BATTLE CREEK - The following commentary by Dr. Thomas R. Akland on the Children's Healthcare Access Program was published in the Battle Creek Enquirer Sept. 1, 2011:

Delivering high quality health care to at-risk kids

Written by Dr. Thomas R. Akland
Opinion/Editorials

There is a movement afoot in the way that health care is delivered to impoverished children in our state. The Children's Healthcare Access Program (CHAP) here in southwest Michigan, Kent County (Grand Rapids) and Wayne County (Detroit) has been working hard to bring communities together around the issue of delivering high-quality health care to impoverished children by focusing on primary preventive care and early intervention.

We have been working with families, community partners and the Medicaid Health Plans to make this happen. The results of this effort in Grand Rapids were released last week and they are impressive.

As our economy has declined, the number of children living in poverty has sharply risen. In the past decade, there has been a 60 percent increase in children under 5 years old who live in poverty in our community. Currently, 48 percent of the babies born in our area hospitals are born into impoverished families and into the Medicaid system.

We know that children with Medicaid have different health outcomes than children on private health insurance due to the many factors of being poor in our society. For example, if a child on Medicaid is admitted to the hospital, he or she has almost twice the mortality rate of a child on private insurance. And, an infant on Medicaid has a 1.7 times higher mortality rate as an infant. The ever-expanding population of impoverished children who are at risk of poor health outcomes in our community strains the safety net for these children - our area hospitals, physician practices and health clinics.

Unfortunately, it is often this population - which needs it the most - that struggles to access health care. Whether it be same-day transportation, the cost of medications or the policies of physician practices, the families of impoverished children often have many barriers to accessing appropriate care. CHAP has collaborated with physician practices, families of children on Medicaid, community organizations, hospitals, schools and business leaders to change the way health care is delivered, and better coordinate wrap-around community services for impoverished children. In Kent County, this has produced dramatic results.

The successful innovation of the CHAP model in developing partnerships in communities has helped to lessen the impact of poverty on the children's health. For the more than 2,000 children enrolled in Kent County CHAP, there was a 35 percent decrease in how often these children went to the emergency room and a 62 percent decrease in how often they were admitted to the hospital. Amongst the children with asthma, there was a 78 percent decrease in missed school days.

These results show how this program helped to deliver better care that resulted in healthier children who went to school more and used expensive hospital-based services more appropriately. The other outcomes are societal - there was a net savings to society - a positive return on investment for this program and it was cost neutral to the Medicaid health plan that supported it.

Medicaid is a shared resource for and supported by the people of Michigan. The proof is clear that, if we work together, we can help to deliver better health care to impoverished children on Medicaid. Thanks to the efforts of the Early Childhood Investment Corporation and the Michigan Chapter of the American Academy of Pediatrics, the Southwest Michigan Children's Healthcare Access Program is evaluating and replicating this successful program and will begin enrolling children and offering services in 2012. Support for innovative and successful programs such as this should continue to be a top priority for our community.

Dr. Thomas R. Akland, DO, FACOP, FAAP, is a board-certified pediatrician, chief of the Department of Pediatrics at Borgess Medical Center and medical director, Southwest Michigan Children's Healthcare Access Program.