Ballad Health this month is launching the Appalachian Highlands Care Network, designed to help low-income and uninsured people in our region. It will make a major difference in the lives and health of people by getting healthcare to those who are most in need.
The goals of the Appalachian Highlands Care Network are to improve quality, increase access and reduce cost – so people can get the right care, in the right setting, at the right time. The network will cover care gaps and improve care management for those in need, and it will involve all Ballad Health hospitals and physicians, as well as other community providers.
How does it work?
To accomplish this, Ballad Health will work with a trusted regional partner – Project Access – and regional organizations and providers.
Project Access enrolls people based on a financial assessment and gives them a membership card. This membership card, along with a referral and arranged appointment from Project Access, will result in members receiving services from Ballad Health and other community providers in the network without being billed. Ballad Health practice managers, schedulers and billers are receiving special training to manage these patients correctly.
Two parts: Care Coordination and Care Management
Two program elements will launch this fiscal year. Care Coordination will begin in September, and Care Management will begin in January.
Care Coordination
- The work Project Access has been doing in Washington County, Tennessee, will be scaled to our entire 21-county area. Participating primary care providers can refer appropriate patients who need help and essential services to Project Access, which will connect them with Ballad Health. Likewise, Ballad Health providers will be able to refer patients into the network.
- Project Access will also conduct a social-needs screening and refer patients to the appropriate community resources.
- Members of Project Access sign an agreement committing to strive toward good health and to utilize healthcare services appropriately.
Care Management
- Care Management will focus on a subset of the uninsured who have complex conditions, and will involve community health workers and care managers working to help those people better manage their health and self-care. This means connecting those patients with the community resources they need, and preventing avoidable hospital utilization.
- These people will be identified and enrolled based on inpatient case management risk scores, prior utilization patterns and health conditions.
Look for more information on the Appalachian Highlands Care Network coming your way soon, as Ballad Health works to improve the health of our region.