Jan. 11--Even as politicians and health advocates nationally clamor to create new patient protections, a home-grown information hotline is winning acclaim for helping Sacramento-area health consumers understand and exercise their existing rights.
Sacramento-based Health Rights Hotline provides free, independent information and advice to consumers navigating the often confusing world of health care. The group was formed about three years ago and provides services in Sacramento, El Dorado, Placer and Yolo counties.
'At the time (the hotline started) patients' rights weren't even on the agenda,' said Larry Levitt of the Kaiser Family Foundation. The organization provided a four-year grant along with two other California health foundations to launch the hotline as a pilot program.
Since then, California health consumers have acquired the right to sue their health plan, class-action lawsuits against health insurers are sprouting nationally and the U.S. Congress is considering passing a 'patients' bill of rights.'
And the 10-employee Health Rights Hotline is being singled out as a possible national model for patient education and advocacy. It is the only program of its kind in the nation, according to the Kaiser Family Foundation. The hotline is highlighted by the august Lewin Group, a leading health policy think tank, in an article published in the January/February issue of the journal Health Affairs.
'There appears to be a real need for independent assistance programs like the Health Rights Hotline to educate consumers about their rights and effective means for resolving problems they experience with the health care system,' said Gina Livermore of the Lewin Group, which recently completed an evaluation of the hotline.
Hotline counselors responded to more than 4,300 calls during its first 18 months of operation, the period of time evaluated. According to the Lewin Group evaluation, some two-thirds of the callers said they had not contacted their health insurer for help. The remaining third, who said they had contacted their plan, said the plan was not helpful and 30 percent said they disagreed with the action the plan took to resolve their problem.
'I think we are showing that there is value added to the health care system because we are around,' said Shelley Rouillard, the hotline's director.
Walter Zelman, president of the California Association of Health Plans, said the hotline best functions as a bellwether of trends and identifier of common problems. He questions whether the regional hotline model is the best one to help resolve those problems.
The hotline's operating cost for one year is about $1 million. It handled about 3,500 calls last year.
'It seems to me a very expensive way to go, given the amount of people they actually reach,' Zelman said.
Dispute resolution and problem solving is best left to the state, whose newly created Department of Managed Care regulates health insurers, he said.
The department includes an Office of the Patient Advocate, with 13 staff members and a budget of $880,000 for the 2000-2001 budget year, to assist consumers.
HEALTH RIGHTS HOTLINE AT A GLANCE
Where: Sacramento
Whom it serves: Health care consumers in Sacramento, El Dorado, Placer and Yolo counties.
What it does: The independent, privately funded hotline provides free information and assistance to health care consumers who have problems and/or questions regarding their health plan or provider.
Contact information: Call (888) 354-4474, 9 a.m.-5 p.m. Monday through Friday.
