“We put the checkbook in the hands of case managers.”
That’s how Gia Limanek of the Commonwealth Care Alliance (CCA) explained how CCA is able to keep patients with chronic conditions in their homes and out of the hospital. Sometimes that means purchasing an air conditioner for a patient with asthma – an expense that few would deem medical, but which goes a long way toward helping that patient keep a chronic condition under control during hot and humid days.
Limanek told her story during the Massachusetts Campaign for Better Care’s community forum in Norwood last night. Held at the Morrill Memorial Library, the event attracted a small — but lively — audience that engaged in a good discussion of some of what ails our health care system.
Milton resident Jeff Stone talked about the experiences of a friend of his, a 58-year-old man with chronic mental illness who has been placed in several different facilities ranging from a group home to various nursing homes. Noting that being “bounced around” like that is a sign that something’s not working in the management of his friend Joel’s care. Joel’s condition has deteriorated considerably and several resultant hospitalizations have required care that is costing the system. At this point, Stone said, he wasn’t sure what the best options were for his friend.
One audience member, a nurse who works in home health care, noted that she sees many people with mental health conditions similar to Joel’s. And those with conditions like Chronic Obstructive Pulmonary Disorder, who need constant care monitoring in order to optimally manage their condition, end up deteriorating much more quickly than they otherwise would and see a much-diminished quality of life.
Another audience member, who develops programs for a company that works with seniors, talked of the disconnect that exists between what the patient needs and what policies the state and federal government — via Medicaid and Medicare — will actually pay for.
Which prompted Limanek to once again remind everyone that coordination of a patient’s care coupled with budgeted annual costs — as opposed to “fee for service” — made it fiscally possible to do what was best for the patient. Even if that meant paying for an air conditioner.
The next community forum will take place August 11 at the Brockton Neighborhood Health Center 63 Main Street, in Brockton from 7-9pm.
The campaign will hold forums throughout the state over the next six to eight months collecting consumer stories of their experiences within the health care system.