Executive Director LisaBritt Solsky Visits NH Today to talk NH Medicaid Open Enrollment

Well Sense Sits Down With NH Today to Discuss NH Medicaid Open Enrollment

LisaBritt Solsky, Executive Director of Well Sense Health Plan sits down with Scott Spradling to talk about New Hampshire Medicaid and what to expect for Open Enrollment in August.

Listen to Interview

Transcript:

Scott Spradling (Interviewer): “Among the many topics that we talk about at the state house, one of the most important conversations that is an ongoing one at the state house is healthcare coverage. And not too many years ago, Medicaid was expanded to hopefully try and better serve a population of Granite Staters that are struggling, that don’t necessarily have access to good care, don’t necessarily have an income, or a job, or sustainable revenue to be able to have the basic healthcare coverage that’s necessary to just get into the system. So with Medicaid expansion, came a need for different associations and business and non-profit groups to step in and try to manage those relationships, to connect the dots if you will. And one of the key figures in not only the creation of Medicaid expansion, which we’ll talk about in a minute, but also in connecting those dots, between the Medicaid population and the services that are available, is the Executive Director of Well Sense Health Plan here in New Hampshire, Lisabritt Solsky. And Lisabritt joins us on the listener line this morning. Good morning Mademoiselle how are you?”

Lisabritt: “I’m great how are you today?”

Scott: “I’m doing very well Lisabritt. Let’s start simply with this. Could you describe the basic mission of Well Sense? Who are you and what do you do? And then I want to talk a little bit about your own background because it’s unique. But what does Well Sense do?”

Lisabritt: “We are one of the state’s Medicaid Managed Care Organizations. So basically that means we are a boutique insurance company that specializes in coverage for people who are eligible for Medicaid. We are a not-for-profit. And we are part of the Boston Medical Center Health System and that gives us a little bit of gravitas in this space, because, believe it or not, Boston Medical Center has been taking care of medically underserved people since Abraham Lincoln’s administration. So when I say this is in the DNA I am being completely sincere.”

Scott: “So you exist mainly because of Medicaid and connecting these dots. So how many people are we talking about here and what kind of services do you basically provide?”

Lisabritt: “So right now Well Sense boasts about 94,000 enrolled members and I should say we’re not the only player in this state so there’s a lot more people on Medicaid, but we’ve got about 94,000 of them here in New Hampshire. We do a lot of what a traditional insurance company would do which is pay claims when you go and see the provider right? You go to the PCP and you get a physical, they submit a bill, we pay it. But there’s a whole lot more that we do, and I would argue we are obliged to do, in order to manage this more unique population. Our members can face a lot of barriers, just by virtue of being low or extremely low income. So we have a pretty large cohort of members who are homeless or who are managing substance abuse and so we create a lot of individually tailored programs and care plans for our members that address some of those what we call social determinates of health to make it easier for them to manage everyday health conditions, sometimes chronic or co-occurring health conditions that would be hard even if you didn’t have the deck kind of stacked against you”

Scott: “I’m here with Lisabritt Solsky the Executive Director of Well Sense Health Plan in New Hampshire, a non-profit that is really engineered to try and help provide connect-the-dot coverage to those on Medicaid who need access to quality care and may for a number of different reasons and challenges have a lot of trouble. Lisabritt welcome back thank you for joining us and you were talking  just a couple of minutes ago about how  some of the clients you serve are homeless or low income and have real challenges to getting even basic care. Can you give me a couple of examples of the type of challenges that your members face?”

Lisabritt: “We hear a lot about the typical challenges of being low income. Food insecurity, housing insecurity. How much do you hear people talking about diaper insecurity? This is something that is very real in our community and something that our health plan addresses, in addition to addressing food insecurity and housing insecurity, but we do a lot to giveaway diapers to families in need. Job insecurity is a big issue. We have a lot of folks who are seasonal employees or struggling to keep and hold a job that will make a dent in some of those monthly obligations. So we’ve got a whole robust platform of offerings that we bring together. Really, like I said earlier, to individually tailor to the needs of our members. It’s a hustle out there for a lot of folks on Well Sense.”

Scott: “So Lisabritt, a few years ago, the political debate around Medicaid expansion was a pretty tense one, and it was an almost existential debate of--- do we do this or do we not do it? I feel like we’re on the other side of having to prove whether or not the program is necessary, important and useful but I’m wondering from your experience and your perspective what do you see as the impact of getting this system right? What is the impact on families that you are serving?” 

Lisabritt: “So I can answer that question in sort of a micro and a macro way. First, for individuals it actually means the difference between being able to get that flu shot or that shingles vaccine and not having to pay out of pocket. It means being able to go to the pharmacy and the most you’re ever going to pay is $1 for a copay. It means getting any kind of office visit for no out of pocket at all. For people who have been uninsured and maybe haven’t been able to address just basic preventive health care, that honestly feels like a gift to a lot of people.  But if we look at big picture, this is a program that really pays dividends in our communities every single day.

So our folks, who are now covered because of the Medicaid expansion, were previously uninsured. So they weren’t getting that preventive care, but when something went really bad, they would turn up in an emergency department and not be able to pay and our community hospitals are obligated to treat them, if it’s an emergency. So these folks were creating, through no fault of their own, a pretty significant drag on hospital budgets because they just couldn’t pay. And so now, those same people are able to engage in preventive care, so maybe they’re not landing in the emergency department, which is the most expensive place to get your get your care. They’re not landing in the emergency department inappropriately, because they’re getting that preventive care, and even if they do go to the emergency department, cause I don’t know, maybe they had some kind of accident, they really have an emergency on their hands but now that hospital is getting reimbursed for the care they’re providing instead of filing that care under “no pay”.”

Scott: “That’s a huge impact.”

Lisabritt: “So you know we’ve got impact at the individual level, and at the community level.”

Scott: “Lisabritt Solsky of the Well Sense Health Plan New Hampshire. Lisabritt there’s a window opening very soon for people that might need access to this type of care to be able to sign up for it and get enrolled and get rolling. That’s coming sometime soon. What do people need to know?”

Lisabritt: “So people who are on Medicaid now are going to have their annual open enrollment period a little off cycle this year, so it’s going to happen in August. Normally open enrollment happens in the fall. So this year, like I said we’re a little off cycle. People are going to be getting notified from the New Hampshire Department of Health and Human Services that it’s open enrollment time. The good news is that if you like your health plan, you don’t have to do anything. We call it passive right, if you like where you are, you don’t need to do anything. Come September 1, nothing changes for you. But if you want to make a change and hey if you want to try out Well Sense Health Plan we would welcome you aboard! August is your time to let DHHS know that you want to make a change and come September 1 would be the first effective day of your new coverage.”

Scott: “This is a wonderful opportunity to jump online for people to learn more about Well Sense and to possibly get that information to get aligned and to be enrolled. Thank you for what you do, every single day you serve a very important role in a very important population of folks that just need that extra hand up to get that access to quality healthcare. We appreciate all that you do.”