DHS news release
Published Aug. 20, 2005, by the Salem Statesman-Journal
By Bryan Johnston, Interim Director
Length: 511 words
Health plan's commitment to prevention is a lifelong payoff
The Marion County woman did drugs and, as a result, the Oregon Department of Human Services took her children into foster care for their safety. Her illegal drug use -- and her unwillingness to seek treatment -- meant she was unable to properly care for her children.
When her doctor learned that she was pregnant with another child, his office contacted her medical insurer, the Marion Polk Community Health Plan.
A plan employee made multiple calls to locate the woman to tell her about the medical benefits available to her as an expectant mom.
It was a teachable moment: The woman was motivated to enter drug treatment, her baby was born healthy and, because of Mom's lifestyle change, she got to take the baby home with her.
This shows how the local health plan, owned and operated by 480 local physicians, tries to improve the health of the 35,000 Marion and Polk county Oregon Health Plan enrollees it serves. It's also an example of how it goes beyond what the state requires, ideally resulting in healthier local residents, more cost savings and fewer tragic medical outcomes.
Here's why it's important: At any given time, 700-800 Marion and Polk county women enrolled in the Oregon Health Plan are pregnant. It's known that babies are more likely to be healthy if Mom doesn't use tobacco, alcohol or other drugs and also enjoys good dental health.
It's no surprise that pregnancy is the best time to persuade women to attend to all of these things. Moms want healthy babies.
Although a single healthy baby is reward enough, spending money up front to avoid a low-weight delivery saves thousands of dollars in rehospitalizations, treatment for chronic conditions, medical foster care and other costs.
The plan's work produced early significant gains in women enrolling in prenatal care, including during the first trimester. New research will document whether gains were sustained or expanded.
The Marion-Polk health plan offers $25 gift certificates to doctors' front-office staff to provide prompt information about patients who are pregnant, this to help them reach the women early to connect them with resources that result in healthy babies.
Marion Polk Community Health Plan pays for pregnant women who smoke to enroll in Salem Hospital tobacco-cessation classes, offering a $50 gift certificate for completion. One woman who quit both tobacco and illegal drugs said she wanted to use the $50 to buy things for the baby she couldn't afford.
Because women want healthy babies, pregnant women are more likely to disclose alcohol or other drug use; women are referred for treatment at Bridgeway, and the health plan will soon offer mentors to recovering women using a model successful at Marion County Corrections.
The health plan is also exploring how to ensure that women's dental disease is identified and treated early.
Bottom line: By spending more money than required up front, an insurer can avoid costs in the long run for itself and for the tax-supported Oregon Health Plan. The Marion Polk Community Health Plan is showing that helping people improve their health is also good business.
Bryan Johnston of Salem is interim director of the Oregon Department of Human Services, which contracts with the Marion Polk Community Health Plan for Oregon Health Plan services.