CHARLESTON, W.Va. -- Ten thousand uninsured West Virginia workers will get almost-free, nonhospital health care for the next five years through a huge new state-sponsored demonstration project.
Each person will pay no more than $30 a year for unlimited doctor visits, immunizations and screenings, chronic disease management, and minor surgical procedures. So far, more than 2,500 people have signed up at eight participating community health centers, according to a Gazette-Mail phone survey of the centers.
Eligible people can enroll until the slots are gone, said Rick Simon, CEO of Tri-County Health Center, a participating community health center. To be eligible, a person must have a job, be between 19 and 64, and make less than $43,320 for a single person or $88,200 for a family of four. Two centers have set lower limits.
"We're signing up a lot of hardworking people who put in long hours to make a livable wage, but still don't make enough to afford health care," Simon said.
These are people, he said, who make too much for Medicaid, but not enough to afford insurance. "They tell us, 'We never get a break like this.' They can't believe it's for real."
In return, patients will let the state fold their medical data - blood pressure, blood sugar, etc. - into an anonymous 10,000-person database the state plans to use to make more informed choices as health-care reform unfolds.
"With this project, we're going to improve the state's ability to manage chronic disease and show how follow-up care between doctor visits improves people's health," said Craig Robinson, CEO of Cabin Creek Health Services. "It's an opportunity to manage the care of that group the way it should be managed, to collect data and monitor our own performance."
"It's an amazing opportunity for us to provide a true medical home for a large group of working people who need it," he said. "When people are healthier, the state saves money."
West Virginia Connect is funded by a $36 million federal Health Resources and Services Administration (HRSA) grant, which also includes funding for the state health insurance exchange and an electronic system that lets health centers, hospitals and agencies send medical records back and forth easily.
The eight centers applied to participate and were chosen in September by the state Department of Health and Human Resources, which oversees it.
"West Virginia has a wonderful, nationally-known network of community health centers, located all over the state," DHHR spokesman John Law said. "They were the logical choice."
The DHHR got its funding in August 2009 but waited almost a year to begin the project. "We were waiting to see how health reform was unfolding," Law said.
Center directors say the project is intended to:
"This is potentially a very important project," said Delegate Don Perdue, D-Wayne, chairman of the House Health and Human Resources Committee. "We need to be sure [the] DHHR is gathering the information that will help us learn as much as possible from it.
"West Virginia has a long history of setting up terrific projects, but not getting the data we need," he said.
He cited the Medicaid Redesign project, in which the DHHR failed to get baseline data needed to know if participants had improved.
West Virginia Connect is collecting baseline medical indicators like blood sugar and pressure, but center directors say the project has no uniform list of questions for new patients about previous emergency room usage, hospitalization, amount of regular health care, sociological situation, occupation, etc.
"We will get baseline information after we decide what the questions are," said Richard Brennan, project director. "This is the beginning. We're learning as we go."
The project has no advisory council yet, he said. It is governed by a steering committee of the DHHR secretary, insurance commissioner, and director of the GO HELP office. No academic institutions are involved.