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Community Access Program (CAP)- West Virginia
| Topics |
Health insurance and uninsured
Health services
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| States served |
West Virginia
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| Description |
Partners CAP received three years of funding from the Healthy Communities Access Program. This funding allowed the members of Partners in Health Network to design and implement a health program that improved access to health care services, provided discounts and/or free services to patients who met the financial eligibility screening and provided care management services to adults ages 19-64 with asthma, depression, diabetes and hypertension. Carryover funding was used during the fourth year of this project to provide minimal support to the participating members for patient supplies and to manage the web-based information system (CAPGate) that maintains demographic, basic health history and care management data. CAPGate also generates a point-of-service patient summary and generates reports for monitoring individual patients and practice performance reports.
Partners CAP enrolled approximately 9,000 individuals during the life of this program. Patients were dis-enrolled if they did not visit their primary care home during a 12-month period of time or if they did not want to participate in the program. Active enrollment stabilized at approximately 4,000 individuals. At any given point in time, approximately 52% of the enrollees participated in the care management program. Many of the enrollees were existing patients of the FQHCs and were enrolled in the program to benefit from the care management program and/or the discounted services that were negotiated with Charleston Area Medical Center (CAMC). This large, academic medical center agreed to accept the financial screens conducted at the primary care centers and rural health clinics and discounted hospital-based services to Partners CAP enrollees. CAMC provided more than $10.9 million in services to CAP patients from 2002 - 2005. Although the federal grant has expired, this agreement remains in place. Approximately 10% of the enrollment resulted from emergency room referrals for patients who did not have a primary care home. |
| Services offered |
Grant funds were utilized to hire care managers and to establish CAPGate. Currently, the primary care centers are providing some care management activities, but at a lesser level. The FQHCs are still enrolling patients in CAP, and CAMC is still accepting the CAP card. Partners in Health Network is actively seeking funding to enhance the Program.
PIHN received federal funding. An experienced FQHC director was recruited and hired to run the program. The Charleston Area Medical Center’s Health Education and Research Institute was provided a contract to establish CapGate. Sub grants were provided to the FQHCs allowing them to hire care managers. |
| Results |
It is clear that when the care management activities were fully implemented in 2004, the benefits of care management were being realized. Hospitalizations, emergency room visits and outpatient services all decreased. Visits dropped by 65 % between 2003 and 2004 and 49% between 2003 and 2005. With a decease in care management activities following the loss of federal funding, inpatient, outpatient and emergency room visits again increased (23% between 2004 and 2005) but still below the number of visits in 2003. |
| Replication |
Lessons Learned, Concerns, Barriers:
Hospitals and Community Health Centers can work together to improve access to health care for the working poor;
Care Management works.
Based only on anecdotal evidence, we believe that providing the CAP Card to the working uninsured provides a patient with enhance self-esteem. CAMC and the participating FQHCs accept the card as if it was an insurance card. |
| Source |
National Cooperative of Health Networks (NCHN)
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| Contact person |
Bob Whitler, Executive Director
Partners in Health Network(PIHN)
304-388-7385
bob.whitler@camc.org
501 Morris Street
Charleston, West Virginia 25301 |
| Date added |
April 4, 2008 |
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