Development and Implementation Grant
                            Phase Two National Press Release

Macon, GA




The goals are to:  (1) Provide healthcare access to individuals currently without appropriate care; (2) Decrease the cost of care for individuals with prevalent, high-risk conditions through effective grassroots care management, and (3) Improve the overall health status of those enrolled in HCCG.

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        Program Design

CHW is an enrollment-based program designed to address the needs of the most vulnerable uninsured - the working poor with high-risk medical conditions.  The plan is designed for adults (19-64) with income below 235% of the Federal Poverty Level (FPL), who are not covered by other healthcare benefit or access programs.  Individuals diagnosed with one or more of four prevalent conditions (hypertension, diabetes, heart disease, and depression) are targeted for enrollment.  The initiative is outstanding in the state as it crosses county lines, has among its Board leadership representatives from multiple county governments, incorporates a variety of historically competitive providers, serves both rural and urban needs and integrates behavioral and physical health services.

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        Financing & Outreach Strategies

Financing was expected through DSH hospitals applying increased Indigent Care Trust Funds made possible through a change in the State Medicaid plan contingent upon approval by the Department of Community Health (DCH) and HCFA.  When that plan proved unsuccessful, CHW implemented a donated care model with partner contributions financing pharmaceutical purchases.  CHW continues to seek direct state appropriations.

Delivery System

Community Health Works has grown into a vertically integrated network of 91 physicians, 2 clinics, 22 pharmacies, 2 behavioral health providers, 8 public health departments, multiple social service agencies and 5 hospitals.  The focus of CHW is on assuring smooth access to a full continuum of preventive, primary and specialty care; necessary labs and diagnostics, as well as access to life sustaining pharmaceuticals and pre-emergent hospital care bound together by health promotion and disease management and holistic care management to address complex psychosocial needs.

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        Accomplishments to Date

  • Developed a completely new continuum of services and a separate, private not-for-profit corporation governed by a Board representing multiple county governments, provider institutions, academic medicine and community leadership that commits resources.

  • Built a preliminary delivery system of a vertically integrated network of 91 physicians, 2 clinics, 22 pharmacies, 2 behavioral health providers, 8 public health departments, multiple social service agencies, and 5 hospitals across a 2200 square + mile rural/urban region.

  • Leveraged The Robert Wood Johnson Foundation (RWJF) financing to draw $3,368,684 additional grant funding and $1.9 million in local partner investments.  These investments have enabled delivery of an additional $10.3 million in services and medications to the uninsured and chronically ill of central Georgia to date.  These investments have also enabled the recovery of $530,475.92 in Medicaid to the provider system.

  • Served 2,132 persons as of December 2003.  These individuals average 3 morbidities and 5.06 prescriptions per member per month, an average educational attainment level of 11th grade and an average annual income of $4949.30.

  • CHW member utilization and costs are significantly lower, when compared to the control group of singly diagnosed uninsured individuals represented in the Medical Expenditure Panel Survey.  Specifically, CHW members are hospitalized at rates 27% lower than MEPS respondents and visit the ER 13% less frequently.  The evaluation further documents that partners would have expanded an additional $1,101,962 annually (516,613 per thousand members) without the presence of CHW and that hospitalization and ER use trends continue falling throughout program membership.  The next evaluation is due June 2004.

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The evaporation of the planned financing strategy has been a challenge.  However, the collaborative has persevered to become THE trusted regional convener around health.  This "door to knock on" and the developed IT infrastructure have opened up new project and funding opportunities that we expect to assist with subsidizing the work of serving the uninsured until state appropriation can be secured.

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        Contact Us

Gregory J. Dent
President & CEO
Community Health Works
233 Medical Court
Forsyth, GA 31029
Phone: (478) 994-1914
Fax: (478) 994-8302



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 Communities In Charge 2002 is a program of The Robert Wood Johnson Foundation.
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