Industry Voices—How innovation could mitigate Puerto Rico’s Medicaid challenges

The U.S. territories' Medicaid programs are set to regress to a state of permanent underfunding unless policymakers take action. (Pixabay)

The U.S. territories' Medicaid programs are set to regress to a state of permanent underfunding unless policymakers take action when Medicaid funds expire in September 2019, impacting an already challenging healthcare environment at a time when Puerto Rico is still rebuilding after Hurricane Maria.

Fortunately, innovative healthcare solutions now enable underinsured and uninsured individuals across the Hispanic community to gain access to quality care designed to serve their needs.

These solutions give Hispanics and other underserved populations everywhere access to care at an affordable price, whether it’s in the U.S. or Puerto Rico, in either English or Spanish, and without the need for any type of insurance or third-party payment.

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Inside a healthcare crisis

Roughly 1 in 2 Puerto Ricans are enrolled in the island’s Medicaid program. What’s more, Puerto Rico’s healthcare system faces a number of issues. Given its demographics, health indicators are worse than for the rest of the United States, and the island’s Medicaid program that covers half of the population faces financing difficulties in addition to Puerto Rico’s overall fiscal challenges.

In addition, Puerto Rico's health system has seen a dearth of resources due to systemically unequal reimbursement rates. As a result, many health professionals are leaving the island every year to earn more money in the mainland U.S.

Also, healthcare centers in Puerto Rico now face growing health needs, broader health system changes and infrastructure issues.

Healthcare administrators in the territories warn that the uninsured population could double if funding collapses. What’s more, if the Medicaid programs reduce provider reimbursement, it will make matters much worse.

The best solution is the elimination of spending caps as a way to help meet the healthcare needs of the Medicaid populations in Puerto Rico and the territories. Another solution involves proven technology that leverages decades of health industry knowledge and speed to access care among Hispanic communities—including Puerto Rico.

Accessing care when and where it is needed

These solutions and digital access align with Hispanic use of new technology tools: 84% of all Hispanics are online and Hispanic internet smartphone usage is 10.5 hours per week—25% more than the national average.

Now, a growing number of Hispanic consumers can access several cash-based primary care and pharmacy solutions, such as:

  • A medication voucher program that gives consumers the ability to prepurchase generic medications at affordable price points. They can be purchased for personal use or gifted to a friend or family member either domestically in the U.S. and Puerto Rico, or internationally.
  • A free prescription savings card model allows cash-pay consumers to save a significant percentage on brand name and generic medications across a wide network of pharmacies.
  • An end-to-end clinical solution for patients with diabetes, hypertension, asthma and obesity that includes vouchers for medications, peripherals, testing supplies, tablet, apps and access to lifestyle coach consults.
  • A bilingual telemedicine platform, which helps underserved populations access the healthcare they need with more ease.

Technology solutions can dramatically simplify access and delivery of quality health and wellness products, and allow individuals to access care, learn about their health, determine their wellness needs, access low cost medications, manage their chronic conditions and engage in behavior modification solutions to help them lead healthier and more productive lives.

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