Kent CHAP History Health Net of West Michigan

How did the Kent County Children’s Healthcare Access Program begin? 2008: First demonstration project launched by the Early Childhood Children’s Commission (later to become First Steps) Initially modeled on the Colorado Children’s Healthcare Access Program Based on the concept of pediatric medical home Key partners: First Steps, Helen DeVos Children’s Hospital, Priority Health, the Asthma Network of West Michigan Funders: United Way, Steelcase Foundation, Frey Foundation, Grand Rapids Community Foundation, Kellogg Foundation, Great Start Collaborative, Priority Health Health Net of West Michigan

The Need for CHAP If the hospitalization rate for children on Medicaid was the same as for those with private insurance, the estimated savings for one year would be $300-$400 million. Health Net of West Michigan

Original Kent CHAP definition Collaborative, community-based medical home improvement program that provides: Technical assistance to improve “medical homeness” of primary care practices Resource coordination of community services Increased office, patient and family education Needed services for children/families Office efficiency assistance Convening of community stakeholders to address systems issues Health Net of West Michigan

Kent CHAP DESIRED OUTCOMES Improve health outcomes among children on Medicaid while better utilizing existing resources and decreasing costs Decrease inappropriate use of emergency departments and hospitalizations Increase appropriate use of medical home. Increase access to a medical home Improve medical home quality Provide supportive services and parent education Advocate for system-level improvements in the delivery of health care to children 6

Kent CHAP Demonstration Project Target population: ~15,000 children ages 0-17 receiving Priority Health Medicaid in Kent County Timeframe: August- December 2008: Ramp up 2009- 2011: 3 Year Demonstration Project 2012: Expansion Pilot Sites Private Pediatric Practices Federally Qualified Health Center- 9 community and school-based clinics Pediatrics Resident Clinic Nurse Practitioner Clinic Total providers: 40 pediatricians and 10-12 FP’s and midlevel providers Health Net of West Michigan

Kent CHAP Demonstration Project – Key Partners & Funders First Steps Kent Priority Health Helen DeVos Children’s Hospital Asthma Network of West Michigan ADDITIONAL FUNDERS Kent County Great Start Collaborative Grand Rapids Community Foundation Kellogg Foundation Early Childhood Investment Corporation Health Net of West Michigan

Key CHAP Results (2008 – 2011) Served 5,227 children 1578 asthma home visits 888 CHAP home visits 2717 transportations coordinated Infants up to date on 0-15 month well child visits increased by 24% 35% decrease in ED visits among CHAP clients 46% decrease in IP admissions among CHAP clients 100% increase in children with an up-to-date asthma action plan Social cost benefit analysis: For every $1 spent, there was a savings of $1.53. Health Net of West Michigan

CHAP Growth at First Steps Expanded to additional Medicaid health plan Added new practices 30% funded by earned income (contracts with health plans, Medicaid Outreach) Growth in special projects Asthma Fit Kids 360 Kent County Oral Health Coalition Interest from other communities in Michigan to replicate CHAP model – resulted in the formation of MI-CHAP Wayne County received funding to implement Other counties were interested…but needed funding Health Net of West Michigan

Kent CHAP at Health Net In April 2014, CHAP (along with Fit Kids and the KCOHC) merged with Kent Health Plan to form Health Net of West Michigan (repurposing KHP’s 501c3 status) CHAP expanded to serve adults, and was renamed the Community Healthcare Access Program In 2015, CHAP served 2,177 children and 1,279 adults We receive 500-600 referrals per month We currently work with 35 CHAP practices Health Net of West Michigan

MI-CHAP Health Net of West Michigan

Replication of Pediatric CHAP Model In late 2014, Health Net partnered with the Michigan Association of United Ways to submit a Michigan Health Endowment Fund grant for MI-CHAP - $5 million awarded Expansion in Kent and Wayne Counties Implementation in Genesee, NW Michigan, Macomb, Kalamazoo, Ingham, Saginaw, and UP Development of Virtual CHAP via partnership with 2-1-1 Goal is to serve over 83,000 children on Medicaid within 2 years Health Net provides technical assistance to local CHAPs Health Net of West Michigan

MI-CHAP Goals Improve the health of Medicaid-enrolled children Improve the quality of and access to medical homes in MI-CHAP communities Lower the total cost of care by reducing emergency department visits and inpatient hospital admissions among children on Medicaid Innovate efficiencies and scalability by delivering components of the CHAP model statewide through a new virtual strategy Health Net of West Michigan

Virtual CHAP (V-CHAP) Goals To create a cost-effective way to expand MI-CHAP services to counties that do not have a local, on-the-ground CHAP. Identify and connect eligible Michigan families with CHAP-related services to address social determinants of health and/or health services navigation. Health Net of West Michigan

V-CHAP Services Medicaid Information Health Plan Information Provider Information Education regarding children’s health Referrals for services (if needed) Build out 2-1-1 database to include pediatric providers Manage the statewide community Resource database Health Net of West Michigan