Health Care

Priority Health gives Medicaid patients access to Metro Health

June 10, 2013
| By Pete Daly |
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Priority Health has increased access to care for Medicaid members in a new relationship with Metro Health in the Grand Rapids area.

Priority Health Medicaid members will now have access to the Metro Health network of physicians, neighborhood outpatient centers and the Metro Health Hospital in Wyoming.

The move is an extension of Priority Health's contract with Metro Health, which already offers access to Priority Health HMO, PPO, individual and Medicare members.

“We are committed to addressing real concerns around access to health care for our Medicaid members,” said Michael P. Freed, president/CEO of Priority Health.

With the addition of Metro Health hospital and physicians, Priority Health will further enhance its already sizeable Medicaid network of more than 8,000 health care providers and 39 hospitals, serving nearly 70,000 Medicaid members. Priority Health offers Medicaid benefits in 17 counties in Michigan.

“As a community hospital, we are committed to providing access to quality, affordable health care to our residents. As new regulations come into effect under federal health care reform, Metro Health is looking at ways to expand the services we provide. We look forward to serving more Medicaid patients through our expanded relationships with Priority Health,” said Michael Faas, president and CEO of Metro Health.

Also new to its agreement with Metro Health is a continuity of care arrangement that enables Priority Health members to continue to see their Metro Health physician even if they switch between employer-sponsored, individual, Medicare or Medicaid coverage.

“Traditionally, access to a facility or physician varies depending on the type of health insurance you carry,” said Freed. “With our enhanced agreement with Metro Health, we are making it easier for our members to access quality health care and preserve the relationships they have built with their physician and hospital, regardless of the Priority Health product they have selected.”

Medicaid coverage

Medicaid is an assistance program for low-income people of all ages, with medical bills paid from federal, state and local tax funds. It is a federal-state program that varies from state to state, run by state and local governments within federal guidelines.

There is currently a proposal in the Michigan Legislature to expand Medicaid coverage to families with incomes under 133 percent of the federal poverty level: roughly equal to $15,900 for an individual or $32,500 for a family of four per year.

So far, opponents to the Affordable Care Act in the Legislature have blocked attempts to expand Medicaid coverage in Michigan.

Supporters of the proposed legislation say it would immediately provide access to care to more than 450,000 uninsured Michigan residents and save the state millions of dollars in the future by providing health care early enough to head off more serious health problems later.

Proponents also note that under the Affordable Care Act, 26 states have already acted to expand their Medicaid coverage before Jan. 1, 2014, when Medicaid eligibility changes nationwide.

States that refuse to expand coverage risk losing federal funding to cover those who are eligible for Medicaid.

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