Insurance Coverage Gaps Create Health Care Challenges
Ten months after the opening of the
Nearly 1,000 patient visits a month have been logged at the roughly
But while some clinics in the facility accept myriad types of insurance -- including
The patchwork payment systems highlight one of the challenges facing some innovative health care efforts: Integrated care may only go as far the insurance covering it.
"Some of the insurance companies are slowly, gradually coming around," said
UCCS worked for months after opening the center to negotiate insurance contracts with several carriers, including Anthem,
For the time being, some university and nonprofit officials say grants appear to be the best solution to help patients pay for services not covered by insurance. One goal is that the grants prove to insurance companies that the center's model can work, said
"That's part of why you do innovative things -- because this will be the future model," Bigelow said.
UCCS Chancellor
"There are obviously some barriers that remain, but if we just stop because there are some challenges, we will never get where we need to be," she said.
The payment issues come as the university focuses on increasing the number of patients.
The goal is to offer all-encompassing care -- often preventative, and often for the aging Baby Boomer generation -- by centralizing services and removing transportation barriers.
In all, five UCCS clinics occupy the building's first three floors, along with the Peak Vista clinic.
Under the model, if a person complained to a Peak Vista physician or to the
The UCCS Aging Center also offers mental health care, along with programs addressing memory loss. And the
One of the clinics most affected by the coverage gap is the high-tech
Resting after an arm workout in the center,
"I had been in a big gym -- it wasn't a good fit, let's just put it that way," said Coffee, recalling treadmills too high to step onto, and high personal trainer turnover rates.
The UCCS exercise center operates as a small, data-driven gym. People undergo physical assessments on their first visit, then receive their own USB computer drives to plug into machines -- such as a treadmill -- during each visit. The USB devices describe the day's exercise regimen, then collect information during the workout.
"We really go in-depth depending on how you come to us, and what your needs are," said
Few patients who enter the
Despite treating six to eight people a day, the
A similar trend has developed at the Peak Vista clinic, which expanded in recent months beyond just senior care.
A very small number of the thousands of Peak Vista patients who primarily use the Lane Center have been sent to the clinic, and even then, funding help has been needed, said
She framed the low numbers as a byproduct of a new type of integrated care -- one going beyond physical and mental care to include nutritional and exercise programs to form a more holistic health care experience.
She viewed grants as the best way to remedy coverage gaps until insurance companies expand their payments.
The Aging Center recently received a
Perhaps in time, the Lane Center will show insurance companies that those programs work, and should be covered, McManus said.
"We are exploring new territory by having this collaboration," McManus said.
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