Grant Workshop Office of Rural Health Policy Winchester, KY John Isfort, Director Project HOME Network Marcum & Wallace Memorial Hospital 60 Mercy Ct Irvine, KY 40336
ORHP Network Planning Grant 2009 ORHP Rural Healthcare Outreach Grant 2012 $450,000 (3 Years/ 2012-2015) Based on Collaboration with CAH & FQHC s Focused on Uninsured Overutilization of ED for Primary Care Transportation Specialty Care Lung Cancer Screening
Lexington Estill & Lee Counties Campbell Boone Kenton Ballard McCracken Project HOME Network Henderson Daviess Union Webster Mclean Ohio Crittenden Hopkins Muhlenberg Butler Caldwell Lyon Meade Breckinridge Grayson Edmonson Warren Hardin Hart Barren Gallatin Bracken Carroll Pendleton Grant Trimble Mason Owen Robertson Greenup Lewis Henry Harrison Oldham Fleming Nicholas Carter Boyd Scott Franklin Jefferson Shelby Rowan Bourbon Bath Elliott Lawrence Spencer Fayette Bullitt Anderson Clark Menifee Morgan Mercer Powell Johnson Nelson Martin Washington Madison Wolfe Magoffin Estill Garrard Lee Floyd Larue Marion Breathitt Lincoln Jackson Owsley Pike Rockcastle Knott Casey Perry Green Clay Adair Laurel Pulaski Leslie Letcher Metcalfe Russell Carlisle Hickman Fulton Graves Marshall Calloway Trigg Christian Todd Logan Simpson Allen Monroe Cumberland Clinton Wayne Mccreary Whitley Knox Bell Harlan
14 Agencies in Network Marcum & Wallace Hospital White House Clinics Juniper Healthcare, Inc Foothills Mobile Clinic Mercy Health Clinics Team Health (MESA) Kentucky Homeplace Westcare Estill Development Alliance Lee Health Department Estill Health Department KRCC Bluegrass.org Hospice Care Plus
Programs/Focus Areas ED Navigation Program Target 184 Seen 96 Navigated 51 Declined 43 Discharged 2 53% Navigated CT Screening Program Target 40 SDM 22 Screened 22 Percent Screened 55% ACA Insurance Program Target 100 Contacted 246 Signed Up 246 Percent Signed up 246% Specialty Care/ Transportation Target 00 Specialty Care 04 Transportation 06
Emergency Department Health Care Navigation
Health Care Navigator (HCN) for the ED Lay Worker Trained by Kentucky Homeplace Database Provided by Kentucky Homeplace Liaison to Network Clinical Partners Works with Medicaid MCO s 40 hour week (Peak Hours) Onsite in ED Jim Thacker
Criteria for Navigation Uninsured 6 or more ED visits in previous 12 months No Primary Care Provider Resident of Project HOME Network Counties
Project HOME Network Cost Comparison for Navigated Patients (2013) 96 Patients 821 ED Visits $2,660 Average ED cost per patient ($311 per visit) $255,361 Total cost for ED visit $134.50 Average cost of Clinic Visit $110,424 Total Cost of ED visits if in Clinic 187 ED visits after Navigation 77% decrease in ED Visits after HCN contact
ACA Enrollment
Project Project HOME HOME Network Network ACA Supplemental Funding $25,000 Open Enrollment Health Care Navigator Target 100 Enrolled 246 300 250 200 150 100 50 0 100 Target ACA 246 Enrolled Target Enrolled
Affordable Care Act Kynect Enrollment ACA Results 300 250 200 150 100 50 0 100 Target 246 Enrolled Target Enrolled 1% 1% 4% 7% 1% 3% ACA Total 246 Estill (205) 0% 0% Lee (10) Powell (17) Owsley (1) 83% Jackson (2) Wolfe (1) Madison (8) Fayette (1) Clark (1)
Estill County Uninsured/Enrolled 8% 92% Uninsured Estill County (2351) Number Enrolled by HCN (205)
300 250 200 150 100 50 246 ACA Supplemental Grant Information 179 During the ACA Enrollment Period 52 Grantees enrolled 9,287 individuals. The average enrollment for each grantee was 179 individuals. The HCN and Financial Counselor enrolled 246 individuals. This was a 27% increase above the average enrollment Enrolled by HCN Average enrolled by other grantees 0
ED Payor Mix 6000 Results 5000 4000 3000 2000 2012 2013 2014 Annualized 1000 0 Medicare Medicaid Commercial Self Pay
Community Lung Cancer CT Screening Program
Project Project HOME HOME Network Network Lung Cancer CT Scan Screening Program Partnership with University of Kentucky Markey Cancer Center 40 Patients to be Screened (Uninsured) Community Program (Screened Locally) Treatment and Follow-up Provided by UK Multi Disciplinary Team
Lung Cancer CT Scan Screening Program 22 - Patients screened 2 - Positive 8 - with 3-6 month followup 12 - Negative Patients Lung Cancer Screening Results N = 22 8, 36% 2, 9% 12, 55% Positive (2) Negative (12) Suspicious (8)
Summary of Accomplishments Navigated 364 patients in all programs (18 months) 77% reduction in ED visits after contact with HCN ACA enrollment penetrated 8% of local uninsured market CT Lung Screening detected 2 early cancers ED Navigator providing significant ROI
Thank You Questions