Food gurus weighed as option in health plan 

If you’ve never thought of a food coach as part of your approach to health care, it may be time to start.

Preventative care — including food coaches, medication managers and lifestyle counselors — could be a major focus of any subsidized plan to provide health coverage for uninsured adults in San Mateo County, said S.T. Mayer, health policy and program analyst for the county.

The preventative care approach is just one of three options to be discussed today by the county Blue Ribbon Task Force on Adult Health Care Coverage Expansion.

The task force has set a July deadline to come up with a plan to cover the county’s uninsured and help curb the skyrocketing cost of indigent care.

Indigent care costs at the county’s publicly funded hospital, the San Mateo County Medical Center, rose to about $66 million this year,up from $54 million a year ago, Medical Center spokesman Dave Hook said.

The county is swimming in an estimated 36,000 to 44,000 uninsured adults.

Those with the most chronic diseases, about 15 percent, are responsible for about 80 percent of the costs, according to health experts.

Such preventative care and early intervention could not only help cut costs for some of the most expensive patients, but also improve patients’ health, Hook said.

"For individuals who have chronic care needs, we would organize their care, including all those things that go into their health care, not just their doctor visits," Mayer said.

The task force plans to run the estimated costs of the preventative care option two ways in the coming weeks: incorporating them into existing programs and funding sources, and separating them out as an insurance-based approach, Mayer said.

The third option would focus on providing incentives to patients for preventative procedures, likely in the form of subsidized prices, but would require deductibles for nonpreventative care.

The county would also act as a safety net for those who face financial ruin as a result of medical expenses, Mayer said.

Under any of the three models, families making at or below 400 percent of the federal poverty line, about $64,000 annually, would qualify.

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