Rural Health Network Development Grantee Meeting August 2, 2010

1. Rural Health Network Development Grantee MeetingAugust 2, 2010 Diane M. Hughes, MBA Executive Director

2. Mission Statement Access Health Adams County (AHAC) develops, supports, and coordinates programs to provide appropriate access to healthcare for individuals whose access to services are limited due to insurance status and other factors including health conditions, health literacy, and social issues.

3. Three Main Components • Community Service Link • Physician Led Access Network • Care Management

4. Community Service Link (CSL)

5. 27 Participating Agencies 1,477 unduplicated Adams County residents Quarterly provider audit Ongoing user training 159 Users Quarterly User Group Meetings 35 referrals came to AHAC from Oct - May CSL Statistics

6. Medicaider statistics Medicaider screens Adams County residents for eligibility into all state and federal programs. • 992 Medicaider screenings • 238 clients screened eligible for programs • Avg. interview time: 2.17 minutes • 80 users community-wide

7. Community Service Link (CSL) • What makes the linking system and Medicaider valuable?

8. Community Service Link (CSL) • How could this software pay for itself?

9. Community Service Link (CSL) What is AHAC doing to make system Sustainable and valuable? • Require Participation Agreements • Quarterly User Group Meetings • Training Sessions • Weekly emails to update users • Participation Certificates • Executive user group meeting planned for the Fall 2010

10. Physician Led Access Network (PLAN)

11. Physician Led Access Network (PLAN) • Blessing Hospital • Clinical Radiologists • SIU Quincy Family Practice Center • Quincy Medical Group • Blessing Physician Services • Dr. Ronald Wheeler • Dr. Duane Hanzel • Dr. James Hayashi • Community Outreach Clinic

12. Sliding Fee Scale

13. PLAN statistics • Over 700 Adams County residents • 79 clients on waiting list • Value of $1.6 million has been donated in healthcare from May 2008 to April 2010 • 62% of patients have had a medical physical in the past two years • 23 new providers in 2010 • Provider Satisfaction had a score of 93% in 2009 • 100% of AHAC patients have a primary care home

14. PLAN Value and SustainabilityHow do we continue participation? • Care Management • Patient accountability • Cost savings (ROI) • Referral source for network members • Assessing satisfaction • Systematic volunteer opportunity for physicians/providers • Equitable distribution • Ensuring patient eligibility

15. Care Management

16. Who receives care management? • All clients enrolled in the Physician Led Access Network

17. Activities of Care Management • Client advocacy • Connecting clients to community resources • Coordination of healthcare services in PLAN • Follow-up after medical appointments • Assistance with applications such as MedAssist, Community Outreach Clinic, charity applications

18. Activities of Care Management, cont. • Facilitate Referrals to CareLink for nursing care management • Provide or connect clients with appropriate disease education • Managing client healthcare appointments and ensuring eligibility to physician offices • Provide healthcare appointment reminders

19. Evaluation of the Program

20. What are we tracking to demonstrate value? • Medical appointment attendance rates • Charity care for local hospital to maintain tax-exempt status • Reduction in the cost of care per member per month • Reduction in Emergency Room and Inpatient Utilization • Appropriate utilization of healthcare system for treatment of ambulatory sensitive conditions

21. Medical AppointmentsFebruary 2010 – April 2010523 physician appointments 3% 16% 81%

22. Blessing HospitalFinancial Assistance Applications

23. Value of Donated Care

24. Results of program $530.89 $267.49

25. Emergency Room/Inpatient Utilization • Hospital service data collected on AHAC enrollees • Group 1 • May 1, 2008 – Nov 30, 2008 • 41 unduplicated individuals

26. ER Utilization – Group 1

27. Inpatient Hospitalizations – Group 1

28. Emergency Room/Inpatient Utilization • Group 2 • Dec 1, 2008 – April 30, 2009 (exclusive of Group 1 clients) • 114 unduplicated clients

29. ER Utilization – Group 2

30. Inpatient Hospitalizations – Group 2

31. Ambulatory Sensitive Care Conditions Treated at the Hospital 2005 problematic conditions • Congestive Heart Failure • Bacterial Pneumonia • Urinary Infection • Dehydration • Diabetes • Chronic Obstructive Pulmonary Disorder • Hypertension

32. Group 1 • 254 individual hospital charges representing ER, inpatient, and outpatient charges • 14% or 36 charges represented one of the seven ambulatory sensitive care conditions • 6 charges associated with ER encounters and inpatient hospitalizations • Remaining 83% or 30 charges associated with outpatient service utilization

33. Group 2 • 630 individual hospital charges representing ER, inpatient, and outpatient charges • 9% or 56 hospital charges represented one of the seven ambulatory sensitive care conditions • Of interest, 4 of 56 were associated with ER encounters PRIOR to the AHAC enrollment • NONE were associated with ER and Inpatient hospitalization after enrollment • 93% of those ambulatory sensitive diagnosis codes were associated with outpatient hospital charges

34. Healthcare Reform: Where does AHAC fit in? • Strong network has been developed • AHAC is known to tailor to its clients needs • Care coordination • Disease Management

35. Future Funding • Community Meeting “Celebration” May 18, 2010 • Public Relations • Patient highlighted in news • Newspaper articles • Radio interviews • TV interviews • Notice of intent to grant from local health system • Diverse funding

36. Resources • www.CHSDonline.com • Georgia Health Policy Center Sustainability Formative Assessment Tool