The community of Duluth, Minn., will soon begin a pilot program designed to help small businesses that cannot afford to provide health insurance to their employees.
With $5 million in funding over five years from the Minnesota Legislature, the program - called HealthShare - will focus on cost and access to quality care for the uninsured, said executive director Dan Svendsen.
The coverage program will include a disease management component and emphasize prevention and wellness, health education and health status improvement, according to program director Jenny Peterson.
HealthShare's goal to increase access to healthcare is a two-step process - getting eligible people into state programs such as Medicaid and catching the two-thirds of the working uninsured who "fall through the cracks," said Svendsen.
St. Luke's Hospital in Duluth became a pilot participant because HealthShare was aligned with its broader community mission of caring for the underinsured and uninsured. Partnering with HealthShare was the "next logical progression," said JoAnn Hoag, vice president of St. Luke's and HealthShare board member.
"There are so many small employers with no mechanism for insurance," she said. "The traditional model that is already available is not working."
HealthShare is based on Access Health, an eight-year-old program in Muskegon, Mich. Although executive director Jeff Fortenbacher loosely described Access Health as a self-insured group, he said it is successful precisely because it doesn't "fall under the insurance umbrella."
With oversight by Michigan's Department of Human Services, Access Health has established community ownership and partnership between the program, providers and businesses.
"We need everyone in the community, most notably our providers, to buy into this," Fortenbacher said.
Over eight years, Access Health's premiums have increased less than one percent, from $42 Per Member Per Month to $46 PMPM, enabling companies such as Muskegon-based Pioneer Resources to provide health insurance to its part-time employees.
"Without insurance, there was no incentive for them to stay with us," said Pioneer Resources business director Susan Dennison. A nonprofit agency that assists people with disabilities, Pioneer has experienced low turnover since offering Access Health in 2001.
Both Peterson and Svendsen have great expectations for HealthShare.
"If we can get one person who is diabetic, but doesn't know it, to a primary care physician, then we've done our job in our community," said Peterson.