WAMU Series Examines Washington, D.C.’s New Indigent Health System
D.C. HealthCare Alliance, the private corporation running Washington, D.C.'s public health system, is "making good progress" toward enrolling eligible residents, but some advocates "worry" that it might not be reaching all individuals who had sought treatment at D.C. General Hospital, the city's former safety-net hospital, public radio station WAMU reports in the first of a series on the city's indigent health system. Paul Offner, a Georgetown University professor and a member of the Health Care Safety Net Administration, which manages the D.C. HealthCare Alliance, said, "This is just an enormously frustrating period for everybody who is involved in monitoring this new system, because we just don't know anything for sure" (Jones, "WAMU News," WAMU, 4/17). Last April, the District transferred management of the city's indigent health system from the bankrupt Public Benefit Corp. to D.C. HealthCare Alliance and began to phase out inpatient and trauma services at D.C. General Hospital. Under the new indigent care system, D.C. HealthCare Alliance manages a network of more than 20 clinics that contract with private physicians, and Greater Southeast Community Hospital treats patients requiring hospitalization or trauma care. Residents may enroll in the system if they have a permanent District address and annual incomes less than 200% of the poverty level, or $17,720 for an individual. As of December 2001, 17,000 individuals had enrolled in the system, short of an expected 25,000. Because of the low enrollment, the system at that time had not spent the entire allotment of funds it received from the District. As a result, Washington, D.C., Mayor Anthony Williams' (D) budget plan for the fiscal year beginning Oct. 1 includes an $11.6 million reduction in funding for the Health Care Safety Net Administration (Kaiser Daily Health Policy Report, 4/3).
Monitoring Beneficiary Numbers
D.C. Chartered Health Plan Inc. Chief Operating Officer Karen Dale said that enrollment numbers might be lower than expected because some of the people who had received treatment at D.C. General before the system switch would not necessarily be eligible to participate in the new system. For instance, about 9,000 of D.C. General's patients were Maryland residents, and a "very high number" of patients already had health insurance. She added that enrollment in the system is likely to increase with a series of radio, television and print advertisements launched by the Alliance. Dr. Ivan Walks, chief health officer for the D.C. Department of Health, said that although the system needs some "mid-course corrections," it now meets the "most important goal" -- getting residents "good care." Walks said, "We're still in the first year of a brand-new type of program. So for us to pretend that we know everything that we would like to know, or that we could know or that we will know, is all wrong" ("WAMU News," WAMU, 4/17). A clip of the segment is available online. Note: You must have RealPlayer to hear the clip.