Since South Carolina began offering Medicaid members choices of health care plans almost two years ago, both patients and providers are seeing the benefits of the transition.

Isaiah Lineberry, practice manager for the Singleton Clinic in Orangeburg, said the process of choosing a health plan has improved since the beginning of the program. "Patients didn't realize that making no choice was making a choice," he explained. "Healthy Connections Choices (HCC) has made the process more patient- friendly for the selection of health plans. HCC has been very responsive to our questions and needs," he added.

Lineberry said responsiveness, improvements to the selection process, and patient- friendly attitudes are why the Singleton Clinic feels good about encouraging patients and other practices to work with Healthy Connections Choices.

In Charleston, Dr. Mike Wheaton's pediatrics practice is 70 percent Hispanic patients. "My niche is the Hispanic population in this area, and I take Medicaid patients," he said. "I am a big advocate for Medicaid. The medical home model establishes a relationship between the family, child, and doctor," he added. "For children, the concept of a medical home is very important. A patient who receives care from one doctor is better served because I know their history, their family, and any other factors that can affect the care of the child."

"Healthy Connections is helping children find medical homes. I have a patient in my practice who received his asthma care from the emergency room every other month," Dr. Wheaton said. "Since joining a health plan, the parent was told about my practice and the acceptance of new patients. This patient has been well controlled now for over six months."

Dr. Wheaton likes being able to see prescription data on his patients from the health plans. "This helps me make adjustments to my prescriptions and helps me track emergency room visits so I can go back and find out why a parent felt that visit was necessary. I am available to my patients 24/7 and encourage them to contact me before going to the emergency room," he explained. "The health plans also give me alerts about a child not making well visits or refilling an important prescription."

He acknowledges that standardizing prior authorizations would make the process easier for patients to get services. "Overall, my job is easier the more times I see a patient," Dr. Wheaton added.

At York Pediatrics in Rock Hill, Dr. Tunde Ayodule and his staff have also learned to navigate the managed care system to benefit their patients. "We encourage patients to look at all the health plans offered in this county and select the one that best meets their needs and those of their family," said Toks Ayodule, practice manager.

Staff member Brandi Humphreys says she looks for the specialists who are in the network with the health plans. "Patients call and ask what plans we take. We don't recommend any one plan but let them know some plans offer extra services they may need."

"In pediatrics the two biggest issues we face are allergies and asthma," said Dr. Ayodule. "With asthma patients we work with medications and other actions parents can take to avoid taking the child to the emergency room unnecessarily. The health plans can look up a patient and work with the primary care physician to be sure the patient is taking appropriate medicines," he said.

"We are working with patients to talk to a nurse first so we can triage with patients," he added.

Healthy Connections Choices is part of the state's overall Medicaid reform plan and is designed to get a better return on South Carolina's health care investment. Through partnerships with managed care organizations, medical homes networks, and special enrollment counselors, the SC Department of Health and Human Services (SCDHHS) seeks to increase care coordination and disease prevention methods not found in traditional Fee- for- Service Medicaid. Those who choose to enroll in a health plan will be able to establish crucial relationships with a primary care doctor.

For more information on SC Healthy Connections call free 1-877- 552-4642 or visit the website at www.SCchoices.com.