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Life Health > Long-Term Care Planning

University to test 'medical home' plan

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COLUMBIA, S.C. (AP) — The Medical University of South Carolina is getting the chance to try out a new way of providing health care for its employees, in an experiment that could pave the way for changes for all state employees.

On Tuesday, the Budget and Control Board approved the school’s proposal for a one-year pilot program, which would create a “patient-centered medical home” for the university’s 18,000 employees. Workers and their families would get health care through a more centralized system, with case managers helping ensure they get the most effective, efficient care.

Employees would be able to pick from the university’s primary care doctors, all of whom have been certified to provide that level of care, according to Pat Cawley, the university’s chief executive officer.

Cawley said Tuesday the program would incentivize people to first seek out their primary care providers instead of going to an emergency room — visits that can be time consuming and costly, for all parties involved.

“We’ll try to persuade them to go over to the medical home office,” Cawley told the board.

Those incentives could include lower deductibles. Comptroller General Richard Eckstrom, one of the Budget and Control Board’s five members, said Tuesday that the real deciding factor of the program’s success would be the costs — and savings — borne by employees themselves.

“That’s going to be the driver,” Eckstrom said.

The program, approved earlier this year by the Public Employee Benefit Authority, goes into effect Jan. 1. If it’s successful, South Carolina could implement something similar for all state employees as part of an ongoing effort to hold down costs.

“Primary care is very important,” Gov. Nikki Haley, R, who chairs the Budget and Control Board, said. “Preventative care is very important. If you focus in on those two, it should be very effective.”

Also Tuesday, the Budget and Control Board unanimously approved changes to the health plan that covers all state employees. That proposal increases employer premiums by 6.8 percent but keeps subscriber rates the same. But co-pays and deductibles would go up by 20 percent, a change Eckstrom praised.

“I think it’s a lot easier for many users of the health plan to pay during office visits and to pay deductibles than it is to have a fixed increase in premium costs,” Eckstrom said. “Either way, the costs are spread, and that’s the sort of focus that needs to be maintained.”

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