PROJECT REDIRECT Workshop Solutions for Non-Urgent Use of Delta Emergency Departments: Creating Medical Homes in CHCs December 7 – 8, 2009  Harrah’s Resort ~ Terrace Hotel Tunica, MS

Need for Project 1) Lack of medical home 2) Use of local hospital emergency department (ED) as common source of care 1/3 to 1/2 of ED visits are for non-urgent complaints (CDC’s National Center for Health Statistics) “Austin ERs got 2,678 visits from 9 people over 6 years” (Austin American-Statesman: 4/1/09) 3) Inappropriate ED use involves negative impacts on hospitals, primary care providers, patients, and payers Uncompensated care Service duplication Advanced disease states Lack of continuity of care Increase in overall health costs

Core Medical Home Concepts Health care services that are Accessible Continuous Comprehensive Coordinated Compassionate Culturally competent Patient-centered (Family-centered)

Target Population Medically underserved residents within the 18-county region served by DHA The entire region is MUA (HRSA) Approximately 125,000 live within the federal definition of poverty (Census) Approximately 110,000 (23%) have no form of health insurance (Census) Compared to only 17% uninsured nationwide.

Collaborative Model Hospitals are the cornerstone of medical care in most communities Community Health Centers (CHCs) are the major primary care provider serving vulnerable populations Statewide CHC patient volume has grown from approximately 150,000 in 1990 to 300,000 today Intent is to create ‘win-win’ partnerships that yield more appropriate utilization of resources, higher quality of care, and better health outcomes

Anticipated Organizational Benefits Hospitals: Reductions in uncompensated care More appropriate use of staff, supplies, operations CHCs: Increased patient volume Enhanced diversity of payer mix Both: Improved efficiencies Operational savings

Anticipated Community/Patient Benefits Increased access to primary care, including follow-up care Identification of medical home Greater patient satisfaction with the local health care delivery system Improvement in health status Overall reductions in health care expenditures

Major Steps 1) DHA Grant Opportunity 2) Determine Organizational Interest 3) ED Assessment 4) Local Redirect Projects 5) Workshop 6) Ongoing TA & Support

Local Redirect Projects Purpose: Provide support to Delta CHCs and hospital partners to develop collaborative relationships and service delivery models Primary Objectives Reduce non-urgent Emergency Department (ED) use Increase the number of individuals using a CHC as a medical home Federal funds provided by the Delta Health Alliance (DHA) used to make grant sub-awards

Use of Sub-award Funds Develop collaborative service delivery model Create a mutual triage and/or referral policy agreement between CHC and hospital to include follow-up care/establishment of medical home Initiate and provide expanded services to CHC patients through expansion of hours/staff Implement technical infrastructure to facilitate redirection of non-urgent/primary care patients from emergency department to CHC Conduct patient education regarding appropriate use of health resources

Workshop Features ED Assessment & Project Evaluation Examples of CHC/Hospital Success ER Diversion Lessons Learned Legal/Risk Management Perspective Advancing Medical Home Concepts

Contact Info Mitch Morris, Special Projects Director MS Primary Health Care Association 6400 Lakeover Road, Suite A Jackson, MS 39213 (601) 981-1817: Office (769) 233-3486: Cell mmorris@mphca.com