and a push at both the state and national level to control costs, this project is invaluable because it identifies areas where we can reduce costs while maintaining or improving care,” O’Connor said. “At the same time, we’re providing enhanced services to the neediest patients, and it ensures that each individual patient is getting the appropriate resources.”

The new network is based on an existing patient-centered medical home initiative within the Alabama Medicaid program known as Patient 1st, which gives Medicaid beneficiaries access to medical homes. Patients either choose a primary care practice to be their medical home or Medicaid officials assign them to one.

GCPCN will partner with all Patient 1st providers in Mobile and Washington Counties, including the University of South Alabama Health System, the Bayou La Batre Health Development Board, Franklin Primary Health Center, the Family Oriented Primary Health Care, and private practice physicians. GCPCN will also provide case management services in support of these partners.

According to Becky Tate, chief executive officer of the USA Health Services Foundation and president of the board of directors for GCPCN, the USA Health System is excited to be part of this innovative program.

“We look forward to working with our network partners in improving the health of our community,” Tate said.

According to O’Connor, the USA Center for Strategic Health Innovation will provide medical informatics services to Medicaid for use in this program. “All providers will participate in quarterly medical management committee meetings.” O’Connor said. “They will review trends and patterns of care delivery to identify best practices, as well as areas needing follow-up.”

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