Wexford Health works with inmates

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Wexford Health Sources Inc. is among the most successful local companies people never hear about, despite once being headed by one of the region's most prominent local politicians.

Wexford Health contracts with cities, counties and states to provide medical care for inmates in jails, prisons and a handful of juvenile facilities, supplying the expertise of their doctors, nurses and administrators.

With annual sales of $160 million, the Green Tree company is one of the top three in its field nationally, doing business in six states with more than 100 facilities holding 95,000 inmates.

That few people know about Wexford Health -- once led by former Allegheny County Chief Executive Jim Roddey -- suits current Wexford President Mark Hale just fine.

"The inmates are so litigious that we try to keep a low profile," he said.

Although uncommon, lawsuits filed by inmates do tend to generate lots of attention. Two years ago, Wexford Health's insurer agreed to a $1 million settlement in Florida with the family of an inmate injured in a fight. The family contended the medical staff waited too long to treat him; the company acknowledged no wrongdoing and "we don't feel that we did anything wrong," Mr. Hale said.

But lawsuits remain the exception to the rule, he said.

"Inmates view health care workers as their friends, that they're actually there to help them. Most of our people don't know what the individual did that got them there, and they don't care. They are there to treat the patient."

Although facilities and policies differ from institution to institution, Mr. Hale said most of their workplace environments strongly resemble civilian infirmaries and clinics. The inmates generally are not shackled. Unarmed guards remain in the room, but there are rarely problems.

"Just about every disease imaginable is seen in this population," said Mr. Hale. "You have your typical flus and colds and injuries, but you also have chronic conditions" such as diabetes or heart disease.

"It's a community, and people live their lives there. People need health care -- that does not go away."

Wexford Health was started in 1992 after courts issued rulings in support of inmates' rights to proper medical care during their incarceration. Wexford Health's founders, Kevin Halloran and Norm McCann, saw a business opportunity. "The people who are running corrections facilities know safety and security," said Mr. Hale, "but they don't know health care."

Wexford's philosophy is that physicians know best: If a physician on site needs a consult, they get in touch with one of the company's regional medical directors, not nonclinician administrators.

The goal, said Mr. Hale, is "to deliver the care as quickly as possible in long-term case management. It's more efficient and more effective."

The company says it generated $9 million in cost savings in its first 18 months working with the Maryland Department of Public Safety and Correctional Services through utilization management, network contracts and claims processing services. Wexford Health has been the statewide provider for West Virginia since December 2007, implementing drug utilization and centralized purchasing programs at the state's 11 facilities.

"We're in the business of public safety. We're not in the business of health care," said Joe Thornton, West Virginia's deputy secretary for the department that oversees corrections. "It would be like the Department of Health and Human Services running a prison. That's not something they're equipped to do."

Now in the second year of a five-year, $22 million contract, Mr. Thornton says "things appear to be running smoothly." While too soon to quantify any savings, "the quality is top-notch and the personnel are easy to work with," he said. "I have not heard one negative comment -- and inmates are not afraid to ask us about anything."

The company also briefly had the contract for Pennsylvania's state prison system until 2003, but terminated it "due to unexpected rising costs as well as additional risk factors that were put into the contract," Mr. Hale said. Nashville, Tenn.-based Prison Health Services is the current contract holder in the state.

Wexford Health physicians, nurses and administrators are assigned to a facility, although a handful travel to fill in for vacationing colleagues. The clinical staff like the set hours, Mr. Hale said, and particularly like not having to worry about haggling with insurers, paying malpractice premiums or overseeing the administration of a medical office. Wexford Health takes care of all of that.

"There's no financial incentive on their part to do anything but practice the best medical care," said Mr. Hale. "They are paid a salary -- they don't get paid by the procedure."

Although he would not specify what the salaries are, he did describe them as competitive and said Wexford has no more staff turnover than any medical facility.

Mr. Hale said he did hope to grow the business, which has been flat the last few years.

With states wrestling with budget deficits, Mr. Hale believes there's more incentive for them to look to outside contractors.

"We work with them to try to save money," he said. "It helps them, and it helps us at the same time."

Steve Twedt can be reached at stwedt@post-gazette.com or 412-263-1963.


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