MEDFORD, Ore. -- El proveedor de vehículos "Mercy Flights" para emergencias, está contactando gente en el Condado Jackson, fuera de las instalaciones de emergencia. Se trata de un modelo de atención preventiva que busca mantener a las personas fuera del hospital.
Los primeros en brindar atención van más allá de las emergencias, para apoyar a la gente en el sur de Oregon. "Mercy Flights" (Vuelos de Misericordia) es proveedor de transporte de emergencia en el Condado Jackson.
Meg Wills, de la organización "Jackson Care Connect", dice que su organización colabora con Mercy Flights para que un equipo de paramédicos especialmente capacitados pueda implementar un sistema único de apoyo para gente que llega con frecuencia al hospital.
"Lo que pueden hacer los paramedicos integrados ambulantes de "Mercy Flights Mobile" es cubrir de cuidados a la gente que haya sido identificada en esas condiciones agudas y asegurarse de contactarla con los servicios, que idealmente evitaran que vuelvan a internarse en un hospital."
Wills dice que el equipo ofrece hasta 30 días de apoyo adicional luego de que se les da de alta, incluyendo una evaluación y ayuda a domicilio para, por ejemplo, enseñar a las personas sobre sus medicamentos.
Sabrina Ballew, Supervisora del programa de Atención Integral a la Salud en "Mercy Flights", dice que los paramédicos de este programa pueden evaluar a las personas en donde sea.
"Los veremos cuando les acomode. Pudiera ser en la calle, en una esquina, en una cafeteria, en sus casas."
El equipo tiene bastantes soluciones a su disposición. Pueden contactar gente con tratamientos con medicamentos para evaluar un abuso de substancias, o para repartir cajas de alimentos, lo que ha sido especialmente importante durante la pandemia del COVID-19. Ballew dice que la ayuda puede ser tan sencilla como conseguirle a alguien su medicamento.
"Se les da de alta pero no tienen en que regresar para recoger sus medicinas, o sus medicinas no estan listas, o simplemente no tienen fuerzas o no entienden el proceso. Asi que nuestro equipo va, recoge sus medicinas y se las lleva a su casa."
Willis dice que entre 75 y 80 por ciento de la gente que contactan se inscribe al programa. Agrega que uno de los factores más poderosos es cómo son los paramédicos itinerantes.
"Andan por la comunidad y en verdad contactan a la gente en esos momentos cuando hay oportunidad de realmente reflexionar y pensar sobre... 'Que es lo que necesito en este momento para ya no regresar aqui?'"
Quienes atienden primero las llamadas van mas alla de las emergencias y apoyan a la gente del sur de Oregon.
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A recent report examined how some rural Tennessee hospitals have managed to stay afloat despite financial challenges.
The report includes interviews from staff at five different rural hospitals, which range in size from 25 to 125 beds.
Judy Roitman, executive director of the Tennessee Health Care Campaign, said some of the hospitals are drowning in uncompensated care. She explained as part of their research, they did an interview with a CEO from a rural hospital in Kentucky who expressed the importance of Medicaid expansion.
"Kentucky has expanded its Medicaid program and Tennessee has not," Roitman pointed out. "He said that's the key to our stability is actually having the funds coming in to treat these patients. And the CEOs and others in Tennessee hospitals said it would make a huge difference to have that federal funding."
Roitman added the federal government is offering Tennessee a nine-to-one match. If Tennessee were to expand Medicaid, at least 330,000 people would gain access to coverage.
Roitman pointed out the report suggested further steps hospitals could take, including examining how they are reimbursed for services provided. She noted private insurance plans tend to provide the highest reimbursement rates, and said more funding is needed to support TennCare, which does not cover enough of the cost.
"TennCare is all managed by managed-care organizations," Roitman explained. "They negotiate with every hospital about how they're going to reimburse and the big hospitals have some leverage to demand better payment and the smaller hospitals are just, they're just not getting paid."
Roitman added the report credited strong community engagement and effective hospital leadership as key factors in staff retention. Robust management and maintaining an engaged workforce significantly affect a hospital's viability, according to the report.
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Medicare and Medicaid are key sources of health coverage for many Americans and some people qualify for assistance under both programs. With lagging enrollment for the unique plans, outreach efforts are underway.
According to KFF Health News, only about three in 10 people who qualify for Dual-Eligible Special Needs Plans were enrolled in 2021. Experts said the option is designed for people who need additional help because of disabilities, certain health conditions or their age.
Dr. Gina Williams, associate medical director for UnitedHealthcare, said the plans try to take a dynamic approach to serving those eligible.
"Everything from managing your wellness to managing your behavioral health needs and then everyday needs," Williams outlined. "It's kind of a more comprehensive package for people who need a little bit more support."
Everyday needs include meal benefits and bathroom safety devices. The National Council on Aging said D-SNPs aim to provide a more streamlined coordination of care because there is assistance in arranging the services. Wisconsin's enrollment numbers are similar to the national rate, at 28%.
Christine Huberty, lead benefit specialist and northern region supervising attorney for the Greater Wisconsin Agency on Aging Resources, said a tricky component of the plans is navigating provider network restrictions. A rural resident might have to travel farther to see a doctor covered under the plan and she cautioned it warrants careful research when enrolling.
"I would say first and foremost, look at the provider network restrictions," Huberty advised. "Look at what's available in your area."
Meanwhile, Williams noted the push to get more eligible people to sign up coincides with more awareness around preventive care in a post-pandemic world.
"Everybody's kind of going into a phase where they're not only thinking about acute illness, but they're thinking about overall care," Williams observed. "What was the impact of the pandemic from a psychological standpoint? Do you need more support and then you also need more coordination of benefits?"
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In Mississippi and across the country, Community Health Centers are getting a funding increase, thanks to Congress passing a bipartisan spending package.
Community Health Centers in Mississippi serve patients without regard to their insurance status or ability to pay. More than 20 locations in the state provide medical care to more than more than 380,000 people.
Joe Dunn, senior vice president of public policy and advocacy for the National Association of Community Health Centers, said roughly one in 11 Americans gets their care from this type of clinic.
"Community Health Centers are the largest primary care network in the nation, providing care for 31 million Americans," Dunn pointed out. "This network is critically important, because they provide primary care, behavioral health, dental; just an array of services that are so critically needed."
Dunn emphasized more can be done. Research shows more than 100 million Americans need better access to primary care. Community Health Centers in Mississippi also support more than 4,000 jobs and about $678 million dollars in economic activity in the communities where they're located.
Dunn noted the increased funding from Congress will help the clinics provide more comprehensive care and reach more underserved patients, especially in rural communities, which ends up saving the state money.
"By incentivizing people to go get primary care, you alleviate more downstream costs," Dunn emphasized. "There's fewer hospitalizations and complications from chronic conditions, based on preventive screening and care at the outset."
The Congressional Budget Office reports the increase in funding for Community Health Centers just through the end of this year will reduce federal spending on public health insurance programs by more than $700 million.
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