One of the most common complaints about the American health care system is that it’s too complicated.
Providers are either inside or outside of your insurance network, you have to pay a certain amount out of pocket before even getting to use your insurance, and it’s not always clear how much procedures and medicine actually cost.
Plus, there’s the constant fluctuation with the Affordable Care Act, or Obamacare, as President Donald Trump’s administration tries picking it apart and courts make decisions about what sections of the law are legal.
Health service coordinators help patients — usually the elderly and families with children — navigate this system.
Coordinators develop a more personal relationship with patients and help evaluate options, answer questions, get connected with other helpful resources and even administer basic tests and screenings.
Coordinators are the “boots on the ground,” said Margo Boeh, the senior care service line director at Eskenazi Health.
Boeh said she has five coordinators in her department, and along with helping patients understand the health care system, they can also perform tests to measure cognitive function and level of depression, for example, which are standardized and don’t require a license or certification. The coordinators can then relay that information to physicians.
It may be simple enough for healthy adults to figure out what they need to do to get their yearly physical, but it becomes increasingly complicated for people who have more needs or don’t have the capacity to get help on their own.
“Ultimately, being unable to successfully navigate the systems of care, including the health care system, can result in families’ needs remaining unmet,” said Megan Wade-Taxter, a spokesperson for the Children’s Special Health Care Services (CSHCS) program, which is part of the Indiana State Department of Health.
CSHCS has coordinators available for families who qualify for the program. Those coordinators are knowledgeable about programs, services and financial resources that are available to families who have children with special health care needs.
The program can also assist with care coordination for families who aren’t enrolled or don’t qualify by connecting them with community resources, providers and agencies to assist them.
WGU Indiana, a private, nonprofit online university, recently launched a first-of-its-kind bachelor’s degree program in health services coordination, which will teach students how to coordinate among health care providers, patients, caregivers and services.
Dr. Mary Carney, WGU Indiana’s state director of nursing, said there’s a shortage of people to help navigate the health care system, which is “absolutely the most complex in the world.”
Health service coordinators — as well as those who train and oversee them — can spend their free time pushing for a health care system that isn’t so complicated if they want, but health care is referred to as an industry for a reason: it’s big and powerful and tends to get its way.
“That would be a perfect world,” Boeh said of the system that’s easier to understand. “… In reality, I don’t know if that’s ever gonna be a possibility. I think health care just by the nature of the beast is complex to navigate.”
Besides, no matter what the future holds for health care in America, people need help right now.
Carney said she can advocate for a less complex health care system, but that won’t mean much for someone who is diagnosed with cancer tomorrow.
Contact staff writer Tyler Fenwick at 317-762-7853. Follow him on Twitter @Ty_Fenwick.