Regarding your recent article "HMOs adapt to Medicaid market" (April 10, p. 42), I was quite impressed at the wealth of resources being put into capturing Medicaid market share, especially as you described Blue Cross of California.
Yet most of their resources seem to be devoted to enrollment, which, however necessary a first step, is still only the first step. As the director of an outreach program for Medicaid managed-care recipients, it's clear to me that access and education are but two of the issues facing Medicaid recipients.
Use your primary-care doctor? Yes, but what if you have no telephone to call for an appointment or for advice on urgent care? What if the doctor's office staff says they speak your language but it turns out that their part-time receptionist only speaks some Spanish, not enough to convey your concerns properly?
We are intensively working with our members through a multilingual and multicultural staff of outreach workers who, unlike your description of Blue Cross' program, are full-time employees with full benefits. They help patients through the system and with their eligibility, visit patients at home, run support groups, develop targeted education efforts, translate, accompany patients to appointments and much more.
Outreach programs for this population must not be an afterthought or used primarily for marketing programs. Outreach should be an integral part of every Medicaid HMO.
Coordinator of community outreach
Health Plus, Brooklyn, N.Y.