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Press Releases

School-Based Health Care Coalition Announces

PRESS RELEASE

For Immediate Release

Contacts:
Elinor Goldberg - Maine Children's Alliance (207) 623-1868
Katherine Pelletreau - Maine Association of Health Plans (207) 829-5696


School-Based Health Care Coalition Announces
Pilot Project for Maine Students


Goal is to increase student access to quality care
in a timely manner


Deering High School, Portland, ME. - A group of Maine's leading health insurers, school officials and health centers have announced their collaboration for an innovative pilot program designed to help adolescents gain increased access to quality care in a timely manner. The goals of the program are to evaluate whether adolescent health status and access to health care improve through commercial insurance reimbursement for primary care services provided at School-Based Health centers with cost neutrality or savings.

The School-Based Health Care Coalition announced the project at a news conference today. Students aged 12 - 18 years old from over 10 school districts in the state will be able to participate in the pilot program.

"This is a great idea whose time has come," said Senate President Rick Bennett. "This shows how members of the state's health care community can come and work together without involving mandates."

As part of the pilot program, the state's leading health insurers, Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Inc., Aetna Health, Inc. and CIGNA HealthCare, Inc., will reimburse School-Based Health centers for covered primary care services and will not require prior authorization, unless they are for specialties that would normally require prior authorization.

"We're very glad to be part of this coalition for a number of reasons," said Karen M. Bell, M.D., Medical Director, Anthem Blue Cross and Blue Shield in Maine. "This can help adolescents access care through a school based center that may be more convenient or more comfortable for

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School-Based Health Care Coalition, pg. 2.

them to attend. Also, the health centers will be providing feedback to the adolescents' primary
care physicians so there is enhanced patient communication. Finally, this will hopefully be one
step towards helping reduce emergency room visits, hospitalizations and days lost from school among our students."

To begin with, the pilot program will involve schools that have a contracted health center available. Children will also need parental permission to use the Center. Use of the school based
health center can only be for covered primary care services and the adolescents already have to be covered by one of the health plans for the School-Based Health center to be eligible for reimbursement. It is expected that the data collection for the pilot program can begin in September of 2003 and extend for up to three years. To date, two health fairs have been hosted by the Health Plans to educate School-Based Health center staff on credentialing their providers and contracting with the Health Plans.

One of the components of the program is to have an independent outside evaluator compare the outcomes of children attending the centers once the pilot is complete. The independent evaluator team who has been awarded the project is Dan Meyer of the Dartmouth Family Residency Program and Brian Pearson of the Maine Health Information Center.

"We hope to have satisfaction from a number of fronts," said Ellie Goldberg of the Maine Children's Alliance. "Certainly, we want to see satisfaction from the students in the care they receive. We also want to continue to work with the primary care physicians and have satisfaction from their perspective as they stay informed with the centers on the care being given to students." In addition, Goldberg observed that the evaluation of this project will provide information that will continue to increase the health of Maine youth and will serve as a national model.'

This Pilot will help the state identify and understand any gaps there may be in health care access for adolescents and validate those gaps to provide solutions for the future. All of the School-Based Health care centers that are participating in the pilot are on school sites and have a variety of models for the hours they're open and the populations they serve.

The Maine Children's Alliance, a non-profit, non-partisan group advocating for the well being of Maine's children, youth and families convened the coalition in order to improve the health of all Maine children and youth.

The Maine Association of Health Plans represents health plans committed to providing exceptional quality and affordable health care coverage to the people of Maine. Our members, Aetna Health, Inc, Anthem Blue Cross and Blue Shield, CIGNA HealthCare, Inc., and Harvard Pilgrim Health Care, Inc., provide health care coverage to over 500,000 Maine people. Our mission is to educate and inform the public about the benefits of wellness, prevention and coordinated health care.

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