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Presented to Florida Hospital Association Webinar February 18, 2010 By Wally Plosky, Program Director HERAP Duval Count

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Presented to Florida Hospital Association Webinar February 18, 2010 By Wally Plosky, Program Director HERAP Duval County Health Department. HERAP Focus. Uninsured and low income populations. Patients without a family physician.

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Presentation Transcript
slide1
Presented to Florida Hospital Association Webinar

February 18, 2010

By

Wally Plosky, Program Director HERAP

Duval County Health Department

herap focus
HERAP Focus
  • Uninsured and low income populations.
  • Patients without a family physician.
  • Patients requiring case and disease management assistance (for diabetes, cardiovascular, pulmonary and other chronic conditions).
  • Patients who have trouble filling prescriptions.
  • Zip codes with high hospital use for Ambulatory Care Sensitive conditions.
herap components
HERAP Components
  • Coordination of hospital ER and inpatient referrals.
  • Primary care medical homes.
  • Multi-disciplinary disease management services.
  • Free walk-in medical condition management centers (MCMCs).
  • Neighborhood community living rooms (CLRs).
  • Medication assistance program (MAP).
  • Expanded clinic hours – evenings and Saturdays.
  • Stanford Medical School’sChronic Disease Self Management Program (CDSMP) - Living Healthy.
  • Regional health information exchange (JHIN).
herap staffing
HERAP Staffing
  • RN disease managers
  • Financial eligibility specialists
  • Clinical pharmacologists/pharmacists
  • Registered dietitians/certified diabetic educators
  • Health educators
  • Mental health counselors
  • Patient navigators
2009 herap accomplishments
2009 HERAP Accomplishments
  • Received 2,697 client referrals from hospitals and community partners.
  • Connected 70% of hospital-referred patients with medical homes in the community.
  • Reduced emergency room utilization of HERAP-enrolled clients by 55.4%.
  • Reduced hospitalization of HERAP-enrolled clients by 89.8%.
  • Coordinated with hospitals to recoup over $1M in billable Medicaid dollars.
  • Helped hospitals in accessing over $75,000 in billable Medicaid under the Medically Needy Share of Cost program.
2009 herap accomplishments cont d
2009 HERAP Accomplishments (cont’d)
  • Submitted 264 medication assistance applications totaling $83,841.
  • Provided chronic disease management services for an average of 200 patients monthly
  • Conducted three 6-week Stanford Medical School Chronic Disease Self Management Programs (CDSMP), graduating 30 participants
  • Held 28 CLR outreach events, attended by 1007 participants, resulting in 227 HERAP enrollments
  • Implemented innovative technology to streamline financial eligibility for hospital-referred clients needing access to medical homes within 72 hours
  • Provided office space and IT support for the Duval County WE CARE program and a volunteer Project Dentists Care
key herap partners
Key HERAP Partners
  • Baptist Health (BMC – Baptist South)
  • Memorial Hospital (HCA)
  • St. Vincent’s Medical Center (includes St. Luke’s)
  • Jacksonville Health Information Network (JHIN)
  • DCHD Institute for Public Health Informatics and Research (IPHIR)
  • Agape Community Health Center Network (Co-Applicant public entity FQHC with DCHD)
  • WE CARE, Inc.
herap referral sources
HERAP Referral Sources

Hospitals/

ERs

Agape CHC

Network

Community

partners

Volunteers in

Medicine

We Care

HERAP

Community

physicians

Community

outreach

DCHD

programs

Self referral

I M Sulzbacher

slide9
HERAP Referrals by ZIP Codes

>40

30-39

24-29

10-23

<10

duval county herap cost effectiveness review
Duval County HERAP Cost Effectiveness Review
  • Objectives
    • Evaluate the impact of HERAP’s comprehensive multi-disciplinary disease management and medical home program on:
      • Emergency room utilization
      • In-patient hospital admissions/stays
    • Evaluate the effectiveness of a health information exchange in monitoring HERAP effectiveness (Jacksonville Health Information Network – JHIN)
    • Measure the effectiveness of a multi-hospital partnership model with individual hospital-specific program elements
duval county herap impact analysis
Duval County HERAP Impact Analysis
  • Methods/Procedures
    • Data set stratification
      • 521 uninsured patients formally enrolled in HERAP’s disease management program with at least one emergency room visit or one in-patient admission
      • January 1, 2009 – September 30, 2009
    • “Before and after” utilization rate comparison
      • Time bounded: 180 days immediately prior to and following HERAP admission
duval county hospital emergency room alternatives program herap impact analysis
Duval County Hospital Emergency Room Alternatives Program (HERAP) Impact Analysis
  • Emergency room visits
    • Reduction: 55.5%
    • Projected six month savings:
      • $176,490
  • Hospital in-patient admissions
    • Reduction: 89.8%
    • Projected six month savings:
      • $4,324,260
resources our partner hospitals want for their discharged patients
Resources Our Partner Hospitals Want for Their Discharged Patients
  • Assistance with non-compliant clients.
  • Primary care medical home.
  • Prescription access.
  • Chronic disease care and case management.
  • Knowledge of available community resources and how to connect clients to those resources.
  • Dental access.
  • Behavioral health and substance abuse services.
herap contact information
HERAP Contact Information

Hospital Emergency Room Alternatives Program

Duval County Health Department MC-92

900 University Blvd. N., Suite 202

Jacksonville, FL 32211

Tel: (904) 253-1444

Fax: (904) 745-3005

http://www.dchd.net/herap.htm

Wallace B. Plosky, MBA, Program Administrator

[email protected]

Brenda Bernardez, MSN, Project Director

[email protected]

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