Doctor spurs plan to improve town's health

A small city in Rhode Island hopes to merge the preventive approach of group-model HMOs with the choice of consumer-driven plans.

By Julie A. Jacob, AMNews staff. July 22, 2002.

Michael Fine, MD's professional life is defined by activism -- in particular pushing for increased access to family medicine and advocating more community involvement by physicians as a way to improve public health. Now Dr. Fine, working with a small city in Rhode Island, believes he's found a way to merge these passions into one grand experiment.

Dr. Fine is leading the development of the Scituate Health Plan, named for the town whose people it will serve. By next year, Dr. Fine plans to have in place a system in which Scituate's 10,000 residents will be able to buy into a health plan combining medical savings accounts with a high-deductible indemnity plan.

An individual buying into the plan would see $200 of his or her money used annually to support a "population-based primary care practice," which would aggressively seek out patients to stay on top of their health, regardless of their insurance status.

"It is in some ways a realization of the dream in primary health care," Dr. Fine said, "the ability to take care of the health care needs of the entire community."

The town council of Scituate -- a suburb with a rural feel, bordering a reservoir that provides most of the drinking water to Providence, 14 miles east -- believes enough in Dr. Fine's plan that they will offer it to municipal employees starting in September 2003, as well as taking on the task of finding commercial MSA and indemnity providers to administer it.

Paul Ginsburg, PhD, president of the Center for Studying Health System Change in Washington, D.C., said the philosophy of the Scituate plan is like group-model HMOs such as Harvard Pilgrim and Kaiser Permanente. [...]