The state has fixed a problem with the Children's Health Insurance Program that has temporarily reduced access and increased costs for low-income Castle Country families.
According to Bruce Quinton, business manager at the Castle Country Clinic in Price, it wasn't that health care providers were charging more. It was because pediatric care providers in Carbon and Emery counties were not part of the Intermountain Health Care SelectHealth system.
Last July 1, the State Department of Health transferred CHIP from the previous insurer, the Public Employees Health Plan, to IHC. That meant that to find a doctor or nurse practitioner with IHC insurance credentials, people had to drive their sick kids over the hill to Utah County.
That in turn meant extra time away from work, gasoline expense and wear and tear on cars became costs of health care. "There are some people who couldn't be sure their cars would make it to Provo and back," Quinton said.
The way around the program was to open the field for Molina Healthcare to again provide CHIP coverage in the two counties. Low-income families can now contact the state health department to change their coverage and return to local providers.
"Molina Healthcare has served members in the CHIP program in Utah for over 12 years," said Paul Muench, president of Molina Healthcare of Utah. "As a health plan that serves a vulnerable population, we understand some of the challenges our members face. Understanding these needs, Molina Healthcare provides our members living in rural counties with access to a network of providers and hospitals that is as close to their home as possible."
The only hospital that serves Carbon and Emery counties is Castleview Hospital. Muench said Molina is contracted with this hospital. "Castleview is a critical component to our network because they are able to care for pediatric in-patients through their medical surgery floor, allowing Molina members to remain close to home if a hospital stay is necessary," he explained.
In Carbon and Emery, Molina is contracted with 13 Primary Care Providers (PCPs) and 10 Specialists. Of the PCPs, three are pediatricians and seven are family practice physicians. To put it into perspective, the CHIP population in Carbon and Emery is 379. That allows for one PCP per every 29 Molina CHIP members.
Muench said Molina's total statewide network in Utah includes 1,519 primary care physicians, 7,374 specialty physicians and 47 hospitals.