Access to care
Hampshire HealthConnect (HHC)
HHC continues to target all local residents who are uninsured along with current and former clients. Over the period September 1, 2012 to August 31, 2013, over 3,400 individuals (746 children and 2,720 adults) were assisted by HHC. Of the total households served, clients resided in 105 different towns throughout Massachusetts. Additionally, HHC assists by matching uninsured individuals with physician care and other programs.
Match uninsured or underinsured residents to state insurance programs for which they are eligible and to providers who will treat them for free or reduced fee.
Patients in the Cooley Dickinson Hospital service area will have access to care.
Short term goals:
Make program adjustments based on changes in state regulations.
This project addresses the Massachusetts health priorities of supporting health reform.
Hampshire County Health Access Task Force
Local residents who are uninsured or underinsured including those with mental illness, immigrants, and veterans.
Massachusetts leads the nation in residents with insurance and public support for the law remains high, however counting enrollment in real-time is challenging and the numbers reported present a coverage snapshot. Even with coverage, access to primary and specialized care is challenging. According to the Massachusetts Medical Society’s 2010 Physician Workforce Study, patients in Hampshire County must wait 56 days for a new internal medicine appointment, and children must wait 26 days for a new pediatric appointment. In the fall of 2010, the board of Hampshire HealthConnect and the hospital’s healthy communities committee sponsored an event to identify health access problems in the area. A subset of participants – the Hampshire County Health Access Task Force – met in a second meeting to identify potential solutions.
The task force identified six potential solutions:
• Use community health workers
• Increase use of case management
• Increase cultural competence
• Improve coordination and communication across silos
• Create a health center in Amherst
• Create primary care walk-in service in the hospital emergency department
The committee evaluated the possible solutions against the following criteria: practical, affordable, availability of a lead entity, and acceptability by the population being served. The committee assigned workgroups to further study the feasibility of these solutions. In 2011, the Hilltown Health Centers received a grant from the Blue Cross Blue Shield Foundation to study the feasibility of creating a satellite health center in the Amherst area. The assessment showed that the project is feasible. Cooley Dickinson worked closely with the Hilltown Community Health Centers and staff from Representative Ellen Story’s office to develop a planning process. Four planning meetings were conducted in 2013, with 32 participants at the most recent meeting. This project has been met with great enthusiasm.
Continue supporting the planning efforts to establish the Pioneer Valley Community Health Center in the Amherst area.
Short term goals:
Establish a site for the program; continue community engagement in program development, outreach, and funding.
Improved Access to Care by Improving Access to Transportation
Residents in the CDHCC service area
The regional survey referenced earlier asked about barriers to receiving needed care. 2.6% of responses cited lack of transportation. Although other barriers such as lack of insurance, inability to afford care, and problems with hours/scheduling an appointment were bigger barriers, transportation emerged as a key theme in the focus groups and community forums. Key informant interviewees also identified the lack of public transportation as a significant barrier to accessing community assets and services. People who attended the community forum on transportation identified some specific transportation barriers as they seek health care or health supporting services.
o PVTA van service not available/accessible; one can be denied use of the van; times for van service do not fit needs; as a result, people use an ambulance for transportation to access health care
o Need to take 3 buses to get from Amherst to Northampton; can take hours
o No rides home after discharge from hospital; patients may not be able to afford cab ride and often don’t feel well enough to take the bus home
Engage regional partners to further study transportation barriers and develop a high level action plan.
A set of high level recommendations for increased access to transportation will be developed by a regional, representative group.
Cooley Dickinson Hospital • 30 Locust St. (Route 9), Northampton, Mass. • (413) 582-2000