HEALTH CARE:
Recession frays a health care safety net for low-income Nevadans
Medical group, serving poor and uninsured, struggles to survive
Mona Shield Payne / Special to the Sun
Horencia Sanchez, 36, discusses her dental options Tuesday with office clerk Carmen Garcia at the Nevada Health Centers location at 2212 S. Eastern Avenue. The increase of uninsured patients has hurt the nonprofit Nevada Health Centers, which has 33 locations across the state.
Wednesday, April 21, 2010 | 2 a.m.
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The weight of the recession is pushing Nevada Health Centers, the medical safety net for tens of thousands of low-income Nevadans, to the financial breaking point, officials with the nonprofit organization say.
The number of patient visits is up 25 percent to about 205,000 a year, and an increasing number of them — almost three in 10 — are uninsured, Nevada Health Centers CEO Tom Chase said. And when the uninsured agree to greatly reduced payment plans, they frequently stiff the agency.
The result is what Chase diplomatically calls a “cash pinch.” The organization is behind in paying its own bills, has had to restrict access for patients who don’t pay their bills and came close to not meeting payroll, he said.
This month the federal government gave Nevada Health Centers temporary reprieve in the form of a $1.7 million advance on a $35 million, five-year grant. Now the organization has about $750,000 in the bank, with expectations that it will increase, Chase said.
Chase is scheduled today to talk about his organization’s struggles before the Legislative Committee on Health Care. Over the long haul, if the recession continues, services to people who can’t pay will be limited unless the payer mix can be improved, Chase said.
“We’re going to be forced to make hard decisions about services and sites,” he said.
More than 600,000 Nevadans are expected to be without health insurance in 2010. Nevada Health Centers is a $28 million organization that qualifies for federal grants and funding because its 33 locations are in far-flung towns such as Beatty and Elko and blighted urban parts of Las Vegas and North Las Vegas. Patients who qualify get discounts on services. A typical physical examination and medical history, with lab tests, costs about $45 for a low-income patient — about half what it costs the organization, Chase said.
The organization’s struggles are bad news for people such as Patricia Annis of Henderson. Annis, 67, is a retired legislative aid whose teeth are breaking. She’s desperate for care and heard about a Nevada Health Centers’ program providing free dental work to low-income elderly patients. Her $733 a month in Social Security income qualifies her.
“I’ve had two teeth die on me,” Annis said. “I’ve had to find a way to get temporary treatment from a private dentist, but I need a root canal.”
The problem is Nevada Health Centers is flooded with low-income elderly with dental needs, Chase said. The $150,000 dental-care grant was divided evenly between Nevada Health Centers in Elko and Las Vegas, and the money is going fast, Chase said.
“The need is incredible with each of these patients,” he said. “They’ve had no dental work in years.”
Annis has been on the waiting list for months and is frustrated with Nevada Health Centers. But Chase said it’s slow going because his people are doling out the grant funds patient by patient, sometimes as much as $4,000 a pop.
Chase said the payer-mix problem is partly attributed to the low percentage of patients covered by Medicaid, the state government’s insurance program for low-income residents. Most federally qualified health centers have 36 percent of their patients covered by Medicaid, he said, but it’s only about 20 percent for Nevada Health Centers.
That’s because customers of Health Plan of Nevada, the managed care organization owned by UnitedHealth Group, which is part of the Medicaid program, has a closed network of doctors, so its patients can’t go to Nevada Health Centers, Chase said.
Chase said Medicaid patients are supposed to be allowed to choose a federally qualified health clinic such as Nevada Health Centers.
“All I ask is that (Health Plan of Nevada) patients, who have chosen to enroll in that network, be afforded the opportunity” to come to Nevada Health Centers, Chase said. “We think when they come they’ll like us and they’ll stay. My problem is they’re not even allowed to come.”
Chase said he has spoken with Health Plan of Nevada officials and they agreed to examine their allocation of Medicaid patients.
“I expect we will see a more robust Medicaid mix,” he said. “It’s taken getting to this stage for everybody to realize how important that is.”
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Comment removed by moderator. Post in all caps.
Ok, here ya' go SUN,
Why the hell are we handin' out dough for these 'medical and dental' patients?
When all they gotta do is go to
MEXICO
for the cheeeeeeeeeeeeeeeeeeep-est dental and medical care within driving distance from glorious North Las Vegas, Las Vegas, and Unicorporated Clark County.
And I do mean cheeeeeeeeeeeeeeeeeeeeeeeeeeep.
All they'll need is a
U.S. PASSPORT
to get back into the U.S.A.
What's that you say, they ain't got NO U.S. PASSPORT......
SUN, does this comment NOW meet your extra-ordinarily high and exemplary journalistic standards...?
Oh, and by the way,
ANYONE who is LEGALLY entitled to be in the U.S.A. can always get back in........
"Healthnet" insurance allowed some of their insured to get treatment in Mexico if they wanted to. Seasonal workers, people who had family ties to Mexico or people who wanted to save on the co-pay.
Also, many people are going to New Zealand and India for hip and joint replacement, etc.
Mexico does have some government care as well as private care.
I'm glad Bernie Sanders put more funding in the healthcare bill for community medical clinics.
Hey wizard. Read the decleration of independence where one of the main complaints is the difficulty of immigration laws.
Annis shouldn't be "frustrated" because she can't get her free dental care. She should be thankful that there are services like this that can help you out.
I've heard in Canada, because of nationalized healthcare that it can sometimes take a very long time to get ANY sort of work done. I've heard, I don't know for sure in all honesty.
My question for Marshall Allen is in regards to the future impacts of President Obama's health care reform, say in 2017 or 2018.
Does Mr. Chase know what will happen to his clinic when everyone would be required to have affordable health insurance? Would they have to "report" those that come to the center for free work ups, since they would I believe be fined for not having health insurance?
Would they then revert to simply providing services at discounted prices? How will that fare the future of these centers?
I believe this article shows why our health system is so broken. While I think it is plain stupid to "fine" someone 5% of their income (or more) for not having health insurance, but I believe this reform is a relief to many who need to have access to affordable healthcare.
The worst part about this article is Marshall Allen choosing to ignore the volumes of information provided to him about the federal fraud, misuse of grant funding, and financial mismanagement perpetrated by Nevada Health Center executive management. What about the $300,000 repayment that had to made to Medicare? What about the fradulent demographic information submitted to HRSA to ensure greater Federal funding? What about the grant money from North Las Vegas to fund tests that NVHC still charges for? What about the many thousands of dollars donated for the Mammovan that are used elsewhere? What about the THOUSANDS of H1N1 flu vaccine doses discarded because NVHC wasn't making a big enough profit?
Shame on you Marshall. And shame on Tom Chase for lying about the reasons his organization is failing.
Hey By lectrocuda : Learn to spell
Drastic times call for drastic measures.If they don't curtail who comes in they'll have the same issue next month and the month after.If the number of patients that stiff the clinics increase,then they'll just close and no one will have anything. It's that simple.
The place fell apart after Dr. Suarez in dental was let go. She was so nice and everyone liked her. Thanks Dr. Suarez