Health care reform, New Orleans-style

Mary Stucky May 11, 2011

Health care reform, New Orleans-style

Mary Stucky May 11, 2011

Kai Ryssdal: Waters are rising along the southern stretches of the Mississippi River today. Crews are shoring up levees in Baton Rouge and New Orleans. They’ve got no desire for a repeat of the flooding from five years ago and Hurricane Katrina.

But that storm is still helping re-shape the city of New Orleans. Health care, in this instance. Before Katrina the only way a lot of people saw a doctor was to go to the public hospital emergency room — with taxpayers often picking up the tab. But when Katrina wrecked all the public hospitals there, the city decided to start over.

Mary Stucky reports on health care reform — New Orleans-style.

Mary Stucky: It’s a typical day at this red-brick clinic near New Orleans’ French Quarter. A steady flow of patients comes in for routine tests, counseling and the usual colds and flu.

Doctor: Are you diabetic?

Patient: No, high blood pressure.

What’s not so typical is the clinic itself. Or at least it wasn’t before Katrina. It’s what’s known as a medical home — a place where local, usually poor, residents can get most of the care they need right in the neighborhood. The care is coordinated, so patients see the same doctor every time. A case worker keeps track of medications and appointments. The clinics have extended hours.

Austin Duskin, Sr. is a patient at the clinic near the French Quarter. Duskin says he’s relieved to finally have a regular doctor who takes time to discuss his overall health and to explain the chronic pain in his hip.

Austin Duskin: I told him about it and he explained that the cartilage is gone. He talked to me about changing my diet and try to eat more healthier.

Before Hurricane Katrina, Duskin and many other residents of New Orleans went without a regular doctor. They typically got the treatment they needed at the emergency room. But now, using a $100 million federal grant, the city has rebuilt its health care system along the medical home model. There are 93 across New Orleans.

Dr. Karen DeSalvo is New Orleans commissioner of health. She says this “team” model, allows individual staff members to work at what she calls the top of their license. Primary-care doctors, for instance, aren’t doubling as social workers at physician’s rates.

Karen DeSalvo: It makes the system less doctor heavy. So it makes us work as a team. And then it makes you find those patients to bring them back into the clinic when they don’t follow up, so they don’t end up the emergency room or an expensive part of the health care system.

New Orleans has some of the highest rates in the nation for obesity, diabetes, heart disease and asthma. All diseases that can best be managed with regular attention. The medical homes have saved taxpayers millions of dollars, according to DeSalvo. Whether patients are healthier is being studied.

But New Orleans Dr. Eboni Price-Haywood thinks they are.

Eboni Price-Haywood: We have a diabetes care management program and I can tell you that within our clinic, patients who have participate in those programs are those who’ve shown rapid improvement in their disease management.

A Kaiser Family Foundation study found that 20 percent more of the uninsured in New Orleans now have routine medical care. Again, Dr. Price-Haywood.

Price-Haywood: I think with the medical home structure that we’ve built in New Orleans, that has been the primary focus is not only to treat, but also to prevent.

Price-Haywood thinks New Orleans can be a model for other parts of the country. And, she says, it should not have to take a hurricane.

In New Orleans, I’m Mary Stucky for Marketplace.

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