CareNet members' visits to ER fall 25%

3/2/2012

Emergency room visits by Toledo/Lucas County CareNet members have dropped by a quarter in the last five years, a clear indication the program's goal of providing health care to uninsured residents is working, a CareNet official says.

While CareNet's roughly 5,000 members received nearly 15,500 primary care appointments in 2011, a slight increase from the year before, the number of emergency room visits that year alone declined 7 percent. And CareNet members also had a 28 percent decrease in inpatient hospital days between 2010 and 2011, according to a recent report.

Jan Ruma, CareNet's executive director, said CareNet members largely are going to primary care doctors and keeping their conditions in check instead of waiting to get care, which typically results in emergency room visits and hospital stays.

"It just kind of proves that prevention works," Ms. Ruma said. "Our numbers over time have really shown that.

"Because we have all the pieces together, their health is being managed in primary care."

CareNet got its start nearly 10 years ago, when then Toledo Mayor Jack Ford urged health-care providers to work together to help the uninsured. Lucas County residents are eligible for CareNet if they have no other health insurance and their total household income is at or below 200 percent of the federal poverty level, or $46,100 for a family of four.

The nonprofit's provider network includes Mercy, ProMedica, University of Toledo Medical Center, Neighborhood Health Association, Toledo-Lucas County Health Department, Academy of Medicine of Toledo and Lucas County, and Dental Center of Northwest Ohio. Besides providing care, Mercy, ProMedica, the former Medical College of Ohio, and Academy of Medicine are among organizations that contribute money to CareNet.

"I really feel good about CareNet in the Toledo area," said Dennis Newsom, president of Pharmacy Counter, which is part of ProMedica and provided nearly 15,500 low-cost prescriptions to CareNet members last year.

Added Mr. Newsom, who is involved with CareNet's board: "We're a good example of how health systems can work together in a community to provide care to our own."

Last year, CareNet had income of $415,528 primarily from contributors, grants from United Way of Greater Toledo and other sources, and fund-raising efforts. Its network, meanwhile, provided more than $15 million worth of primary care, outpatient services, surgeries, hospital stays, emergency department visits, specialty consults, prescriptions, and other services last year based on Medicaid rates, according to a recent report compiled through a grant from Jackson Healthcare, an Atlanta staffing firm that does research and charitable work.

CareNet enrolled 7,319 members overall last year, down from 8,076 in 2010, when nearly $13 million worth of care was provided.

At Mercy, the hope is to add 2,000 CareNet members by year's end to total nearly 2,900 after capacity issues caused membership there to drop last year, said Sue Spiess, regional director of Mercy's financial assistance program.

"We're real excited about that," Ms. Spiess said. "It's just a great program."

Not only is there a need for health care among uninsured residents, but CareNet makes sense because a range of services are provided, Ms. Spiess said. CareNet members even receive TARTA bus passes to get to medical appointments, she noted.

Still, not all about CareNet is rosy, said Ms. Ruma, the executive director who also is vice president of the Hospital Council of Northwest Ohio.

While there are more than 230 physicians volunteering their services, for example, there remains a need for podiatrists, dermatologists, otolaryngologists, and other specialists, Ms. Ruma said. Last year, 28 percent of specialtycare referrals were not filled for CareNet members, according to the recent report.

Contact Julie M. McKinnon at: jmckinnon@theblade.com or 419-724-6087.