Inland Empire Health Plan (IEHP) | SMG - Solutions Marketing Group

Inland Empire Health Plan (IEHP): Commitment in Action

By Joan Leotta

The need for affordable and convenient healthcare pervades the lives of many Americans, but perhaps none more so than those in the disability community. While many managed care providers seem to be cutting back on services, one group has broadened their offerings to make sure that people with disabilities receive treatment that is both appropriate and accessible. The Inland Empire Health Plan (IEHP) of San Bernardino, California has 32 initiatives in operation or in the works that are aimed at improving both the general health and the delivery of healthcare services to persons with disabilities.

What is IEHP?

IEHP, a licensed not-for-profit public health plan, serves 275,000 members in San Bernardino and Riverside counties in southern California. IEHP provides services through three programs: the Healthy Families program, (part of the state’s S-CHIP or Children’s Health Initiative Program), Medi-Cal (California’s state equivalent to Medicaid) and through their own Healthy Kids Program. IEHP’s service area starts at the eastern edge of Los Angeles County and ends at the border with Arizona, traversing both rural and urban areas and zigzagging across English and Spanish language and culture lines. About 12,000 Medi-Cal clients with disabilities have chosen to join IEHP rather than stay on fee-for-service Medi-Cal. “There may be other persons with disabilities in our other programs but those people may or may not have self-identified,” says Carl Maier, IEHP’s chief marketing officer.

Commitment to People With Disabilities

The commitment to the needs of people with disabilities has been a part of IEHP’s organizational culture since its inception in 1996. Maier indicates that “the leadership of our CEO and the commitment and esprit de corps of our staff guides our motivation to institutionalize good service practices and policy.” The development of programs that serve this community demonstrates this efficacy of that commitment.

He notes that IEHP achieves the goal of developing effective programs through involvement of insiders. “There are several persons with disabilities on staff,” he explains, “and they often come up with ideas that bring us to a closer study of disability issues and how to further improve service to the disability community. Their perspective gives us a greater sensitivity as to how a product works for them.”

Ideas also come from the field. “We talk to our members and study how they use services and technology,” he explains. “When an idea comes forth, our corporate culture makes it an issue to study and tries to apply its best aspects to our own situation.”

An Idea In Action

One of IEHP’s newest ventures is a wheelchair seating clinic for members with neurological or orthopedic diagnoses. The clinic measures clients for custom wheelchairs, seat cushions, or positioning systems. A multi-disciplinary team led by physical therapists performs evaluations to support physicians in obtaining the best fit for patients.

In a press release announcing the clinic, IEHP CEO Richard Bruno said, “When a person relies on their wheelchair for mobility, having the right chair is crucial to living a healthy and independent life. We’re very excited to be able to offer this program to our members.”

Proactive Outlook

Despite their focus on providing public healthcare for lower-income populations, Maier notes that, “We like to be proactive in healthcare. As far as we know, we are the only program with as many initiatives as we have going and one of only two Medicaid programs with a wheelchair clinic like ours in California. It makes sense to us—saves clients from the pain of poor fit and pressure sores and saves the plan money in terms of additional medical care avoided through a good fit.”

Providing quality services is an ongoing process. As Maier explains, “We constantly look at our core services and line that up with the needs of specific communities, such as the disability community. In the case of persons with disabilities, we felt that we offered a good group of core services but that access was not where we wanted it to be.” So IEHP set out to improve access to their centers, tackling this issue as it does any problem--from the point of view of their clients with disabilities.

Researching Problems

Says Maier, “We looked at physical access for people with disabilities in our geographically huge [area of] care and asked questions such as, ‘Can our population get into the door of each physician?’ ‘Is access available with public transportation?’ ‘Are there curb cuts, accessible elevators, and accessible restrooms in the buildings?’”

For some of these issues, IEHP teamed up with the Western University Center of Health Sciences, Centers for Disability Issues in the Health Professions. Anne Grey, IEHP’s disability community relations manager, explains, “The University also helped us develop a physician’s office site audit tool so that members will know what to expect when they choose a doctor.” For example, the architecture in the coverage area often poses problems. “There are a lot of historic buildings in this region,” Grey says, “and 1850s buildings often have lovely architecture but are not always disability-friendly.”

For the Good of All

Many initiatives developed for IEHP’s clients with disabilities often end up providing a contribution to the broader base of members. Maier gives an example. “Our first [disability-focused] initiative was a bus stop directory,” he explains. “While it helps members with visual disabilities, it is also useful in general for low-income members who do not have private cars.”

The IEHP’s diabetes program also provided further-reaching results. Maier notes that the company established “a special program for persons with sight disabilities who might also have diabetes, to get them talking glucometers.” These instruments proved beneficial to other clients with diabetes.

“By looking at the nuances of each program,” Maier said, “we see possibilities for improving the care we offer to people with disabilities. And by looking at the ripples these programs generate, we find ways to apply those improvements to other members in our population. The programs we implement require us to delve deeply into the culture of each community we serve.”

Maier credits Grey for a lot of work on driving disability forward at IEHP. “She often sees other programs, researches them, and then recommends adapting them to our needs,” he says. For example, Grey identified and championed a wellness program from the University of Montana, taught for and by people with disabilities. It's a general health and wellness program helping people to take charge of their own care, set goals, and live independently.

Looking Beyond the Minimum

The initiatives that serve people with disabilities, designed to save clients’ time and preserve their dignity, often save dollars as well. Says Maier, “Dollars saved go back into services and toward implementing goals of doing still better—improving more outcomes for as many of our members as possible.”

So much so that the IEHP’s programs may soon set the standard. “The state of California has looked at some of our work as innovative and groundbreaking,” Maier explains. “But we hope that programs they view in that way can become the minimum standard—we hope that if we excel, such work will raise the bar for healthcare for people with disabilities everywhere. It is our dream that such improvements will permeate the commercial healthcare sector as well and so increase the quality of life for everyone, everywhere.”

Note: To contact IEHP and learn more about their initiatives, call 1-800-440-4347 and ask for Anne Grey, Disability Community Relations Manager, or go to www.iehp.org.

Edited by Mary-Louise Piner.