181821 Medical Access Program (MAP): Organizing and coordinating care for the uninsured through community collaboration

Tuesday, October 28, 2008: 2:45 PM

Erin C. Owen, MPH , Health Policy Research Northwest, Eugene, OR
Susan E. Stearns, MBA, MA , 100% Access Healthcare Initiative, United Way of Lane County, Springfield, OR
Ken Provencher, MBA , PacifcSource Health Plans, Springfield, OR
Steven D. Marks, MD , PacifcSource Health Plans, Springfield, OR
Heidi Hascall, MA , Health Policy Research Northwest, Eugene, OR
Tom Hambly, RN , Medical Access Program, United Way of Lane County, Springfield, OR
Gary Young, MD , Eugene Emergency Physicians, Eugene, OR
Michael R. Tripp, MD , Health Policy Research Northwest, Eugene, OR
Care for the uninsured is often fragmented, uncoordinated and expensive. Healthcare reform proposals have discussed expansion of coverage through savings in expensive hospital care and improved preventive and chronic disease management programs; however, real world tests of this hypothesis are lacking.

In Oregon, an estimated 16% of residents are uninsured; in Lane County, estimates approach 20%. The Lane County 100% Access Healthcare Initiative has developed the partnerships required to address healthcare access issues from a local perspective. The collaborative includes the CEO from every major healthcare institution, provider groups, and leadership from local business, government and non-profit agencies. In December 2007, the Initiative's Medical Access Program (MAP) began piloting a community program that aims to organize and coordinate services for the uninsured. For the pilot, 100% of the medical providers in Lane County, including specialty and ancillary service providers, agreed to provide gratis care.

The MAP pilot consists of 100 enrollees that do not qualify for government-sponsored health insurance programs and cannot afford commercial insurance. United States citizenship is not required. Enrollees work with a central care coordination office to select a primary care medical home and organize medical, dental, mental health and social service needs. A custom web-based system that is accessible through provider offices supports care coordination.

The pilot will provide the data needed to create a sustainable and scalable community healthcare access solution. Traditional medical claims are captured on enrollees to quantify the scope of services required by uninsured enrollees. A comprehensive program evaluation will be performed.

Learning Objectives:
1. Identify key partners and infrastructure required to implement a community-based access model. 2. Recognize and articulate challenges associated with implementing healthcare access models that does not require US citizenship for participation. 3. Discuss evaluation strategies for determining sustainability of community access models.

Keywords: Community Health Planning, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on all aspects of the Medical Access Program including, but not limited to: program development, implementation, stakeholder negotiation and program evaluation. I have presented at CDC hosted conferences in the past. I am also a published author.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
United Way of Lane County, 100% Access Initiative Program Evaluation Independent Contractor (contracted research and clinical trials)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.