New Orleans health care – five years after Katrina

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Yesterday, the NASHP conference in New Orleans started with a plenary session on the state of health care in the city. Things were not great before Katrina – the city was at the bottom of national list for health care access and outcomes. 80% of the housing stock was lost; health care institutions were devastated. Progress in rebuilding has been slow and the BP oil spill has cut into available resources. One speaker compared it to trying to pursue national health reform when two thirds of the nation is under water. EMRs became critical as most medical records were destroyed and patients scattered across the nation. Patient-centered medical homes became a necessity as the lack of providers required teams; coordinating care and engaging patients in their own care was critical. Approximately 90 clinics have grown around the city sponsored by a wide diversity of groups including payers – government, religious, civic groups, foundations – serving different populations – musicians, pregnant women, specific communities. Speakers noted that this diversity is an important strength – if one payer drops support, such as the state – the system can adjust. However, thoughtful planning has hit roadblocks. The state offered to pay all the costs to build desperately needed mental health care capacity, but hospitals refused, instead building transplant services to attract patients from outside the area.
In other news, the big story in New Orleans this morning is that Blue Cross Blue Shield of LA and East Jefferson General Hospital have not been able to reach an agreement. Thousands of patients will no longer be able to get care there. Sound familiar?
Ellen Andrews