SC AHQ July 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: A Technical Assistance Center Define Network Model Community Planning and Development Technical Assistance Centralized Support Services Group Learning / Benchmarks Fund Development AccessHealth SC, Melanie Matney,

AccessHealth SC, Melanie Matney, Funder Collaborative Technical Assistance Center Preparing Community Networks Implementing Community Networks Sustaining Community 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 Model Green = Processes (barriers) Yellow = Impact Measures Blue = Outcome Measures

Network Supporters SC Hospital Association AccessHealth SC SC 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 SC 1000 Center Point Road Columbia, SC P: