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SC AHQ July 10, 2009
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SC AHQJuly 10, 2009
The Uninsured• 2007: 45 million uninsured in US
(uninsured for the whole year)– Decrease of 1.5 million from 2006*
• Mostly children• State expansions in Medicaid and SCHIP
• 81% from working families*• 65% make less than 200% FPL*
* Kaiser Family Foundation, 2008
National Institute for Health Care Management, CPS, 2008
Health Effects of ‘Uninsured’• 50% have no regular source of care*• Four times more likely to delay or forego needed care
than insured*– Cost– Learned culture
• More likely to be hospitalized for avoidable conditions than insured*– Less likely to receive diagnostic and treatment
services than insured**• Higher premature mortality than insured**
* Kaiser Family Foundation** The Urban Institute
Why the Disparity?• Multiple providers wanting to help• Access
– Cost– Fragmented delivery system
• logistics, transportation, availability of providers– Uninformed providers and consumers
• Marketing/outreach
• Patient Activation– Learned behavior, motivation, beliefs
Is Health Insurance the Answer?• Partial• Also need to address the delivery
system– Coordinated services– Work with availability of providers– Education (providers and patients) on
availability of services
AccessHealth SC• Spark sustainable health system change
that results in better health outcomes and 100% access
• TA and Funding Coordination• Objectives
– Improve access to comprehensive, coordinated services for low-income, uninsured
– Leverage and align existing resources by creating a statewide collaborative of key stakeholders
• Data Reporting and Collection– Build on prior successes and experience of existing indigent care
programs - Expand on what is working now.
AccessHealth SC, Melanie Matney, [email protected]
Funder Collaborative
Technical Assistance
Center
PreparingCommunity Networks
ImplementingCommunity Networks
SustainingCommunity Networks
$
$
$
Community Network Assistance Cycle
Network• Collaboration of providers that communicates and works
together to align services• Serves as an advocate for patients and links them to a medical
home to access: – General primary and behavioral healthcare– Preventive and educational services – Specialty care– Dental care– Non-emergent hospital care – Medications
• These components are linked through care navigation that works in conjunction with the medical home so that barriers are addressed and a patient is able to receive the right care in the right place at the right time.
Patient with Medical Home and Primary Care Team
Health Quality of Life
Logistics of Care
Cost of Care
Transportation
Provider Availability
Patient Activation (learned behavior,
motivation & beliefs)
Provider Culture
Marketing & Outreach
Medications Prevention & Education
Emergent Hospital
Specialty
Behavioral Non Emergent Hospital
Dental
Appropriate Utilization
Program ModelGreen = Processes (barriers)Yellow = Impact MeasuresBlue = Outcome Measures
Network Supporters
SC Hospital Association
AccessHealth SCSC Office of Rural Health
SC Medical Association
SC Dept. of Health & Env. Control
SC Dept. of Mental Health
Primary Network Members
Fiduciary (Not for profit hospital or ‘umbrella not for profit organization)
Patient
SC Dental Association
The Duke Endowment
SC Primary Health Care Association
SC Rural Health Research Center
SC Dept. of Alcohol and Other Drug Abuse Services
SC Office of Research and Statistics
Other Funders
SC Free Clinic Association
Other Local Businesses
Legislators
SC Dept. of Health & Human
Svc.
Community Health Centers / FQHCs
Local Health Dept.
Private Providers
Local Behavioral Health Agencies
Pharmacy/Welvista
Rural Health Clinics
Hospitals
Free Medical Clinics
Partnership Model
Anticipated Outcomes• Development of community collaborations• Development of networks delivering
coordinated care to uninsured– Common measurement and evaluation
• Appropriate utilization of health care resources
• Improved health outcomes
Questions?Melanie Matney
Executive Director, AccessHealth SC1000 Center Point Road
Columbia, SC 29210P: 803-744-3556
