1. 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

2. 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

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

4. 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.

5. 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

6. 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

7. 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

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

9. 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

10. 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

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

12. Contact Info
Mitch Morris, Special Projects Director
MS Primary Health Care Association
6400 Lakeover Road, Suite A
Jackson, MS 39213
(601) : Office
(769) : Cell