In 2000, many Medicaid recipients traveled outside Cayuga County to receive costly treatment for substance abuse and obstetrical care.

Five years later, the county's rural health network wants to know if that's changed.

The Cayuga Community Health Network, with help from partners that include East Hill Medical Services and Auburn Memorial Hospital, will look at 2003-04 Medicaid data to determine if service delivery improved, and what still needs to be done.

Studying Medicaid use trends and costs is critical in light of Gov. George Pataki's anticipated cuts to Medicaid, said health network executive director Jim Kennedy. Finding the best way to provide services - coordinating agencies so clients don't have to make repeated visits in and out of the county for treatment, for example - could help meet potential financial challenges.

He would not say for certain it the study will find that things have improved. But he's hopeful and noted that the number of providers have changed during the past five years in Cayuga County.

Sue Cushing, vice president of operations for East Hill, said some Medicaid recipients use the emergency room for routine medical care because they don't have a primary care physician. There are also those who seek medical services through the hospital who don't know they may be eligible for benefits for themselves and their families.

"This will give an idea of what is utilized in health care and whether the access is appropriate or not," she said.

In the 2000 study, the community health network focused its analysis on the most costly services that county residents were leaving the county to receive. Kennedy said those were obstetrical, gynecological, or involved treatment for substance abuse.

The 2005 study will look at what types of patients continue to leave the county for services and where Cayuga County's Medicaid residents go for primary care. Cushing suspects the data may show fewer Medicaid recipients looking to Auburn Memorial Hospital's emergency room for services because there's been an effort to promote care through specialized clinics.

There may be less demand for out-of-county substance abuse services due to Demand Treatment!, a national initiative that focuses on the quality and success of treatment and its outcomes. Kennedy said the program looks for early and less expensive screening and treatment, primarily by primary care providers. To that end, East Hill and Confidential Help for Alcohol and Drugs worked together a few years ago to begin coordinating services. Kennedy said it's a model that other medical providers can use to make some economies of scale and reduce the Medicaid cost burden.

Kennedy said people leaving the county for medical services should be a concern for local businesses as well because they spend money on other things while they are taking care of their health needs.

"A lot of those dollars go to Onondaga or Monroe counties," Cushing said.

The 2003-04 Medicaid data will also help determine a profile of the county's long-term care population in the area of cost containment based on current trends.

Kennedy anticipates the study will be completed mid-year.

Staff writer Louise Hoffman Broach can be reached at 253-5311 ext. 238 or louise.hoffman@lee.net.