Large health care systems in Detroit came together to develop an organizational structure and common goals and policies designed to strengthen the safety net for uninsured residents, leading to increased enrollment in public insurance, enhanced access to primary and specialty care, and lower uncompensated care costs.
A statewide, multipayer pilot program provides technical and financial support to physician practices interested in becoming patient-centered medical homes, leading to all participating practices being recognized as medical homes and to anecdotal reports of better access and higher quality.
As part of a statewide public-private initiative, the diverse Burlington (Vermont) health service area supports 18 patient-centered medical home practices via a multidisciplinary team, real-time electronic information, and financial incentives, leading to more appropriate care, better health outcomes and patient experiences, and lower utilization and costs.
A collaborative program leverages information technology to connect ED patients to a medical home and patients receiving care at FQHCs and county health clinics to specialists, leading to enhanced access to care, fewer ED visits, and significant cost savings.
Emergency department–based case managers at nine Milwaukee hospitals use electronic technologies to schedule and track attendance at follow-up clinic appointments for low-income, uninsured patients who come to the emergency department with nonurgent needs, allowing many such patients to establish a medical home.
A statewide program supports physician practices through multidisciplinary community-based health teams, preventive health expertise, easy access to needed information via electronic systems, and financial incentives, leading to lower utilization and growth in health care spending and enhanced provision of appropriate services.
A solo practitioner leverages various functions within the electronic medical record to redesign care processes, leading to greater adherence to recommended care processes and improved outcomes for patients with diabetes.
A joint case management program sponsored by two competing hospitals addresses the health and social needs of uninsured and underinsured individuals who have a history of using the emergency department for nonemergent issues. The program has led to enhanced access to appropriate care and to a significant decline in emergency department use and costs for nonemergent conditions.
Health navigators help primary care patients access medical and community resources, leading to significant improvements in health-related and self-management behaviors and health outcomes and to meaningful declines in emergency department and inpatient utilization.
Trained, bilingual medical assistants in a capitated health center serve as health coaches to chronically ill (often diabetic) patients of similar ethnic or racial backgrounds, leading to better disease management and clinical outcomes for those with diabetes, very positive feedback from patients and center staff, and low turnover among medical assistants and coaches.