Multi-Share Health Coverage

Communities frequently express an interest in developing a Multi-Share program like that in Muskegon, Michigan. Muskegon is sometimes referred to as the "Alpha" model of Multi -Share community health plans. While Access Health was not the first to pilot a Multi-Share approach, it may be the most successful since its launch in 1999. Access Health is a community-based, not-for-profit organization that provides affordable health coverage to small businesses for uninsured employees. The AH model is not insurance. It is a community health coverage collaborative that coordinates care, reimburses providers, integrates community resources into care delivery, keeps costs affordable, and results in the health improvement of its members. The Multi-Share model fills a gap in coverage between entitlement safety-net services and commercial coverage. It is the product of out-of-the-box thinking by the volunteers in Muskegon who designed the model as an affordable health program to help those not covered by insurance.

The Muskegon Multi-Share model is financed with contributions from employers (30%), employees (30%), and through community funds (40%). The total monthly contribution amounts to $156 from all three sources. The employer and employee only contribute $46 per month, making the product affordable to small business owners.

The benefit plan for Access Health is a fairly comprehensive design. It includes; inpatient care, primary care, specialist care, medications, ER and urgent care, hospice, durable medical equipment and other standard benefits. It does not cover health services provided outside Muskegon County as it is limited geographically to providers in the County. The plan is not intended to operate as insurance, but does fill the gap in coverage for small businesses until they can afford insurance.

The Muskegon Multi-Share model also incorporates several features that are unique to community-based (sub-state) initiatives and not commonly included with insurance styled models. These community based Multi-Share features include:

1. Community governance in plan design, financial management, and medical policy


2. Niche sales and marketing programs to reach the small group business customer


3. Care management of chronic disease patients with integrated community resources


4. Information sharing through a web-based "mini-EMR" software program


5. Claims payment directly by the Multi-Share program (not through a TPA)


6. Integration of claims data with care management data available to all providers online

Development of a community based Multi-Share model along the lines of Access Health utilizes resources available in most communities. There may be institutional barriers (regulatory, political and finance barriers) in some communities that limit the development of an Access Health look-alike. However, the core community Multi-Share concepts may still apply in those areas where barriers limit some of the design flexibility.