RALEIGH, NC – Eight healthcare organizations in Wake County, N.C., are collaborating in hopes of improving coordination of care for their uninsured residents, thus providing better quality and cost savings.
CapitalCare Collaborative is implementing its first phase of services, an eligibility screening tool. So far in the pilot phase, information from 400 to 500 patients has been collected.
The group includes the county’s three hospitals, Wake County Human Services and several clinics. Wake County Medical Society serves as a neutral third party, charged with responsibility for CapitalCare Collaborative.
By focusing on coordinating care for the uninsured, the county’s health organizations can get patients into the most appropriate and cost-effective venue for care, said Susan Weaver, MD, president of the collaborative and executive director of Alliance Medical Ministry, a faith-led medical ministry that provides care to the uninsured working poor.
It can cost $1,100 to treat a patient in an emergency department for a non-life-threatening care episode, compared to only $80 in an ambulatory setting, Weaver said.
“The other thing we’ve found is there is a lot of duplication of services,” she said. “Patients who don’t have insurance may have been treated in various settings.”
The project is using using an adapted application from R&B Solutions of Waukegan, Ill. As uninsured patients come for healthcare services, the application helps them through the application process for Medicaid services or identifies if they qualify for help through other community programs, said Polly Hathaway, who started as director of the collaborative in June.
The RAMP program from R&B Solutions also can print out specific instructions for patients on accessing care, Weaver said.
“The goal is to match all uninsured with a primary care home,” she said. The first phase includes an effort to enroll patients in assistance programs so they can get needed medications for free.
Early next year, the initiative hopes to gather clinical data on patients in a clinical data repository, so that participating healthcare organizations can access it and thus better coordinate care.
“If we can collect really good data on the uninsured in the county and put it into one database, we’ll be able to share information about patients and make sure they’re being treated and getting the best possible care,” Hathaway said.
The collaborative is supported by a combination of funding sources, including participating members, foundation grants and funding from Blue Cross Blue Shield of North Carolina.
The lack of current coordination of care for these patients exacerbates current provider capacity levels, Weaver said.
“Once we get the data, we can figure out how we can work together as a community to increase capacity,” she said. “We believe that collaboration can impact the financing solution for the region simply by the fact that we’re working together,” she said.