By Christine Whitmarsh, RN, BSN
One of the most effective pieces in the state of Vermont’s innovative model of healthcare allows long term care, elderly and patients with disabilities more choices than they would normally be offered under traditional Medicaid. The program, called “Choices for Care”, gives individuals who would normally receive a nursing home bed access to alternatives such as home care. The state has also used their 2005 waiver granted by the Bush administration to implement other consumer-driven, cost-saving changes to their Medicaid program. All of the state’s changes have been met with resounding consumer satisfaction (in the 90 percent range). Is it just me or does Vermont’s Medicaid model fall more under the description of customized healthcare than universal healthcare?
Offering consumers the choice between nursing homes and staying in their own home, is a powerful reminder that at one point in history, universal healthcare and home care were one in the same. Travel nursing occurred when the designated “nurse”, elder healer or town doctor would travel up and down dirt roads from home to home with their bag of medical tools or simple home remedies. It is refreshing to see that when given the choice between facility and home, most Medicaid consumers in Vermont chose to stay home and be cared for by their families, with regular visits by registered nurses and other healthcare professionals (modern day healers). Perhaps the real key to universal healthcare is remembering the universal needs of patients when given the choice. As nurses we learn that the most effective patient teaching occurs when the patient is given a voice in the process, rather than simply being dictated to.
I am curious to see what other states of taken Vermont’s lead in implementing unique healthcare models that work. Travel nurses: What are the most innovative ways of emphasizing consumer choice that you have seen in various states, cities and hospitals?
Christine Whitmarsh is a Registered Nurse with a BSN from the University of Rhode Island. She is a freelance health journalist and medical writer and a contributor to Travel Nurse Source and Allied Travel Careers.