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SC AHQ July 10, 2009

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*. Health Effects of ‘Uninsured’.

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SC AHQ July 10, 2009

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  1. SC AHQ July 10, 2009

  2. 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

  3. National Institute for Health Care Management, CPS, 2008

  4. 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

  5. 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

  6. 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

  7. 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.

  8. AccessHealth SC, Melanie Matney, mmatney@scha.org

  9. Community Network Assistance Cycle Technical Assistance Center $ Funder Collaborative $ $ Sustaining Community Networks Preparing Community Networks Implementing Community Networks AccessHealth SC, Melanie Matney, mmatney@scha.org

  10. 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.

  11. Program Model Green = Processes (barriers) Yellow = Impact Measures Blue = Outcome Measures Health Quality of Life Patient with Medical Home and Primary Care Team Logistics of Care Provider Availability Transportation Provider Culture Prevention & Education Emergent Hospital Medications Specialty Cost of Care Non Emergent Hospital Behavioral Dental Marketing & Outreach Patient Activation (learned behavior, motivation & beliefs) Appropriate Utilization

  12. PartnershipModel Primary Network Members Network Supporters SC Hospital Association SC Office of Rural Health SC Medical Association AccessHealth SC SC Dept. of Health & Env. Control SC Dept. of Mental Health Community Health Centers / FQHCs SC Dental Association SC Dept. of Health & Human Svc. Local Health Dept. Free Medical Clinics The Duke Endowment Legislators Hospitals Private Providers Patient SC Primary Health Care Association Other Local Businesses Local Behavioral Health Agencies Rural Health Clinics SC Rural Health Research Center Pharmacy/Welvista SC Free Clinic Association SC Dept. of Alcohol and Other Drug Abuse Services Other Funders Fiduciary (Not for profit hospital or ‘umbrella not for profit organization) SC Office of Research and Statistics

  13. 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

  14. Questions? Melanie Matney Executive Director, AccessHealth SC 1000 Center Point Road Columbia, SC 29210 P: 803-744-3556 mmatney@scha.org www.accesshealthsc.net

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