COLUMBIA, S.C.-- A Medicaid program at a Columbia hospital that treats children with chronic illnesses is winning praise from parents and state officials who say it improves patient health and saves the state money.
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State health and social services officials say the Medically Fragile Children's program at Palmetto Health has worked so well that a second site was set up in Easley earlier this year, and plans are in the works to expand the program statewide.
The Medicaid-funded program in Columbia treats 67 children with chronic illnesses and disabilities, such as cerebral palsy. It was originally designed for foster children but now includes other children whose care is covered by Medicaid.
The program does not limit visits or care and has few other restrictions. More money is spent on upfront care, such as physical therapy and special equipment for children and education programs for parents, which reduces costs of more expensive emergency room visits.
The Columbia program has seen emergency room visits drop by more than a third, according to a University of South Carolina analysis.
Medicaid, which is supported through state and federal money, reports it has saved an average of $10,000 a year for each participating child.
The state Social Services Department and the Department of Health and Human Services, which manages Medicaid, began working more than a decade ago with Richland Memorial, now part of Palmetto Health, to provide foster parents with a central system for taking care of foster children's medical needs.
Before the program was created, medical care for foster children was spread across several agencies, with duplicated services and little coordination.
Since the program was created, new rules have encouraged more adoptions of medically fragile children. Under the old system, payments to foster parents of such children were reduced by as much as 50 percent. Payments are now reduced by 25 percent or less, officials say.
The adoption rate for the foster children in the medically fragile children's program has increased to 60 percent. Outside the program, the adoption rate for children with severe medical problems is about 5 percent.
"The major thing we've learned is that coordinated care does work well, but it has to involve the payer, the provider and the family," said Darlynn Thomas, who oversees Medicaid as a bureau chief in the state's Department of Health and Human Services.
The collaboration has worked so well that Medicaid plans to expand the program across the state, including programs in Greenville, Charleston and possibly Florence, Thomas said.
Some foster parents were first skeptical of the program as an attempt to limit care. But the USC analysis found the program has attained a 99 percent satisfaction rate among parents.
"I don't know what I would have done without it," said Charline Mullins-Lowman, whose 9-year-old daughter Savannah Mullins has spina bifida and is in the program. "It was a blessing to us."
The pilot program shows that spending money upfront for a higher level of care can save money in the long run, said Ana Lopez-De Fede, who helped develop the program and has tracked its progress.
It also shows one of the best ways to save money in health care is to develop targeted programs for those who use it most, said Lopez-De Fede, director of USC's Division of Health and Family Studies.
"By doing a better job with a small population that accounts for a big percentage of the costs, it frees up money for the rest of us," she said.
