182905 A custom web-based application designed to coordinate care for the uninsured in Lane County, Oregon

Monday, October 27, 2008: 5:15 PM

Heidi Hascall, MA , Health Policy Research Northwest, Eugene, OR
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
Christopher Ebert, BS , Health Policy Research Northwest, Eugene, OR
Tom Hambly, RN , Medical Access Program, United Way of Lane County, Springfield, OR
Michael R. Tripp, MD , Health Policy Research Northwest, Eugene, OR
Care for the uninsured is often fragmented, uncoordinated, inefficient and expensive. In Oregon, an estimated 16% of residents are uninsured; in Lane County, estimates approach 20%. In response, a new community program called the Medical Access Program (MAP) aims to connect clients to existing resources and provide a basic preventive healthcare benefit for individuals that do not qualify for government-sponsored health insurance programs and cannot afford commercial insurance. US citizenship is not required.

The Medical Access Program (MAP) has created a HIPAA-compliant, web-based tracking system that screens, enrolls and assists in care delivery and coordination for uninsured participants. Screening is performed in the community, not at a central location. The screening modules are tailored to assess Medicaid and safety net eligibility, adjusting to dynamic state Medicaid eligibility requirements. Insurance status is tracked across the family, not just the individual. Partnership with the local Medicaid program allows for more efficient eligibility cross-checking.

Healthcare, dental, mental health and social service providers have controlled, privileged access to view client demographics, eligibility, activities (appointments, service requests) and a list of current providers involved in the care of the client. A central care coordination office manages “private” view versus “public” activity postings, which are generated by the care coordinator or the receipt of encounter data from participating provider officers.

The system will be vigorously evaluated following a pilot MAP enrollment population of 100 uninsured individuals. Results will determine the additional features required to optimize care delivery for a population that historically has received uncoordinated healthcare.

Learning Objectives:
1. Evaluate the effectiveness of a web based tool to coordinate community care and connect patients with providers and existing social services. 2. Identify and assess specific improvements for a web based system. 3. Articulate the process for enrolling patients in an appropriate system of care.

Keywords: Access to Care, Communication Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am one of the project managers for the technology program being developed and have been a contributor to the development and implementation of user training materials and community presentations. I have experience teaching a college level course on theory and practice with particular emphasis on engaging students in critical thinking.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
United Way of Lane County, 100% Access Healthcare Initiative Program Development 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.