Dr. Brad Lucas has seen the effects of poverty and how it can make a certain population seem helpless and unreachable. Instead of watching, he has done something about it.
From studying addiction in pregnancy to writing a book for how fathers receiving Medicaid can get involved and increase their children’s chances of success, Lucas has conducted outreach for the hard-to-reach populations, removing barriers to medical care.
Lucas, a Columbus native, attended Miami University of Ohio and graduated with a bachelor’s degree in chemistry. He then attended the Medical College of Ohio and completed his residency at Johns Hopkins University.
During his residency, Lucas says, he was exposed to patients whose needs drove his transition into the administrative side of medicine.
“When I trained at Hopkins, in a big academic center with a big population of underinsured individuals, (I learned) to love that population,” Lucas says. “I had to learn how to relate to them, enjoy who they were and walk them through scary paths. I learned to bond with them. When I came back to Ohio, I made sure I was taking care of the underinsured.”
He first practiced as an OB/GYN in Columbus, but moved to Cleveland and worked in the University Hospitals system. He continues to practice part-time at AxessPointe Community Health Center in Akron.
He now works as the chief medical officer of Buckeye Health Plan, a Columbus-based Medicaid managed care plan. He mentions that there was a transition to being on the administrative side.
“While working on the health plan side, I discovered that there are ways to impact whole populations of individuals, and here (at Buckeye), we are improving the health of the community one person at a time,” he says.
Lucas recognized a need for fatherhood initiatives. That’s when he decided to write what he calls “the dad book.”
Dad: Little Word…Big Deal
The book aims to educate expectant fathers of Medicaid recipients through Buckeye Health, covering pregnancy and how to get involved in their children’s lives early on.
“It helps dispel myths about the role of the father of the baby. It helps them understand their role as a new dad,” Lucas says. “It’s really unique because you can’t go to the bookstore or Amazon to find similar topics.”
Lucas says we don’t do enough for the fathers in this clinic setting.
“It wasn’t an inviting environment for the father,” he says. “Some people make the assumption that fathers don’t want to be involved, and that’s a dangerous assumption.”
And that’s no exaggeration: Research shows it really is dangerous and puts the child at risk of failure. If the father is absent in the home, the child is three times more likely to fail in school and two times more likely to be involved in drugs. Children without fathers won’t develop as well emotionally. On the flip side, those who have fathers present will likely have fewer behavioral problems and do better in school.
“We have medical therapies that we promote, but fatherhood is so much more impactful than some of the most proven medical therapies,” Lucas says.
Addiction in Pregnancy Program
With the Addiction in Pregnancy Program, Lucas deals with a transient, hard-to-reach population.
“When you go back to the evolution of health care – when you get to the challenging, difficult members in the health plan – we felt like we couldn’t touch them and couldn’t communicate with them,” he says.
“We tended to turn our attention to people we have a better chance of helping. But the problem was growing. So we said, ‘Let’s take this head on and get a sense for how big a problem it is.’” - Dr. Brad Lucas
And the problem was growing worse at a rapid rate.
Conducting studies that compared newborns with mothers addicted to narcotics, the data from 2009 to 2013 across Ohio showed that babies born addicted to narcotics had gone up 500 percent. Lucas says this data pushed the initiative into urgent action.
Not only does the program provide the medicine that removes the physical need for narcotics, it also identifies the members so they can stay on track to follow the doctor’s orders. Lucas says more women are enrolling in the program, and they work to keep them in long after the baby is born.
But the program’s success also comes from its openness and the staff who genuinely understand the barriers facing this fragile population.
“We were concerned that it would be hard to talk to these members. We learned that a lot of times, these individuals have burned every bridge that they have, and the people they have left in their lives are dangerous and actually encouraging them to use drugs,” Lucas says. “With this program, they learn there’s somebody there to really help them, and it’s a non-judgmental environment. We know how they got where they are and we understand.”
Lucas says that identifying challenges can be as simple as a quick conversation with the doctor, but it usually reveals complex barriers to getting medical care.
“There’s usually nonmedical care that has to happen for individuals to be in a place where they can think about getting care. If they have nonclinical barriers to getting care,” he says, “if that’s their reality – then it prevents them from getting the preventative care they need.”
Smart Start for Your Baby
In 2008, Lucas helped launch Buckeye Health’s Smart Start for Your Baby program, the health plan’s first effort to have a greater impact on pregnant mothers. It provides moms with information on pregnancy and early childhood through education and care management.
“You’d think it’d be intuitive that a health plan knows who’s pregnant, but that’s not always the case. We can’t even depend on claims because they can be delayed or inaccurate,” Lucas says.
“We want to find out who’s pregnant and understand their overall risk of having an unhealthy outcome, unhealthy baby or low birth weight baby.” - Dr. Brad Lucas
The program stratifies that risk to see those who are most in peril and need to have more care management. These populations get home visits to meet their individual needs, Lucas says.
“Those that are low risk, we keep a lookout and see if risk changes to see if we need to move them into a more high-risk plan,” Lucas says. “They all receive information about pregnancy and written in culturally competent fashion for literacy needs for everybody. And if they need transportation to get to the doctor’s office, we provide it.”
More so than anything else, the health outcomes are based on behavioral health and social risk factors, which are called social determinants of health.
“Where they live is a more important predictor than their own medical history,” Lucas says.
Lucas lives in Chagrin Falls with his family, including young twin girls and two teenage sons.
Corinne Murphy is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About Dr. Brad Lucas
Dr. Brad Lucas joined Buckeye Health Plan in 2005 and has served as the Chief Medical Officer for the company since 2013. In his role, Lucas helps build programs that reduce the rates of preterm birth, low birth rate and infant mortality.
Completing his OB/GYN residency at Johns Hopkins Hospital, Dr. Lucas is a fellow of the American College of Obstetrics and Gynecology. As a board-certified physician, he continues to see patients at AxessPointe Community Health Center in Akron.
