The Health Care Foundation of Greater Kansas City has been a robustly positive force over a decade that witnessed a deep recession, a necessary but disruptive new health care law and long strides backward by elected state officials in Missouri and Kansas.
Because of the foundation’s leadership, and its distribution of more than $200 million in grants, the region has found new and better ways to treat low-income and uninsured patients. The foundation also has been a leading partner in the growing push to focus on healthy lifestyles.
And so it is good news that a Jackson County Circuit judge last week handed the health care foundation a potentially game-changing legal victory.
Judge John Torrence ruled that HCA, a national for-profit hospital chain, reneged on commitments it made to adequately reimburse the community when it purchased the assets of the non-profit Health Midwest hospital group a dozen years ago. He ordered HCA to pay the foundation a $434 million judgment.
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HCA says it will appeal, and so the dispute is likely to be prolonged for a year or more. But the idea of a gigantic boost to the foundation’s assets holds intriguing possibilities.
Broadly, the foundation’s mission is to help ensure access to health care for uninsured and underserved citizens. In its first 10 years, it focused on helping those people gain access to medical, behavioral health and dental services. Alongside those goals, the foundation supported community efforts to promote healthy living and reduce the use of tobacco products.
Its efforts helped the region move forward, even as state governments in Missouri and Kansas made it harder over the past decade for citizens to access health care and pursue healthy lifestyles.
Missouri slashed Medicaid eligibility in 2005, and the General Assembly has refused to take advantage of the opportunity provided by the Affordable Care Act to expand eligibility limits and enable about 300,000 citizens to access health services.
Kansas also refused to expand eligibility, and concerns are mounting about KanCare, its managed care Medicaid system.
Missouri continues to have the nation’s lowest tax on cigarettes. Along with Kansas, it uses funds from a legal settlement with tobacco manufacturers to pay general state expenses rather than improve health outcomes. Both states invest little in public health, and both have slashed funding and services for mental health.
In a new report, “A Decade of Difference,” the foundation assesses the region’s achievements and challenges ahead.
A bright spot is the area’s embrace of measures such as urban gardens, biking and walking trails and healthier groceries in impoverished neighborhoods. Wyandotte County has embarked on a major initiative to improve residents’ health, and the foundation has supported it with $440,000 in grants.
Although rates of smoking in both states are much too high, many communities have passed smoke-free ordinances in the last decade. Kansas has a statewide prohibition on smoking in public places and workplaces. And a move to raise the legal age for purchasing tobacco products is gaining momentum.
And although the region still needs dentists, access to dental services for low income populations has increased dramatically.
Behavioral health has emerged as a major challenge, as demand has increased and states cut their funding. The region lacks resources to treat patients with problems ranging from mild to acute, and a shift to private, for-profit providers generally has meant less care.
But providers are learning more about how to treat patients efficiently, and cooperation from police and the courts has been encouraging. The health care foundation has awarded almost $50 million in grants to support behavioral health efforts.
The foundation’s 10-year report notes that the region has experienced an increase in poverty over the last decade, most dramatically in suburban areas. In coming years, the foundation will encourage steps to address societal factors and their role in people’s health.
“We know now that ZIP codes matter to health as much as genetic codes,” the report says.
“We also know that events that occur early in life, particularly traumatic ones, can influence physical and behavioral health for years afterward. Health providers consequently are realizing that they need to look beyond their own exam room to better treat patients.”
It is difficult to imagine what the Kansas City region might look like without the work and financial support of the Health Care Foundation of Greater Kansas City these last 10 years. Far better to envision the progress that could lie ahead as the foundation and the region build on the lessons already learned.