Hospital to lead effort on health care access

Yale-New Haven Hospital has been awarded nearly $1 million by the U.S. Department of Health and Human Services to develop a model that will address the growing health care needs of people who are uninsured and underinsured.

The funds will be used to create a database allowing local health care providers to share relevant patient information and make access to appropriate health care easier for those without enough insurance or lacking insurance altogether.

Funded under the federal Community Access Program, or CAP, the $992,000 will be used for an initiative called the Wellness Information Network, a collaborative effort between local institutions led by Yale-New Haven.

“We’re extremely proud that the United States Department of Health and Human Services has selected Yale-New Haven Hospital to be the leading health care institution for this important initiative,” said James Rawlings, the executive director of the hospital’s Community Health Department.

The other organizations sponsoring the initiative include Hill Health Center, Fair Haven Community Health Center, the Hospital of Saint Raphael, and the New Haven Health Department.

“It can be quite expensive,” said Rose Swift, an assistant resource developer at Hill Health Center. “Once you start splitting it up to take on all the tasks, it isn’t as much as it sounds.”

Still, organizers hope the finished project will help alleviate what are common problems faced by health care institutions across the country: enabling communication between nearby institutions and reducing unnecessary emergency room visits.

“Presently, many underinsured and uninsured individuals utilize the emergency department as their only source of health care. Often, they arrive at the hospital’s doors in advanced stages of illness,” Rawlings said. “Care is expensive and often duplicated at the emergency rooms in New Haven and around the country.”

Under the plan, staff members at each institution will try to reduce duplicate and emergency room visits by directing patients to a “medical home” at one of the collaborating facilities.

The initiative could result in a shift of work, directing many additional uninsured patients from the emergency rooms of larger hospitals to smaller to such community health centers such as the Fair Haven or Hill health facilities.

“It could mean that our costs are going to exceed our income,” said Robert Kilpatrick, the director of development at Hill Health Center. “If a visit would normally cost $100, and we charge somebody $15 — our grants only cover a certain amount of that. So the more people we treat like that, in that category, the more into the red our budget will go.”

But Kilpatrick said the resulting efficiency gains and freeing of critical emergency room resources are worth the anticipated increase in patients at local centers. He added that the initiative will put more pressure on state and federal governments to then come up with additional resources.

“There have been efforts for many, many years to encourage people to not use emergency room inappropriately,” Kilpatrick said. “It’s still a lot more cost-efficient to have [uninsured or underinsured patients] come here for primary care than it is to have them go to the emergency room, because that’s a different level of care.”

The initiative’s organizers said people may head directly to the emergency room if they are unable to seek private care because they lack insurance. Educating and providing clearer options for uninsured and underinsured individuals is the ultimate goal of the network.

“Our mission is to serve people regardless of their income, and programs like this help us to do that,” Swift said.

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