Trusted Health Debuts in Washington, DC
On a warm Saturday morning in July, there’s a high-energy health fair kicking off at the Boys and Girls Club on Mississippi Avenue in Ward 8. As the Z-GoGo class starts up, rows and rows of women are lined up ready to workout. They are dressed in white t-shirts that have three letters on the front: “THP” for Trusted Health Plan, the sponsor of the health fair. Thomas Duncan, CEO of TRUSTED Health, smiles proudly as he watches the class move. When asked why should the community choose a start up health insurance company, his response was simple. “We’re going to be here. We’re going to be everywhere our members are. And they will know the Trusted name.”
Quality, Holistic Care
Trusted Health Plan is DC’s newest Medicaid and Alliance provider. They were awarded a multimillion-dollar contract with the District in March. What separates them from other providers? Holistic care. Members are more than just a number on a file. They have lives and challenges to health care that extend beyond the doctor’s office. Dr. Ivan Walks, former director for the DC Department of Health during Anthony Williams’ administration, is the Chief Medical Officer for Trusted. He says Trusted Health keeps up with all areas that affect a patient’s health. “We want to monitor when people go into the emergency room as well as when they are released. If you’re having trouble with your blood pressure, maybe it’s not just related to medication. Maybe the reason your blood pressure is high is because you’re about to lose your house. Maybe your child’s asthma is acting up because you live near a field and in the summer pollen blows into the house. All of the things that impact people’s health matter to me.”
Trusted Health pledges to deliver quality care to all members. But what does quality care mean? For Rachel Harris, Enrollment Manager, quality of care means listening to the patient and meeting them wherever they are in life. “Quality care means looking at what other things a member needs. Do you need your carpet cleaned or an air-conditioner to help with your asthma issues? What other resources can we assist our members with? We don’t just start when they are in-patient. We get out there.”
In addition to monitoring care, Trusted is working to educate members about their health to build a healthier patient pool. Dennis Lane, co-founder of Trusted, says a well-informed member will be the testament of Trusted’s performance. “Preventative health care creates a healthier patient. We want to help them take control of their health and their lives. You’ll only have to look at them to see how well we’re doing.”
Ask Anisha Claggett, Trusted member, how well THR is doing with health care and she will sing their praises. Anisha was enrolled in Medicaid this year and received a packet of information from Trusted Health. When she called them to explain how she had been looking for an optometrist for three years, Trusted intervened. “They helped me find a doctor that suited me and who I was comfortable with. I didn’t have to do a lot of running around. They did the legwork for me. It’s good to know that the people who are taking care of your health care know what you’re going through.”
Building a Managed Care Organization?
Thomas Duncan is not a freshman in the Medicaid arena. His experience began in 2006 when a company recruited him in his native Detroit to enroll uninsured psychiatric ward patients into Medicaid. The idea of helping patients connect to health coverage excited Duncan. “I thought it was a great idea. I had seen many patients in my prior experience go without coverage and wanted to help. So when the offer came up I researched to find out how many companies actually do this for hospitals. There weren’t many that did Medicaid enrollment on behalf of hospitals on a national level. Clearly there was a need for this service.”
Linking uninsured patients to coverage requires helping people complete applications, obtain their medical records, and meet identification requirements. If they were denied, Duncan’s role was to find out why they were denied and appeal. As a result, more hospitals were paid for services rendered. Patients were covered and relieved from insurmountable hospital bills. When the request for proposals came out Duncan decided to strike out on his own. “I didn’t have a lot of experience in this, but I knew I wanted to perform this service for hospitals and patients. So my partner and I put together a proposal and we won.” Care Compensation Specialists Inc. was born in Detroit.
In 2007, Duncan sold the company to Accretive Health. But his passion for helping people enroll in Medicaid didn’t vanish with the sale. The District caught his eye. “I still wanted to continue in the business. I know Medicaid inside and out and I knew that I could help others here the same way I did in Detroit. So I learned DC. I learned every disease that affected the District by ward.” He had liquidity from the sale of his company, did some fundraising and added a new business partner, Dennis Ellis, who was also willing to invest in the company. “Tommy had been in the business for some time on the Medicaid side. I had money and access to funds to help with operations. We both shared the view that our ultimate goal was to better serve the patient and create better patient pool,” says Ellis.
They started over year in advance with applying for licenses, getting partners, and obtaining letters of agreement. “We did a lot of review of the managed care organizations here. We thought we could do a better job and produce better results in care,” says Duncan. Thrive Health (the name was changed to Trusted later on) won a multimillion-dollar contract from the District.
Wayne Turnage, Director of the DC Health Care Finance, has high hopes for Trusted Health. “I think they will do an excellent job. They have some talented employees. They have creative ideas for how to manage care for Medicaid and Alliance members.” Councilmember Yvette Alexander, Chair of the Health Committee, echoes Turnage’s sentiments. “I was impressed by their ward by ward study to assess the Medicaid needs. They were very thorough. They really did a good job with the research. And they are located right here in Ward 7. I’m hoping they will do well and I will hold hearings to see that they are abiding by their contracts.”
Trusted Health: advancing Medicaid and Alliance coverage through total patient care.
For more information about Trusted Health, visit www.trustedhp.com or call 1-855-326-4831.
Candace Y.A. Montague is the health reporter for East of the River