Project Activities

A Cost-Effective Delivery System

• In 2002, FirstHealth Community Voices, through its managed care subsidiary, initiated an innovative health coverage program called FirstPlan. A group of health coverage products, FirstPlan is targeted to small employers, many of which do not offer group health benefits or have low participation in their health coverage plans. Addressing the preeminent issue of cost, through the FirstPlan initiative, small businesses may qualify for favorable adjustments to premium rates based on special criteria, such as certifying 100% participation by employees, meeting set levels of employer contribution and coverage history. Additionally, with the assistance of a federal grant, FirstPlan is able to offer low wage enrollees a cash subsidy to assist them in satisfying employee premium contributions. Participating hospitals and physicians also play an important role in FirstPlan by accepting reduced reimbursement rates for services, making FirstPlan a truly collaborative effort between FirstHealth, employers, employees, and providers.

• FirstHealth's Managed Care Subsidiary, FirstCarolinaCare, incorporates a strong care management emphasis into all its plan offerings, including FirstPlan. New enrollees receive a thorough orientation on how to appropriately access covered services, an especially important feature for those who have not had insurance and who may not be familiar with the system. This is particularly true of Hispanic enrollees, who receive intensive Spanish language education on how to effectively use the health care system. Case managers review the health history and health status of enrollees and advise them as to what interventions may be available to provide the most effective and efficient care. Nurse advisers are available 24/7 to provide assistance if a person is unsure whether emergency services are appropriate or their concerns can be addressed by other means. Such programs reduce unnecessary emergency care utilization, and ultimately overall health costs.

• FirstHealth is also reaching the underserved in its service area is through its three community resource centers. At each center, a community outreach coordinator is available to assist people in need access the resources they need, whether it is public insurance enrollment assistance, interpretation/translation, prescription drug assistance, health care assistance, emergency food supplies, or other necessities.

• Established in 1998, the FirstHealth Dental Care Centers have helped improve the oral health of uninsured and Medicaid eligible children of the area. Now, these children can receive basic dental services that were not previously available. Strategies to improve access, such as transporting children to the centers from school, have been highly successful, resulting in reaching 88% of the target population in the first five years of operation. Averaging approximately 1000 visits per month, the dental care centers have made a tremendous impact on the lives of many children in need.

• Other important programs include youth tobacco prevention and comprehensive smoking cessation programs, which, to date, have presented anti-tobacco messages to over 4,500 elementary school children; taking health care right to the community, with mobile health screenings at workplaces and community sites; and activities and fee scholarships to encourage enrollment/re-enrollment in Health Choice and Health Check, the state children’s insurance and Medicaid programs, respectively.

Informing Public and Marketplace Policy

• FirstHealth has published a report summarizing the findings of the 2003 FirstHealth community health survey, which shows that much work is needed to reduce actual and perceived disparities in access to health care among African-Americans, Native Americans, and low income persons in the core FirstHealth service area. Entitled A Community at the Crossroads, the report also shows troubling trends in behaviors that increase the risk of disease and disability. This report is disseminated to key policymakers, regulators and other audiences to provide data in support of FirstHealth’s policy recommendations.

• The Chief Executive Officer of FirstHealth, Charles Frock, recently spoke at the North Carolina Governor’s Summit on Health Care and Prevention, where he explained how community-based coverage such as FirstPlan can help increase access to disease management, preventive services and health education. FirstHealth also submitted a position statement to the N.C. House of Representatives Select Committee on the Rising Cost of Health Care, in which it called for lawmakers to support policies that make health coverage more affordable for small businesses and lower wage workers, including working toward universal coverage.

• FirstHealth Community Voices continues to establish collaborative relationships with state-wide advocacy groups and other institutions working in policy priority areas, such as the N.C. Hospital Association, the U.N.C. School of Dentistry, the North Carolina Coalition to Promote Health Insurance for Children, the N.C. Pediatrics Society, the National Association of Social Workers – N.C. Chapter, the Metrolina Health Initiative and the North Carolina Health Access Coalition.

FirstHealth Community Voices is committed to providing representation on local work groups and task forces in order to effectively inform policies that will favorably impact health care access for underserved populations in the community.