How Methodist tackled the ACA head on

Hospital implements healthcare reform with cutting-edge patient/employee education initiatives.

By Freida Campbell

For Kentucky, healthcare reform is more than just a statewide transition — it’s a matter of national attention. The state’s transition to the new regulations within the Affordable Care Act (ACA) remains in the national spotlight, since Kentucky smoothly planned its Medicaid expansion and successfully launched the state’s health insurance marketplace, kynect, offering both private and Medicaid insurance.

With industry-wide change comes great responsibility, both statewide and at the local level. The changing landscape of healthcare has left many Kentucky citizens confused about the future of their benefits coverage. While state officials have worked hard to educate consumers on their options, providing crucial information and resources also lies in the hands of local hospitals.

In 2011, Kentucky faced a budget crisis and increasing cases of costly health issues, including morbid obesity, diabetes and respiratory illnesses. As a result, the state undertook a complete overhaul of its state-run Medicaid program and made the transition to a managed care delivery system. This forward-looking approach allowed hospitals across the state, including Methodist Hospital in Henderson, Ky., to work with managed care organizations to coordinate healthcare for Medicaid patients. Methodist was able to successfully adapt to this transition while staying committed to providing quality healthcare to all patients, paving the way for tackling healthcare reform.

Facing the ACA

To face healthcare reform head on, Methodist needed first to look inward to streamline processes and procedures that would be impacted by rollout of the ACA. Working in partnership with Accretive Health, a market leader in revenue cycle management, Methodist planned to leverage its existing resources and personnel to better serve its patient communities.

The first step was hosting an October 2013 Kaizen event that focused on interdepartmental awareness and operational preparations for the ACA, and creating a unified, lean process for the launch of the kynect state exchange and Medicaid expansion, launching January 1, 2014. (Kaizen refers to the philosophy of continuous improvement of processes.)

More than 20 Methodist Hospital leaders participated in the week-long event, which developed a set of best practices for the development of organizational resources and aligned staff with the mission of leading patients through the ACA transition. This is one of several initiatives that have positioned Methodist as a leader in the implementation of the ACA within the region.

Effectively implementing the ACA at Methodist Hospital meant not only educating staff, but also ensuring that patients were equipped with the information and tools they need to make smart benefits decisions. Of the 15 percent of Kentucky citizens who are uninsured, nearly half will qualify for the expanded Medicaid program. Those remaining can choose among state-approved insuranceplans offered through kynect.

Assistance Stations
To tackle the diverse needs and questions of hospital patients and the local community, Methodist established nine kynect assistance stations in the hospital’s Henderson facility and facilities in surrounding counties. The self-service kiosks enable users to access certified application counselors (CACs) who have undergone federal training to help people understand, apply and enroll for healthcare coverage through the state exchange.

Methodist also completed a physical redesign of the facilities to accommodate these kiosks and the influx of users — who are not required to be patients of Methodist, but may need assistance in navigating complex benefits options or the application process through kynect.

The response to the hospital’s initiatives has been tremendous. In fact, a recent patient sent a thank-you note to express her gratitude. She began by explaining that her mother has not had healthcare coverage for years. After navigating her options and applying through a kynect kiosk, her mother called her, and in joyful tears, shared that she is now covered. After continued stress over her mother lacking insurance, this patient was grateful that her mother was finally able to secure the coverage she needed thanks to the support of Methodist staff.

Moving Forward
As the ACA rollout continues across the nation, Methodist will continue its marketing campaign, which focuses on community awareness and the services and support that Methodist offers. Initiatives include the launch of a Methodist Hospital Facebook page with regular activity and policy updates, as well as sharing news and materials with the community through local organizations, health fairs and more. Methodist also added language on the ACA transition to the hospital’s written communications with patients.

Looking ahead, Methodist will further its mission of providing access to outstanding care by focusing on patient-centered initiatives and advocacy. The hospital plans to continue calling upon its strategic partnership with Accretive Health throughout the ACA rollout and beyond to navigate the ongoing transitions that are required as national healthcare reform trickles down to local markets.

Through forward-thinking initiatives and strategic partnerships, Methodist Hospital is positioned to remain at the cutting edge of patient care for generations to come.

Frieda Campbell is director of Data/Process at Methodist Hospital in Henderson, Ky.