The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
Nov. 15--A team of health care workers is primed to fan out in the Eau Claire area, bringing services into the homes of those who need them most.
The Eau Claire Cooperative Health Centers announced the start of their Innovations Health initiative Wednesday, marking the next stride in the concentrated effort to improve the health of people in the 29203 ZIP code. The health centers have hired 17 workers -- nurses, nurse practitioners and community health workers -- to get the program going.
They will form three teams that will provide in-home services and health care coaching to people who are eligible for Medicare or Medicaid and haven't visited a primary care physician in a year. The initial effort is funded by a $2.3 million grant from the federal Centers for Medicare and Medicaid Services and by $1.9 million from the Eau Claire Cooperative Health Centers' fund balance.
Innovations Health "represents a transformative approach to health care for the people of 29203," said Dr. Stuart Hamilton, founder and CEO of the cooperative health centers. "It tears down traditional barriers and creates new access to convenient, personalized health care."
Local health leaders came together last year in the Healthy Columbia Campaign and targeted the 29203 area as a fertile ground for new programs that can both improve residents' health and cut costs. Nearly 40,000 people in the ZIP code are uninsured, which means they often don't seek help until problems are severe. All too often, they end up in hospital emergency rooms, which is an inefficient and expensive use of those limited resources.
During community public input meetings, residents suggested placing nurses or nurse practitioners in parks or community centers to help residents deal with chronic problems such as diabetes, hypertension and heart disease. They also suggested health care guides that visit homes.
Before those meetings were finished, the cooperative health centers already were working on the Innovations Health grant proposal that combines those two notions. Select Health of South Carolina, a managed care organizations that covers more than 234,000 state residents, worked with the cooperative health centers on the grant.
Select Health has pledged to reimburse nurses for their home visits and return 20 percent of the measurable savings to Innovations Health to help keep the program going past the three-year grant period.
"To be lasting, this needs to be sustainable from Day 1," said Cindy Helling, executive director of Select Health of South Carolina.
It's not there yet, but organizers believe it will be, certainly before the three-year grant runs out. Hamilton said two other major players in the field, BlueCross BlueShield of South Carolina and Absolute Total Care of South Carolina, have talked with him about similar programs to share savings.
The long-range goal is for government insurers and health care organizations to pay for the program through savings generated. For instance, a recent report noted one person in the 29203 ZIP code visited local emergency rooms 36 times in a year. A nurse visiting that person's home to treat what's obviously a chronic problem would save the health care system tens of thousands of dollars.
Innovations Health is another version of the patient-centered medical home concept, the health care shift to providing comprehensive care through a team of providers that communicates with each other. BlueCross BlueShield has funded patient-centered medical home trials, mostly dealing with chronic adult ailments.
Innovations Health also is the first patient-centered medical home concept in the state designed to include treatment of a large number of pediatric patients, said Dr. Laura Long, chief medical officer for BlueCross BlueShield.
Nearly 1 million people in South Carolina rely on Medicaid. Innovations Health estimates its teams can serve only about 1,600 people annually. But backers believe that will be enough to start down the road toward improved health for 29203 and created a blueprint for the rest of the state.
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