How Ucare Complete Integrates Care for People with Disabilities
For more than 20 years, Ron Franke of Hopkins has lived with multiple sclerosis. For the first 18 of those years, he navigated the health care system on his own, managing to stay relatively healthy. Then two years ago, he developed a skin ulcer the size of a fist that landed him in the hospital and then a nursing home for more than a year. “After all that time,” said Ron, “I still had my condominium, but didn’t know how to put the pieces together to move back home.”
For Franke, navigating the health care system was like being in a big black room. “You’re fairly certain everything that you need is in there, but you either don’t know what it is or can’t find it when you need it.” Since joining UCare Complete two years ago and meeting his personal Health Coordinator, Franke believes he has finally discovered a light switch in that big black room. After his extensive stay at the nursing home, his Health Coordinator arranged for repairs to be made to his bed that enabled him to return home. “I can just describe my problem and my Health Coordinator will find a solution.”
Frankehad a skin breakdown shortly after joining UCare Complete; however, rather than a year-long ordeal, he made a six-week recovery at home. He attributes this success to the coordinated care he received through UCare Complete.
Like Ron, many people with disabilities on Medical Assistance experience barriers to coordinated care and integrated services. Without appropriate case management, they receive fragmented specialty care and too little primary care, and often incur costs that could have been reduced, or perhaps prevented.
In hopes of alleviating this problem, the Minnesota Department of Human Services (DHS) created a program that integrates delivery of all Medicaid and Medicare services. The program, Minnesota Disability Health Options (MnDHO), is a partnership with UCare Minnesota and AXIS Healthcare. Called UCare Complete, it offers expertise in health care coordination and support for eligible individuals.
UCare Complete focuses on holistic, self-directed health management. Upon enrollment, an AXIS Health Coordinator conducts a comprehensive assessment to identify the enrollee’s health care needs and together they design an individualized plan – one that maintains the individual’s ability to live independently and builds in appropriate levels of support when needed. AXIS CEO Chris Duff says, “The level of specialization of each plan encourages enrollees to play a more active, informed role in their health care.”
Since its inception in September 2001, nearly 350 working-age, Medicaid-eligible individuals with physical disabilities have enrolled in UCare Complete. Survey findings show that the program is improving the overall health experience of enrollees. For instance:
• 82% of members expressed increased satisfaction with their health care services.
• 95% of the participants reported that their health providers took the time to listen to them in the year following enrollment.
Results appear so promising that the partners expect a significant jump in membership over the next two years. DHS also is exploring expansion of this targeted, voluntary model to other populations of people with disabilities.
Franke describes the difference in his health care as “graphic” because of UCare Complete. “I figure my first skin breakdown cost the state between $50,000-$100,000. In the 20 months that I have been a member of UCare Complete, I’ve been hospitalized twice for a total of two days. Compared to before, that’s a huge difference. It’s cheaper and better–a win/win situation. Plus I have peace of mind. I never feel like I can’t get help.”
Franke is back working part-time. He has flowers planted outside his window, and his daughter can take the bus from school to stop by for a visit. Bottom line, he’s thrilled to be back home.