Community Care Coordination Community Care Coordination and Case Managementand Case Management

Kansas Public Health Association, Kansas Public Health Association, Inc.Inc.

2006 Fall Conference2006 Fall Conference

Central Plains Regional Health Central Plains Regional Health Care Foundation, Inc.Care Foundation, Inc.

• Charitable, nonprofit organization, closely affiliated with and housed within the Medical Society of Sedgwick County

• Our vision is to improve the health and well being of the people of Wichita/Sedgwick County, Kansas

• Program areas:– Project Access: Coordinates donated medical care for low-

income, uninsured residents of Sedgwick County– Clinics Patient Index: A shared data project encompassing five

safety net clinics and Project Access– Enhanced Care Management of Sedgwick County: A five-year

pilot care management program for eligible Medicaid HealthConnect patients

– Various special projects and studies, implemented in partnership with local providers, to assess needs and potential areas of impact

• Hospital-wide utilization study/KU School of Medicine-Wichita• ED case management program through area hospitals

Background/NeedBackground/Need

• The need to improve the health of vulnerable, invisible patient populations

• The need to increase access to health care services for the uninsured and underserved

• The need for a more coordinated system of care– A coordinated system of enrollments, referrals and

communication among providers related to patient needs– A more coordinated effort among providers to develop innovative

models that work• The need to track data and information to share with the

community about local efforts • Our projects fit within the Healthy People 2010’s Leading

Health Indicator, Access to Health Care

Goals/ObjectivesGoals/Objectives

• Our goals are to:– Improve the health status of our patients

• By coordinating care and services• By reducing inappropriate utilization of medical

services that are not in the best interest of our patients and are very costly to the community

• By educating patients about how to manage their conditions and access the services they need to live healthier lives

– Extend more care to more people at less cost

Who Is Involved?Who Is Involved?• Physicians and the Medical Society of Sedgwick County• Area hospitals • Safety-net clinics• KU School of Medicine-Wichita and related residency programs• Pharmacies• Funding partners including United Way of the Plains, City of Wichita,

Sedgwick County, Sunflower Foundation, SRS Wichita Area Office, and the Kansas Health Policy Authority

• Community representation on an Operations Council and many working committees– Keep our programs patient-focused and community-based – Provide important leadership and guidance

• To respond to environmental changes• To make course corrections in current program areas• To consider new initiatives

Progress or ResultsProgress or Results• Clinics Patient Index:

– Safety net system is stronger and more viable by communicating more effectively

– New data will provide a unified voice across safety net• Project Access:

– 6,900 Project Access patients have accessed more than $51 million in donated medical care and services

– Broad range of partners convened to serve the uninsured and develop new models that work

• Enhanced Care Management:– Early results are promising– More than 100 patients served– Developed care management concepts that include intensive

supportive services provided by a multi-disciplinary team, patient education techniques, coordination of health care services and integrated quality standards of practice

Expected ImpactExpected Impact• Project Access patients experience a clinically-significant improved

health status• They are also much less likely to visit area emergency departments

for primary care conditions• Local medical community saves money because care is accessed

when needed rather than waiting until conditions become severe and acute

• Enhanced Care Management patients are experiencing positive results early in the program– Anecdotal stories of success– A unique model has been developed and implemented– Detailed evaluation plans in place to track program outcomes– Currently working with the Kansas Health Policy Authority staff on

funding issues so that we may continue this pilot project• The medical community has taken a lead in coordinating activities

that serve the underserved• This leadership will drive us towards new models and approaches

that will improve the health of our entire community

ApplicationApplication• Many communities have initiated similar programs, perhaps your

community is ready• Visit our website and the American Project Access Network’s

website for more information about volunteer-physician programs:– www.projectaccess.net

• Click on evaluation reports– www.apanonline.com

• Access information from many other communities• Identify potential approaches/models• Develop a leadership group to further your mission• Build the political and community will to implement your programs• Develop the key partnerships to get them off the ground• Implement programs with integrity and include objective evaluation

activities to assess strengths and weaknesses• Use that information to make course corrections quickly• Report successes and failures honestly

Contact InformationContact Information

• Anne Nelson, Chief Operations Officer

• Central Plains Regional Health Care Foundation

• 1102 South Hillside

• Wichita, KS 67211

• Phone: 316-688-0600

• Email: annenelson@projectaccess.net