Ballad Health has unveiled a major, coordinated effort to increase healthcare access for low-income uninsured people, aiming to reduce health disparity and inequity.
The new Appalachian Highlands Care Network is designed to bridge care gaps, improve health and reduce avoidable healthcare cost and utilization. The program includes all Ballad Health hospitals, outpatient services and physician practices, along with a regional network of non-Ballad Health care providers and primary care services offered through regional safety-net clinics, health departments and federally-qualified health centers.
“For years, individual health departments, safety-net clinics and healthcare providers have done what they can to care for uninsured, resource-limited people,” said Ballad Health Chairman and CEO Alan Levine. “But to truly improve the health of our communities and reach those who need our help the most, we all have to come together and work cooperatively and collaboratively. Because of the merger creating Ballad Health, and the resulting investment into a common technology platform, Ballad Health has the scale and technology to facilitate this massive effort, along with our partners at East Tennessee State University and many other great organizations.
“The Appalachian Highlands Care Network represents the first region-wide, coordinated effort to bring organization and technology to address the problems faced by individuals without health insurance in our community. Part of what makes the Appalachian Highlands one of the best places in America to live, work, play and raise a family is that we have a culture of caring for each other. This effort is a natural result of the scale of Ballad Health working in partnership with incredible partners such as ETSU, the University of Virginia’s College at Wise, Project Access and our region’s other safety-net healthcare and social service providers.”
The new network was adapted from Appalachian Mountain Project Access, part of a national model of care that has served parts of the Appalachian Highlands – mainly Washington County, Tennessee – for many years. In addition to more than $75 million Ballad Health spends annually providing access to care for people with serious financial limitations through uncompensated care, charity care and unreimbursed Medicaid, the health system is also making significant investments into Project Access across the health system’s entire 21-county service area – the entire Appalachian Highlands.
Through Project Access, and now the Appalachian Highlands Care Network, uninsured patients who need specialty or diagnostic care are referred to the program from providers, hospitals, health departments, community clinics and faith-based centers. The network enrolls members based on a financial assessment, conducts social needs assessments and schedules necessary medical appointments, procedures and testing. The region-wide program has operated in a pilot mode since Sept. 1 and will continue to increase the number of individuals its serves month over month.
As the Appalachian Highlands Care Network continues to grow and evolve, the program’s development will follow three distinct phases:
• Phase 1, care coordination, will meet care gaps for essential services. It will focus on expanding Project Access and Ballad Health offerings regionally to connect people with diagnostic and medical care, with an emphasis on those in need for treatment for urgent and complex medical conditions.
• Phase 2, care management, will utilize a care team model that includes community health workers and care managers to aid people with complex conditions, chronic disease or behavioral health issues and social needs. It will identify patients through referral sources, Ballad Health data analytics and case management, and it will provide disease and medication management services and counseling to prevent harm and unnecessary hospital encounters.
• Phase 3, prevention and self-management, extends the Appalachian Highlands Care Network to healthier, uninsured populations. The ultimate goal of this final phase will be to improve health literacy and healthy behaviors, while consistently ensuring people receive the care they need in the most appropriate setting.
Patients who will qualify for the Appalachian Highlands Care Network include those who do not have access to health insurance and whose income is at or below 225 percent of the Federal Poverty Level. When those patients are referred to the program through a safety net clinic or other provider, they take part in an enrollment process that further evaluates their eligibility and medical needs, as well as their potential need for social services or other assistance.
To see if you qualify for network services or for more information, please visit www.projectaccesseasttn.org.