UNC Health Talk

UNC Health Care, Piedmont Health Services partner to provide a high-quality, cost-effective system of care for the uninsured

July 1, 2008

UNC Health Care, Piedmont Health Services partner to provide a high-quality, cost-effective system of care for the uninsured

UNC Health Care, the UNC School of Medicine and Piedmont Health Services have agreed to work together to create a high-quality cost effective system of care for the uninsured that gives patients access to a medical home, care coordination, medications, and access to diagnostic and specialty services in a timely manner.

The goal of this partnership is to simply provide the right care in the right setting at the right time with the patient, family and provider feeling good about the care.

“Too often,the uninsured are less likely to seek care and they have poorer health outcomes. Our goal is to improve the health of the uninsured by providing access to a patient-centered medical home, care coordination, and specialty care,” said Dr. Warren Newton, who is the UNC physician champion for the new program, called Carolina Health Net. Newton is chair of the Department of Family Medicine in the UNC School of Medicine and chair of Community Care of Central Carolina.

The number of people without health insurance, both in North Carolina and nationally, continues to rise every year. In 2005-2006, more than 1.5 million nonelderly North Carolinians were uninsured, and the rate of growth in the percentage of uninsured in the state is double the national rate. The uninsured account  for approximately 19.5 percent of the state’s population, which means approximately one in five north Carolinians do not have health insurance. UNC and PHS are not in a position to solve the issue of affordable health insurance, but they have developed a plan to make access to health care affordable. This plan includes creating a primary medical home where a patient can see a physician get affordable medications and labs and not delay getting medical attention.

In the four Carolina Health Net counties – Alamance, Orange, Chatham and Caswell – there are more than 82,000 uninsured. Of the uninsured that receive care from UNC Health Care, 47 percent live in one of those four counties.

The number of visits to hospital emergency departments continues to rise as well. At UNC Hospitals, for example, there are more than 62,000 patient visits in the Emergency Department each year and the annual cost of caring for indigent patients exceeds $70 million.

“One of the devastating effects of being uninsured is not having a primary care medical home. Without a medical home, patients often feel like there is no option but to go to an urgent care center or Emergency Department when they get ill, waiting until their illness may have become advanced. This innovative program will help provide access to quality primary care for local residents who lack health insurance, and UNC is excited to be part of this,” said Dr. Allen Daugird, Medical Director & Senior Vice President of Ambulatory Care at UNC Health Care.

“Care offered through a primary medical home is more continuous and coordinated as compared to care provided through episodic visits to the emergency department said Brian Toomey, Chief Executive Officer at Piedmont Health Services. “Our mission is to ensure quality health care for everyone in our community, so partnering to serve the uninsured with the UNC Health Care System helps to accomplish that mission. We are proud to work with such a great organization as UNC Health Care and congratulate them for being so proactive in addressing such a serious issue as the care for the uninsured.  Too often large health care organizations are looking to avoid care for the uninsured. UNC is addressing their responsibility directly and effectively and we congratulate them for caring so much for every North Carolinian, whether they are insured or not.”

Under the new partnership, high cost/high risk uninsured patients who do not have a medical home are contacted by a care coordinator and offered care from one of Piedmont’s six community health centers. Piedmont’s six  locations are in Carrboro, Burlington (two centers), Moncure, Prospect Hill and Siler City. Piedmont will provide a medical “home” for these patients and an array of services that includes medical, dental, nutrition, pharmacy, lab, and care coordination. Carolina Health Net case managers will help patients navigate the health care system coordinating medical services for patients with chronic conditions.

The biggest winner is the patient: each member of the pilot will get a home for their health care, with a health care provider they know, easier access, medications, access to most laboratory tests and routine X-rays, and dental care. There will also be community based-care management, which will support patients outside of the office and streamline getting into UNC Health Care.

Funding for the program comes from UNC Health Care, the UNC School of Medicine and Carolina Health Net’s state-appropriated funds. To date more than 800 patients have been enrolled in the pilot phase of the project.

The partnership comes at the right time as the number of uninsured continues to rise, said Sherry S. Hay, Project Director for Carolina Health Net. “We have the opportunity to learn from patients in building this exciting pilot program,” Hay said. “Lessons learned from the pilot will be used for replicating the model in additional locations.”

Media contact: Tom Hughes, 919-966-6047, tahughes@unch.unc.edu

The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, which is ranked among the top 50 in the nation in six specialties by U.S. News & World Report and ranked one of the country’s 41 best on the Leapfrog 2007 Top Hospitals list; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County. UNC Health Care also manages Chatham Hospital in Siler City.

Piedmont Health Services (PHS) has been a Federally Qualified Health Center (FHQC) since 1970 and currently serves the fifth generation of families at our original Community Health Center (CHC) sites. PHS is governed by a community-based board of directors and its mission is to ensure access to quality health care to all in the community. PHS is a Joint Commission-accredited ambulatory care program that provides medical, dental, pharmacy, lab, social work and federal WIC Program services at its 6 CHC sites.