Health for the Uninsured in Hinds County, Mississippi
Program's goals are to provide 45,125 of the uninsured in Hinds County,
Mississippi with access to a community-based integrated delivery system (IDS)
for comprehensive healthcare by facilitating referral to a "medical
home." The Jackson Medical Mall Foundation will serve as the lead
agency. As of September 2003, 55% of the previously uninsured, or 25,000
residents now have health coverage through SCHIP, Medicaid, or federally
qualified community health centers (FQHC's) in the targeted area.
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Through an innovative
project to revitalize an inner city area, an 800,000 sq. ft. declining shopping
mall was transformed into a Medical Mall with over $50 million of
construction/renovations. Since opening in 1997, it has served over
600,000 clients. Network primary care providers include the University of
Mississippi Medical Center's Outpatient Primary Care and Specialty Clinics,
Jackson-Hinds Comprehensive Health Center (an FQHC), Central Mississippi Health
Services, Inc. (an FQHC), University of Mississippi's School of Nursing UNACARE
Clinic, the Jackson Medical Society and Voice of Calvary Health Center (a
The program is designed to
improve access and continuity of care by facilitating referral to a medical
home. The Alliance is serving both urban and rural populations and will
take advantage of existing telemedicine capabilities and shuttle services to
overcome transportation problems often encountered by the population
served. A thorough community assessment has been conducted through the
University of Mississippi's School of Nursing to design a program to meet the
unique needs of our communities.
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Financing & Outreach Strategies
Mississippi is the first
state in the nation to set aside its entire Tobacco Litigation Settlement of
$3.4 billion in a healthcare Trust Fund to preserve the fund and generate
earnings to be spent on healthcare improvements, including $125 million this
fiscal year. The State's Attorney General who helped lead this initiative
is actively supportive of seeing part of these funds utilized for a program for
the uninsured. Already the Partnership for a Healthy Mississippi, chaired
by the Attorney General, has provided $600,000 of local match for the RWJF
Communities in Charge Project in Hinds County from 2001-2003. Going
forward, two of our participating major hospitals and the United Way of the
Capitol Area have committed $100,000 or $300,000 respectively for 2004 to
continue the work of the Alliance in serving the uninsured.
Program Delivery System
Three Alliance models have
been designed for the uninsured to help improve access to care. They
An ER ReDirect Program
whereby uninsured individuals seeking routine care from the ERs are seen,
treated, and then advised by a hospital case manager of the 7 primary care
community-based facilities that they may choose from, for linkage to a PCP,
access to a medical home and continuity of care. The Hinds County
Health Alliance staff assists the client to secure an appointment at one of
the network primary care sites, if they do not already have a PCP.
A disease management
program for the uninsured diabetics and hypertensives has been successfully
implemented. If a chronically ill patient who is uninsured indicated
to the ER staff that he/she is a diabetic and/or hypertensives, the Alliance
staff arranges an appointment within 5 business days to get the patient
enrolled in the University Metabolic Clinic Program. there the patient
is seen by a specialist in metabolic disease, provided with needed
prescription drugs, counseled on nutritional and exercise needs and
home-visited by a professional nurse if needed. The metabolic
physician refers the patient back to a PCP for routine care, but is
available for specialty care whenever needed. The idea is that the
uninsured patient is provided with tools for better self-management.
Armed with these skills, the patient (ideally) will no longer seek episodic
care by way of the Emergency Room.
A drug discount
program is also available providing 50-60% discounts through a HRSA 340B
program and free maintenance drugs for the chronically ill if they are
financially eligible, through a pharmacy industry MED ASSIST Program.
It is imperative to
involve all levels of the city, county and state government who deal with the
provision of healthcare services. The four major hospitals and health
systems have enthusiastically agreed to work together on this program for the
uninsured. They have begun to refer their uninsured ER and inpatients to
the Hinds County Health Alliance for referral to a PCP. There have been
over 6,000 referrals to the Alliance through the ER ReDirect Program. Of
this amount, approximately 20-25% make an appointment for primary care.
We do believe that the
business community will support this effort. The Metropolitan Council of
Churches will also partner with us in providing outreach to the uninsured.
In addition, some types of community outreach workers who have experienced
firsthand the difficulties of transitioning from welfare to the workforce will
be involved. The local press and television stations have also been asked
to promote this program for the uninsured, as was done during "Covering the
Uninsured Week" in March 2003.
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Accomplishments to Date
four major hospitals and health systems in Hinds County are now referring
uninsured and Medicaid beneficiaries who are Emergency Room "routine
cases" to the Health Alliance for referral to a PCP.
of five outpatient facilities in Health Alliance now offer 340b drug
discount programs with up to 50% discounts off retail, as of January 8,
2002. Impact? For every $1 spent on needed prescribed drugs, $4
of cost savings are realized from reduced unneeded ER visits and inpatient
staff will participate in eligibility determination training for Medicaid or
SCHIP enrollment. Impact? Working with The Robert Wood Johnson
Foundations Covering Kids and Families grant in Mississippi, the Alliance
will help streamline methods of SCHIP enrollment and re-enrollment.
services are made available to those who need to get to a PCP office.
A reminder of their appointment will be made 1-2 days before the scheduled
visit. Impact? Cut down on "no show" rates at clinics
and PCP offices that run as high as 50% in some instances.
Way of the Capitol Area's social services is completely integrated with the
Alliance Health Services Network through Service Point Software.
Impact? The hospital discharging recovering alcoholics can be
immediately placed in an appropriate halfway house for alcoholics in the
physicians for high-risk diabetics and hypertensives are using disease
management clinical protocols. Impact? As of June 2003, the Hind
County Health Alliance in collaboration with the University of Mississippi
Medical Center, the Jackson Medical Mall, the Mississippi Primary Care
Association, McKesson Health Solutions, Health Alliance Pharmacy and
Specialty Disease Management Services, will assist the Division of Medicaid
in the delivery of the disease management program. The program will
focus on all 700,000 Medicaid beneficiaries statewide who are suffering from
diabetes, asthma, and high-risk hypertension.
blood pressure, pulse and weight recordings at kiosks in the Medical Mall
and supermarkets through the County are electronically transmitted to an
Alliance member's PCP. Impact? Patients will be more
knowledgeable of their own health status and be prompted to seek healthcare
assistance if these readings are abnormal.
surveys have been conducted of participating uninsured to find ways to
further improve compliance with physicians' recommendations for clinic
visits and prescription drug usage. A report of these findings are now
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Sustaining the initiative
to help improve the health status and access to needed healthcare services for
all uninsured Mississippians.
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Jackson Medical Mall Foundation
350 West Woodrow Wilson, Suite 615
Jackson, MS 39211
Phone: (601) 982-0673
Fax: (601) 982-0459
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