Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107516

Melanie Matney, MHA, Richland Care, Palmetto Health, 111 Doctor's Circle, Columbia, SC 29203, 803-296-2251, melanie.matney@palmettohealth.org and Tom Brown, DrPH, Health Services Research, Palmetto Health, 111 Doctor's Circle, Columbia, SC 29203.

Richland Care is a coordinated healthcare delivery system that serves uninsured persons with incomes under 200% of the federal poverty level (FPL) who reside in Richland County, South Carolina. The goal of Richland Care is to improve access to care and improve health outcomes for the target population. The program has been operational since November 2001 and has enrolled over 8,600 individuals through January 2005. Participants have access to primary care, prescription drugs, subspecialty care, and hospital inpatient and outpatient services through a network of community hospitals, community health centers, private physicians, and physician residency programs. Richland Care participants are mostly African American (70%), female (69%), single (79%), and have incomes less than 100% of the FPL (55%). Health education and wellness/health promotion services are available to all participants. These activities are supported by the Healthwise Handbook (a self-care reference guide), newsletters and a 24-hour nurse call line which are appropriate for the target population. Richland Care also offers care management services that provide demand management for participants utilizing the emergency departments and disease management for high-risk participants with hypertension and/or diabetes.

This study examines participants' emergency department and inpatient hospital utilization during years one, two and three (34-month period) following Richland Care start up. Prior to enrolling in Richland Care, participants had 860 emergency department visits per 1,000 and utilized emergency departments over two and a half (2.52) times more than the County population. Their hospitalization rate was 112 per 1,000. An earlier analysis after 22 months of Richland Care operations found a 57% reduction in emergency department use and an 82% reduction in inpatient hospitalizations. This result reduces participants' emergency department and inpatient hospital utilization to the level of utilization among the County population. Using the actual median charge for emergency department visits and hospitalizations, the hospital cost savings related to the reductions in utilization are at least $10 million. This presentation will describe the program and its impact on participants' utilization of emergency department and inpatient hospital services compared to their utilization prior to enrollment into Richland Care.

Learning Objectives:

• Describe the demographic characteristics of the low-income, uninsured population in this program;
• List the core Richland Care healthcare services;
• Identify two positive outcomes related to Richland Care’s participants’ utilization of emergency department and hospital inpatient services

Keywords: Health Care Utilization, Access to Health Care

Related Web page: www.palmettohealth.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.