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COMMUNITY
HEALTH WORKS
(CHW)
Macon,
GA
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Objectives
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
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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.
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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.
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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.
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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.
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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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Challenges
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
E-mail: gdent@chwg.org
website:
www.chwg.org
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