A Story Growth - Community Health Network of Connecticut, Inc.

A Story Growth
Community Health Network of CT, Inc.
ANNUAL
REPORT
1
A MESSAGE from
Alfreda D. Turner
CHAIRWOMAN, BOARD OF DIRECTORS
2
As Chairwoman of the Community Health Network of Connecticut,
Inc. (CHNCT) Board of Directors, and President and CEO of Hartford’s
Charter Oak Health Center, over the past 15 years I’ve had the pleasure of
witnessing CHNCT’s remarkable growth. This amazing accomplishment
is made even more extraordinary due to the fact that CHNCT was derived
from one man’s innovative vision.
In the federally-qualified health center (FQHC) world, Mr. Cornell Scott
deserves the title of legend and crusader. Not only was he the longtime
CEO of New Haven’s Hill Health Center, he was also a passionate
advocate of health care equality. Cornell Scott had a vision and his vision
was clear: that one day federally qualified health centers from across the
state would join together in unity and that one day they would become
allies and provide services to those who traditionally went without - those
enrolled in the state’s managed Medicaid program.
Out of his leadership, CHNCT was born. The organization was dutifully
led by Cornell for 13 years until his passing in August 2008. It was then
that I had the distinct honor and privilege to follow in Cornell Scott’s
footsteps, assuming the role of CHNCT’s Board Chairwoman.
Over the past 15 years, I have seen CHNCT transform from one man’s
dream into a premier health plan that has been recognized on both the
local and national levels. Often I have wondered what it is about CHNCT
that contributes to its great success: is it the fact that a not-for-profit
organization is better equipped to understand the inner-workings and
structure of FQHCs and thus can better serve its members? Or is it due
to the fact that much like the FQHCs, CHNCT didn’t have the funding
stream of its commercial competitors so it had to make every dollar count?
Or is it that the dedication and commitment of CHNCT’s leadership and
staff ensured that the purpose of the organization was realized? The truth
is - all of the above. With CHNCT, it’s about more than the bottom line it’s about ensuring high quality health care for a largely at-risk population
that might not otherwise have access to medical services.
Without Cornell Scott’s original plan, there would be no CHNCT for a
largely disenfranchised population - a population that historically had
and currently has a difficult time being heard. Mr. Scott gave us the
ability to build bridges in our communities, both urban and rural and to
be able to strive for equality and balance in the health care arena. For
that reason, I am proud of CHNCT’s story of growth, which is one of
inspiration and success, and I am truly blessed to be part of its continued
accomplishments.
3
A MESSAGE from
Sylvia B. Kelly
PRESIDENT & CEO
4
It’s hard to believe that it’s been 15 years since CHNCT debuted in the
State of Connecticut. So much has changed over the years in the way
health care is delivered throughout the country and I am pleased to say
that CHNCT has always been on the forefront.
When I joined CHNCT as its President and CEO in February 2000,
the organization had just concluded its infancy and was starting to be
recognized as a true competitor within the state’s Medicaid program. Over
the past 10 years, I’ve had the pleasure of witnessing it transform from
a small managed care organization (MCO) that strove to provide high
quality health care to those who may otherwise go without, to the largest
MCO in the state with more than 300,000 members and a leader in its
own right.
Looking back, I am often amazed at how much we’ve grown. Early on,
CHNCT was housed in a small industrial building on Pratt Street in
Meriden and back then our employees weren’t even afforded the luxury of
a true desk. Instead their “desk” was simply an old door that sat atop two
filing cabinets - the cords leading to their rotary phone snaked through
the small circular opening where the doorknob should have been. How
times have changed.
Despite being in cramped quarters and making do with the supplies
it was given, CHNCT continued to arrange for its members - all 94 of
them in the first year - with the best health care it could. We didn’t need
creature comforts because after all, it wasn’t about us. It was about them,
our members.
We wanted our members to know that CHNCT was different than the
other MCOs and not just another stranger on the other end of the line
and that they were our main priority. That’s why we adopted the moniker,
“The One with the Sun,” a beacon of light in the hard to navigate field of
health care, and a provider of warmth to those who hadn’t been afforded
the dignity and respect they deserved when it came to making their health
care decisions. From there, the sunflower emerged – a complex yet simple
flower whose main ambition is to grow tall and stand strong in the face
of tough times. The sunflower is made up of thousands of small and
individual buds that form the sum of its vibrant yellow flower. That’s us,
and welcome to our story of growth.
5
stage
1
6
the seed
A sunflower seed contains a tiny plant. This small seed contains all the food and nutrients it needs to carry it throughout
its lifecycle.
Gouveia Vineyards, Wallingford, Conn.
CHNCT was established in 1995 when a group
of individuals and representatives from nine
federally qualified health centers (FQHCs) came
together to bring non-profit oversight to managed
care with the intention of changing the way health
care was delivered to the state’s Medicaid-eligible
population. CHNCT was considerably smaller than
the other managed care organizations, but it had a
grand mission and big aspirations.
7
stage
2
8
the sPROUT
After the growing conditions have been met and maintained, the seed will begin to germinate. This stage, called the sprout, is
brief as the plant quickly grows into a seedling.
Farmer Joe’s, Wallingford, Conn.
With executive directors from each of the
founding FQHCs serving as its Board of
Directors, CHNCT contracted with a healthcare
management organization in order to create a
strong infrastructure. In addition to the financial
support received from the FQHCs, CHNCT also
obtained a loan to finance this new endeavor.
CHNCT officially launched in June 1995 with
only five employees working out of its office in
Hartford’s Gold Building. After three months,
CHNCT retained 94 members and relocated to a
more central location on Pratt Street in Meriden.
9
stage
3
10
the sEEDLING
The small seedling still has a lot of growing to do before it is recognized as a true sunflower. As it reaches the young sunflower
stage, its stem will become sturdier and thicker, giving it the strength to support the large plant.
Farmer Joe’s, Wallingford, Conn.
In its inaugural year, CHNCT remained a small
presence in the state’s Medicaid arena, beginning
1996 with only 10,000 members. Its membership
base continued to grow, however, and quickly
doubled to 20,000 by its first anniversary in June
1996. One of 11 plans managing Medicaid at the
time, CHNCT hovered in the middle of the pack
in terms of size.
When several managed care plans left the Medicaid
program in 1998, CHNCT’s membership grew
with an additional 5,000 members by year’s end.
CHNCT also ended its contract with the healthcare
management organization in 1998 and hired
permanent executives to oversee its operations. The
number of staff grew to 30 and it had developed
four unique programs to boost healthy outcomes
for its members: Care Express, a program to
help pregnant women and newborns reach their
medical appointments; Healthy Beginnings, a
program to help women have a healthy pregnancy
and a healthy baby; Sun Family Wellness, a
program to promote and ensure members’ access
to care; and a smoking cessation program. The
state Department of Social Services also created
the HUSKY program ­- Health Care for UninSured
Kids and Youth – in 1998. HUSKY A was created
as a traditional Medicaid program while HUSKY B
provided coverage for uninsured children.
11
stage
4
12
the young sunflower
Once the plant becomes several feet tall, it starts to be recognized as a sunflower. The robust plant reaches for the sky, while
buds begin to form at the top of the stem.
Geremia Farms, Wallingford, Conn.
CHNCT continued to reach new heights as the years
passed. By its fifth anniversary in 2000, the young
organization reached 40,000 members. During this
time, CHNCT maintained a member satisfaction
rating of over 90 percent. The Sun Family Wellness
Program was also recognized by the March of Dimes
that year, which named it a Best Practice Model
at its annual conference. Things were looking up
and membership continued to reach new heights.
CHNCT’s number of members soared to more than
50,000 by 2002. It also satisfied its start-up loan
that year and became debt-free. This increased the
organization’s net worth substantially. To further
bolster the organization, CHNCT enhanced its
disease management offerings and collaborated
with other health plans nationwide to develop
quality improvement strategies.
Big changes occurred at CHNCT in late 2007,
which greatly affected it as an organization. As
one of four full-risk managed care organizations
administering the state’s HUSKY plan, thenGov. Jodi M. Rell terminated the managed care
contracts following two competitors’ refusal to
comply with the state’s Freedom of Information
Act requirements. As a result, CHNCT continued
to arrange services for its HUSKY A and HUSKY
B members under a Prepaid Inpatient Health
Plan (PIHP) agreement with the state. This meant
implementing new policies and procedures,
and reconfiguring its claims processing systems
in a very short time. With only one additional
competitor agreeing to contract with the state as
a PIHP, this provided CHNCT the opportunity to
grow as a company.
In 2003, CHNCT continued its commitment to
bettering the community with the formation of
its non-profit, charitable organization Community
Health Network of Connecticut Foundation, Inc.
The mission of the foundation was to enhance
health care services available to poor, distressed
or underprivileged children and families living in
Connecticut while also providing financial and
other support to likeminded organizations that
promote health within Connecticut.
In 2008, the Governor sent out a Request for
Proposal with regard to HUSKY A, HUSKY B and
the soon to be implemented Charter Oak Health
Plan. CHNCT signed a new contract with the
state on July 1, 2008. The re-procurement of the
HUSKY A, HUSKY B and Charter Oak programs
resulted in CHNCT transitioning back from a
PIHP to a risk-based managed care organization.
CHNCT’s three competitors chose not to renew
their respective contracts with the state. Therefore,
CHNCT remained the only organization in the
program since its inception. This turn of events
contributed to a growth spurt for CHNCT.
CHNCT started being recognized for the gem that
it is by 2004. It added a new line of business –
SAGA, State-Administered General Assistance –
and saw its membership jump to nearly 85,000
members. At that time, CHNCT really began to
make its mark in the state’s Medicaid program.
13
1995
2000
94
40,000
2005
85,000
2010
300,000
THE INCREASE
IN MEMBERS
OVER THE
YEARS.
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15
stage
5
16
the ADULT SUNFLOWER
Once the petals start to open and the sunflower begins to bloom, it has reached its adult stage. Its large, yellow head is actually
made up of hundreds of tiny flowers tightly packed together. At this adult stage, the sunflower no longer follows the sun’s path
but instead stands firmly on its own.
Beaumont Farm, Wallingford, Conn.
CHNCT watched its membership grow steadily
over the years but even it was taken aback by the
influx of new members who joined throughout
the latter part of 2008. In one year alone,
CHNCT doubled its membership amassed
since the organization’s founding. During that
transition period, Medicaid members had the
opportunity to choose CHNCT or one of two
other health plans. They overwhelmingly chose
CHNCT and by the end of 2008, CHNCT’s
membership had grown to 175,000; it was a
bountiful harvest of the seeds that were sewn
many years before.
17
Community
Cares
Easy
Breathing
HEALTHY
BEGINNINGS
Text4Baby
Enriching the Soil
18
2010
2010 was a banner year for CHNCT, as its
membership grew to new heights. Not only did
CHNCT’s membership rise to more than 306,000
members, but CHNCT also became the largest
Medicaid managed care organization in the state
of Connecticut.
By 2010, CHNCT stood above of its competitors
though its roots remained firmly all planted within
the community. Determined to strengthen itself even
further as an organization, CHNCT implemented
several changes to better serve its members.
To stay in line with the ever-changing health care
culture, CHNCT began developing a program in
response to the change in the model of health care
delivery. Community Cares was designed to provide
additional support to network providers who are
moving toward a medical home approach which
integrates patients as active participants in their
own health and well-being. This new approach,
which places a nurse in each of the FQHCs,
offers patients comfort, convenience and optimal
health throughout their lifetime. CHNCT created
individualized offerings for each of its FQHCs
based on patient demographics. The program is
slated to be launched in 2011.
CHNCT also implemented a variety of software
upgrades in 2010 to better serve its members. It
employed predictive modeling software, which
enabled the organization to better identify members
in need of case management, disease management
or social services. It also began using McKesson
CareEnhance, which improved efficiencies and
allowed CHNCT to make all of its documentation
consistent while also giving the organization more
enhanced reporting capabilities. Furthermore,
CHNCT expanded its member outreach by utilizing
interactive telephonic technology.
To better serve its members, CHNCT also expanded
many of its disease management offerings. The
organization partnered with Connecticut Children’s
Medical Center so to offer its Easy Breathing
program. Easy Breathing is designed to encourage
comprehensive asthma management by pediatric
providers, patients and parents with the goals of
improving the health status of children with asthma
and reducing medical care expenditures.
It also expanded the content and scope of its
Healthy Beginnings program. This change allowed
the organization to bring members into the program
at an earlier stage in their pregnancy. In addition,
CHNCT began offering text4baby, a free mobile
information service designed to promote maternal
and child health. The service sends participants three
messages each week, which are relevant to where
the member is in her pregnancy or what the baby
is going through at a particular development stage.
Lastly, CHNCT expanded its diabetes program
to increase participation while also changing its
educational and outreach efforts.
19
20
CHNCT further developed its successful
Choices program in 2010 and began offering
educational, instructional cooking workshops to
adults and teenagers. Forty five workshops were
held over the course of the year, reaching nearly
450 members. In each two-hour workshop,
members learned the basics of the five food
groups and how their health is impacted by the
foods they eat. Workshops specifically focused
on the amount of sugar and salt in commonly
consumed products; good fats versus bad
fats; daily calorie requirements; as well as
healthy alternatives to popular foods. After
the educational portion of the class, members
had the opportunity to make several new
healthy recipes. Each participating family who
successfully completed the workshop received
a CHNCT reusable shopping bag, which was
filled with $25 worth of groceries. The Choices
workshops were tremendously successful and
all received positive responses from members.
CHNCT plans to offer the classes, which are
conducted in both English and Spanish, to
children ages four and up in 2011.
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A Healthy Appetite for Growth
22
23
MEMBER SERVICE CALLS
2010
2009
2008
HUSKY A and B
162,197
204,177
135,541
SAGA
27,494*
73,137
52,471
25,608
27,553
5,448
Total
215,299
304,867
193,460
HUSKY A
249,266
231,929
131,048
HUSKY B
8,655
9,380
5,412
45,350*
43,230
38,244
2,766
4,417
919
306,037
288,956
175,623
Charter Oak
ENROLLMENT
SAGA
Charter Oak
Total
* As of April 1, 2010, CHNCT stopped administering SAGA.
24
Financial HIGHLIGHTS
2010
2009
Current Assets
$114,335,597
$74,402,118
Other Assets
$20,344,495
$16,943,420
Total Assets
$134,680,092
$91,345,538
Current Liabilities
$115,494,151
$75,572,258
Total Liabilities
$115,494,151
$75,572,258
Total Net Assets
$19,185,941
$15,773,280
Total Liabilities and Net Assets
$134,680,092
$91,345,538
Revenue
$593,158,015
$519,033,562
Medical Expense
$554,086,984
$493,164,432
$35,638,226
$26,712,133
$3,432,805
- $843,003
Administrative Expenses
Net Gain/Loss
25
Board of Directors
26
Alfreda D. Turner
President & CEO
Charter Oak Health Center
ChairWOman
Katrina H. Clark
Executive Director
Fair Haven Community
Health Center
GARY F. SPINNER
PA
Southwest Community
Health Center
KATHERINE YACAVONE
President & CEO
Southwest Community
Health Center
Secretary
Don Thompson
President & CEO
StayWell Health Care, Inc.
Attilio V. Granata
M.D.
Treasurer
Jamesina E. Henderson
CEO
Cornell Scott-Hill Health
Corporation
Arvind Shaw
CEO
Generations Family
Health Center
LUDWIG M. SPINELLI
CEO
Optimus Health Care, Inc.
Carl A. Mikolowsky
D.D.S.
(Retired)
Evelyn Barnum
CEO
Community Health Center
Association of Connecticut
Sylvia B. Kelly
President & CEO
Community Health Network
of Connecticut, Inc.
27
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Annual Report 2010 | A Story of Growth | 15th Anniversary
Printed on recycled paper and soy-based inks.