Medicaid Managed Care - U.S. Senate Special Committee on Aging

164 Communicating the Quality Message
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Sasha make an appointment with a dentist, he also arranged for Sasha to have free transportation
service to and from the dentist's office and for a Russian-speaking interpreter to
meet him there so Sasha and the dentist could effectively communicate with each other.
For Moua, Sasha, and many other <strong>Medicaid</strong> recipients, having health care coverage
does not necessarily mean having access to health care services. Nor does it mean being able
to follow a doctor's prescriptions for getting or staying healthy. <strong>Medicaid</strong> recipients are, by
definition, people with low incomes, which means they often have pressing social needssuch
as finding housing or keeping a telephone connected-that take precedence over getting
health care, especially preventive care. Indeed, because of a lack of affordable transportation,
many <strong>Medicaid</strong> recipients have trouble just getting to a doctor or dentist. And
even when they do make it to the office of a health care provider, <strong>Medicaid</strong> recipients often
face language or cultural barriers that make it difficult for them to understand what the
provider is advising them to do about their illness.
As Minnesota's largest provider of <strong>Medicaid</strong> managed care, Medica Health Plans understands
that serving low-income populations requires more than simply providing quality
health care services. If a managed care system is going to be truly effective in helping lowincome
people lead healthier lives, it must address their social concerns as well as their medical
ones. That's not to say that Medica or any other managed care organization can take
on all the social and public health problems of its <strong>Medicaid</strong> enrollees. But if the social problems
of <strong>Medicaid</strong> members are not considered at all, those members are likely to get lost in
the complexity of the health care system and will not get the medical care they need.
In recent years, Medica Health Plans has played a leading role in identifying the obstacles
that Minnesota's vulnerable populations face in accessing health care. It has also been
a leader in developing and implementing innovative ways of enabling people to overcome
those obstacles. These efforts have presented the company with a variety of often daunting
communication challenges. For example, how do you effectively present information to a
group of people who understand little or no English, but who individually speak more than
100 different languages? How do you educate people about the need for preventive medicine
when they are struggling with poverty, family violence, hunger, and homelessness? How
do you send health care messages to people who have no telephone nor even a permanent
address? How do you explain to people what their health benefits are when they have just
immigrated from a culture where medical treatment consisted of herbs and spells dispensed
by a village shaman?
Meeting these communications challenges requires managed care organizations to think
in creative, nontraditional ways. The standard communications methods used to reach
health plan enrollees-newsletters, informational packets, customer service phone linesare
frequently ineffective with more vulnerable populations. So although <strong>Medicaid</strong> recipients
must be treated the same as other health plan enrollees in terms of the quality of care
they receive, their very special needs require new and innovative methods of communication.
Indeed, with vulnerable populations, communication takes on a much broader definition.
It includes, for example, such nontraditional tasks as arranging for foreign language
interpreters, keeping a pregnant woman's phone service from being disconnected so her prenatal
nurse can keep in touch with her, or helping a woman find shelter from an abusive
spouse. All of these actions, however, have the same central focus: making it easier for
<strong>Medicaid</strong> recipients to access medical care.
Although Medica Health Plans' efforts in reaching and helping its <strong>Medicaid</strong> enrollees
are by no means complete, it has already experienced some major successes. In fact, a recent
independent survey of thousands of Minnesota's health care consumers found that <strong>Medicaid</strong>
recipients in managed care plans are the most satisfied health care consumers on <strong>Medicaid</strong>
in the state.