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INLAND
NORTHWEST in CHARGE
Spokane,
WA
This
grant is now inactive. The community requested withdrawal from the
program.
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Objectives
Through assessment and
planning activities during 2000-2002 Inland Northwest in Charge (INIC),
identified a series of priorities for regional healthcare system reform, which
include goals to:
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Triage
healthcare access solutions for the region's uninsured and underserved
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Offer
new solutions for employers and employees not currently involved with health
coverage
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Expand
primary, preventive, and chronic disease services available to the uninsured
and underserved
-
Identify
and develop local resources for improving healthcare access for targeted
populations
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Develop
information technologies and infrastructure that support efficient tracking
and channeling for the uninsured/underserved into sustained preventive
healthcare
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Promote
the shared interests of healthcare purchaser as they collaborate to identify
regional solutions that strengthen healthcare access
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Promote
the development of a unified regional healthcare access planning capacity
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Program Design
Inland
Northwest in Charge is a collaborative project to implement comprehensive and
sustainable healthcare access solutions for the uninsured and underserved in
Eastern Washington. Facilitated by the Health Improvement Partnership
(HIP), over 200 organizations and community members in Spokane and surrounding
counties participate in planning and implementation activities.
Collaborators
represent urban and rural populations and are from public and private
sectors. This includes; hospitals, physicians, safety net providers,
health plans, human service providers, Chamber of Commerce and employer
representatives, government agencies and analysts.
INIC
is organized into a large Assembly, and Advisory Committee and smaller targeted
groups. These groups focus on project areas such as long-term
sustainability, establishing referral protocols between hospital emergency
departments and primary care clinics, and developing alternative benefit
packages from small employers. Based on participant's experience in
healthcare and information from the assessment process, work groups develop and prioritize
strategies that are presented to the Advisory Committee for input at key
decision points. INIC staff also work with individual partners and other
plan elements such as policy information systems, and linking the uninsured with
new access options via HealthforAll.
INIC
Goals and Strategies for 2002/03
"Triaging"
Healthcare Access - HIP's HealthforAll phone center talks to approximately
600 uninsured people every month, looking for custom-designed coverage and
access solutions. By far the most important strategy so far has been
educating and enrolling people on Medicaid, Basic Health and SCHIP. As of
May 2002, HealthforAll channeled more than 16,000 previously uninsured people
into those subsidized health plans.
New
Solutions for the Employed Uninsured - Seventy-five percent of the uninsured
in the Spokane region are employed. With its Expanded Choice Initiative,
HIP and its partners have developed a new vision and a new plan for engaging
small employers in offering healthcare coverage for the first time. The
plan involves a creative combination of public and private dollars with
technical assistance for these employers as they transition to the commercial
marketplace.
Cooperative
Regional Funding - There is an economic benefit to achieving full access to
healthcare. HIP is working to quantify this benefit and to define an array
of investments that various regional organizations can make that will produce a
positive return for these organizations as well as for the community as a
whole. Conceivably these investments may form a local subsidy pool that
the community can apply to particular underserved uninsured populations.
Regional
Information Systems Development - One of the keys to serving the underserved
is to know how and where they are, what health problems they are experiencing,
what services and what obstacles are occurring. Another key is to extend
the reach of healthcare technologies to people who can not access services by
other means. The Spokane region has achieved a degree of healthcare
information system integration that is unprecedented nationally. HIP is
working with various partners to see that the uninsured and underserved become
part of the emerging regional computer-based healthcare tracking and delivery
system.
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Financing & Outreach Strategies
Current
Project Funding - Inland Northwest in Charge (INIC) funding comes from a
Robert Wood Johnson Foundation Communities in Charge grants of $700,000 over
three years (2001-2003). Year one was supplemented with $916,000 community
access program grant from the Health Resources and Services Administration
(HRSA). In September 2002, HIP received $641,000 in 2002 HRSA renewal
funds. INIC also receives funding from a variety of smaller groups.
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Accomplishments to Date
Enrollment
and Healthcare Access
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Helped
approximately 6,000 individuals enroll in health coverage (total of
approximately 13,000 since HealthforAll program inception).
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Launched
100% Healthy Kids Campaign, generating three itmes the number of calls from
the previous year.
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Referred
approximately 2,800 individuals to a primary care medical home offering
low-or-no-cost care.
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Began
linking ineligible uninsured individuals with donated primary care via
Columbia Care.
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Implemented
the MEDs program which streamlines the application process for prescription
drugs through pharmaceutical company Patient Assistance Programs.
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Designed
and launched new "Expeditor" role to coordinate access solutions
for uninsured individuals with multiple, complex health issues.
New
Solutions for the Employed Uninsured
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Employers,
brokers, health plans, hospitals, and providers formed the Expanded Choice
Team, designing a new health coverage option for the employed uninsured and
creating recommendations for public-private partnerships.
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The
team coordinated market research to evaluate how well the package meets
employer and employee needs and engaged state policy makers in discussions
regarding financing.
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The
State Health Care Authority (Basic Health Plan) has assigned a design team
to work with HIP and its partners to explore implementation of Expanded
Choice and has expressed commitment to becoming the Expanded Choice
Partners.
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Dialogues
underway with all relevant state agencies regarding developing supportive
relationships/removal of possible barriers to Expanded Choice implementation
(Governor's Office, Healthcare Authority, Office of the Insurance
Commissioner, Department of Social and Health Services, and the Department
of Health).
New
Service for the Chronically Ill
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Challenges
Double-digit
cost increases in Washington State's healthcare budget resulted in "Managed
Enrollment" whereby the state prolonged the Basic Health application
process to decrease the number of enrollees through attrition. This
affected the numbers of uninsured that HealthforAll was able to successfully
enroll and impacted INIC planning in light of reduced state budgets. At
the same time, budget shortfalls have resulted in an increased willingness among
state policy makers to look at creative solutions for healthcare access to work
across traditional state agency boundaries.
INIC
continues to benefit from broad and diverse partnerships locally and
statewide. At times, it has been difficult to secure follow-through with
some partners, but other new partnerships have developed that and provide the
opportunities for fruitful collaboration. The challenge of maintaining the
collaborative model from planning to implementation are offset by the diversity
of expertise and long-term-buy-in results from broad based partnerships.
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Contact
Us
Daniel
Baumgarten
Executive Director
Health Improvement Partnership
421 West Riverside, Suite 400
Spokane, WA 99201
Phone: (509) 444-3088
Fax: (509) 444-3077
E-mail: dbaumgarten@hipspokane.org
Web Address: http://www.inland-nw-in-charge.wsu.edu
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