This issue of the WPA Provider Update features:
- Provider Pledges for 2009
- News about Washington’s Basic Health Plan
- What the Basic Health Plan changes mean for WPA
- Increased Capacity for Physical Therapy
- Patient Thank You’s
Provider Pledges for 2009
We are so grateful for the generosity of our local medical and ancillary providers. We are proud to live in a community that unites to support those in need. Your continued support during these difficult economic times is appreciated beyond measure.
WPA continues to recruit new medical and ancillary providers, financially screen and assist patients with applying for insurance, facilitate fair distribution of donated care, and provide care coordination. In 2008, WPA assisted over 103 people in Whatcom County in accessing care. Thanks to the growing percentage of participating providers and the generosity of the donations pledged, WPA rarely meets capacity for serving patients (i.e uses up the many pledges offered).
With these things in mind, we wanted to give all of our participating providers an opportunity to revisit their original pledge. We are asking that you review and update any contact or billing information as well your pledge for the next 12 months.
In a separate email from Debbie Zmistowski, your practice’s Office Manager will be receiving your pledge form in pdf format within the next few days. If you have any questions or concerns regarding this process, please feel free to contact Debbie Zmistowski, RN, WPA Care Coordinator at 360-788-6547 or dazmistowski@hinet.org. Please return forms via email or fax (360-788-6587). We will continue to utilize the current pledge forms at this time.
News about Washington’s Basic Health Plan
As many of you are aware, Basic Health is the state-sponsored insurance program for low and marginal-income Washington residents in which the state pays an insurance company part of the premium and the member pays the rest.
Washington’s Basic Health (BH) Plan is now closed due to state budget cuts. Since May, Basic Health has started a waiting list. Eligible residents may add their name to the waiting list via the BH website (www.basichealth.hca.wa.gov) or may contact WAHA to assist them with the process. Once it is determined when BH will re-open to new members, people on the waiting list will be contacted with instructions on how to apply.
Additionally, BH has reported plans to cut their current enrollment by 40,000 members. This is a 40% reduction and will be devastating to both the enrollees and their providers. The result will be many more uninsured adults in our state. These cuts are expected to occur by this August. We are awaiting word on which methods or criteria will be used to withdraw members.
Current BH enrollees should be instructed to continue to pay their premiums and follow the recertification process. Any one who does not follow through with these steps will be dropped from the plan. Please feel free to advise your patients that if they have questions regarding their current BH coverage or the recertification process, they can contact WAHA at 788-6594 for assistance.
What Basic Health Plan changes mean for WPA
WPA will continue to screen patients for eligibility for BH. Patients who do not meet previous enrollment measures for BH will not be eligible for WPA. We will also put all WPA enrollees on the Basic Health waiting list and will follow-up with them once BH re-opens. In addition, all patients referred to WPA are screened for eligibility for public insurance options. Likewise patients may be rescreened for public insurance options during their enrollment if their financial or medical status changes.
WPA continues to be considered a transitional program -- not a permanent solution for providing medical care. Every attempt will be made to get appointments for WPA enrollees to set up primary care at one of the community health centers.
In the past, WPA patients who needed assistance beyond 3 months were required to get and keep Basic Health insurance. Thus, after a 9 month “pre-existing” waiting period had expired, any continued care could be billed to BH. With the closing of BH’s doors, more patients may need extended care.
Nearly 70% of the patients enrolled in WPA have completed their specialty care within the initial enrollment period of 3 months. Another 20% have needed follow-up visits through 6 months. However, only a hand-full (the remaining10%) of WPA patients have needed continued care beyond 6 months. For the small amount of patients that may need extended care, we will contact these practices to discuss their preferences for how to provide patients with the care they need.
Increased Capacity for Physical Therapy
Our capacity to assist patients in accessing Physical Therapy has increased thanks to the generous donations of Whatcom Physical Therapy in their Ferndale and Blaine locations, County Orthopedic and Sports Therapy at their locations in Lynden and in Blaine, and Mountain View Physical Therapy in Ferndale. These pledges will be used to support the care provided by our donating specialists which means that WPA will not accept referrals from PCPs for Physical Therapy only.
What patients say about WPA ...
“This program has probably given me more time on earth.”
“I have much gratitude with Project Access for helping me with the hospital debt and making an appointment with the specialist, without your help I would never have been able to see the specialist due to the cost. Thank you and much hope for Project Access helping people like me- Thank You!”- translated from Spanish
I have the pleasure of working everyday with patients who benefit from the care you provide. The gratitude they have for the care they receive as well as the amazement that such a program even exists is a constant topic of discussion. To know that a community has come together to offer medical care to those in need is truly incredible. Thank You-mere words with great meaning that don’t begin to offer you the depth of gratitude for the changes you make in peoples lives!
- Debbie Zmistowski, RN
WPA Care Coordinator
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