Date: Sep 19, 2013 Author: Guy Boulton Source: Journal Sentinel (
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An affiliate of ABC for Health Inc., a public-interest law firm in Madison, has received a $1.2 million grant from the National Institutes of Health to develop software to help hospitals and clinics determine whether patients are eligible for government health programs.
The three-year grant is the second from the NIH Small Business Innovation Research Program for My Coverage Plan Inc., a for-profit affiliate of ABC for Health.
My Coverage Plan hopes to develop decision-support software based on processes used by ABC for Health to determine eligibility for government programs.
"This is niche expertise we have and that we have been doing for 20 years," said Bobby Peterson, founder and president of ABC for Health.
The software would ask a series of questions, such as whether someone was pregnant or a veteran, with each answer leading to other questions, to help staff through the complexities of Medicaid and other programs.
My Coverage Plan received an earlier grant — initially thought to be worth $1.2 million but instead totaling $400,000 — that ran from June 2010 through June 2013.
The first grant enabled the company, which received a patent last year, to develop a prototype.
"We showed that, yeah, this thing could work," Peterson said.
The second NIH grant, contingent on reaching certain milestones, should enable the company to develop a product.
The software could generate millions of dollars in additional revenue for hospitals and clinics by determining if uninsured patients are eligible for government programs.
St. Mary's Hospital in Madison took in an estimated $9 million in additional revenue last year using processes developed by ABC for Health to determine eligibility, Peterson said.
"We figured out a way to help low-income people through the system," he said, "and to help health care providers get paid."
Peterson, who came up with the original idea, owns 51% of the company. ABC for Health owns the remainder.
"We may be the only nonprofit public-interest law firm in the country that has a for-profit tech company as a subsidiary," he said.