Project Access Dallas Partners

Transcription

1 Project Access Dallas Partners Founding Partners City Square formerly Central Dallas Ministries Dallas County Medical Society Dallas/Fort Worth Hospital Council Health Texas Provider Network Charity Medical Clinic Enrollment Sites Brother Bill s Helping Hand City Square formerly CDM Christ s Family Clinic Diabetes Health & Wellness Institute Grand Prairie Wellness Clinic Healing Hands Ministries Hope Clinic Garland Irving Interfaith Clinic Metrocrest Family Medical Clinic Mission East Dallas North Dallas Shared Ministries Pharmacy Support Caremark Hospital Support Baylor Institute for Rehabilitation Baylor Jack & Jane Hamilton Heart and Vascular Hospital Baylor Medical Center at Garland Baylor Medical Center at Irving Baylor Specialty Hospital Baylor University Medical Center Children s Medical Center Las Colinas Medical Center Medical City Dallas Methodist Charlton Medical Center Methodist Dallas Medical Center Our Children s House at Baylor Parkland Health & Hospital System Texas Health Presbyterian Hospital Dallas St. Paul University Hospital Texas Scottish Rite Hospital for Children Zale Lipshy University Hospital Community Partners Baylor Health Care System Blue Cross/Blue Shield of Texas Caring for Children Foundation of Texas The Cirrus Companies Dallas County Commissioners Court DCMS Foundation McCune Charitable Foundation Parkland Health & Hospital System Physicians Foundation for Health Systems Excellence Texas Health Resources Texas Medical Association Thompson & Knight, LLP University of Texas Southwestern Medical Center Mental Health/ Behavioral Health Green Oaks Hospital at Medical City Dallas Pastoral Counseling & Education Center Ancillary Services Support 4 Better Sleep American Health Imaging Med Provider North Central Surgery Center Park Central Surgery Center Patient s Comprehensive Cancer Center in Carrollton Pediatric Surgery Center Prime Diagnostic Quest Diagnostic Sam s Club Hearing Centers Southwest Diagnostic Imaging Center Texas Institute for Surgery Two Forest Imaging Laboratory Services Support Clinical Pathology Laboratories Laboratory Corporation of America

2 Enrollment: PAD finished 211 with a 12-month average of 3,178 active enrollees. Enrollments have remained active (~116 new patients per month) from 11 community clinics and hundreds of private physicians, maintaining the total patient enrollment at approximately 3,. Specialty Care Referrals: PAD completed 1,947 specialty care physician referrals (73% of all 211 specialty requests). This helped ensure that PAD enrollees received timely specialty physician consultations and care, decreasing their need for hospital utilization to stabilize their chronic diseases. This was accomplished by a concerted effort to recruit additional physician volunteers; PAD added 24 physician volunteers (152 primary care and 88 specialty care) in 211. With the assistance of private specialty physicians and the continued support of the University of Texas Southwestern Medical Center and Parkland physicians, we have reduced the average wait time for a specialty care appointment to 5 days, with urgent appointments made within 2 weeks. Pharmacy: During the first half of 211, PAD experienced a 3% increase in pharmaceutical costs (to $23.41 per patient per month). The number of prescriptions per patient increased 21%, with the costs per prescription rising 7%. As a result, PAD made major changes to its pharmacy benefit, helping to bring spending under sustainable budgetary control. Additionally, we added a Pharmaceutical Assistance Program Navigator (PAP-N) in September 211 to help patients obtain free brand-name medications from pharmaceutical companies. The PAP-N has assisted 149 patients obtain 24 unique brand-name prescriptions, saving PAD more than $22,35 in annual prescription costs for these patients. These changes have helped reduce PAD s monthly pharmaceutical costs by 69% and stabilized the program s budget. Care Navigation: PAD has seen a 14% increase in the number of enrollees needing care navigation, particularly transportation. Providing this service helped reduce specialty physician visit no-show rates by 4% (12% no-shows in 211; 2% in 21). Quality in Diabetes Care: Since 29, PAD has collaborated with the Diabetes Equity Project* to improve diabetes care management for PAD enrollees. Combined with PAD s pharmacy support, care navigation, and primary and specialty care physician access, diabetic patients have realized a 15% improvement in average HgbA1c control (8.7% baseline; 7.4% after 12 months).** Further, the DEP s surveillance data reveals a 53% increase in the percentage of diabetic patients experiencing good (HgbA1c < 7%) diabetes control (32.7% at baseline; 5.2% after 12 months). Donations in Care: PAD s volunteer provider network donated a record $9.7 million in care to PAD enrollees during 211: $4.5 million from local physicians $5.2 million from local hospitals and ancillary partners As this report demonstrates, we have made tremendous progress over the last nine years and look forward to 212 and our 1th year of operation. Working together with you, Jim Walton, DO, MBA Medical Director, Project Access Dallas *Diabetes Equity Project Funded by the Merck Co. Foundation s Alliance to Reduce Disparities in Diabetes **Walton JW, Snead C, Collingsworth A, Schmidt K. Reducing Diabetes Disparities Through the Implementation of a Community Health Worker-led Diabetes Self-Management Education Program. Fam Comm Health, 212; 35 (2):

3 14 E. 12th Street P.O. Box 468 Dallas, Texas

4

5 Update from the Medical Director Jim Walton, DO, MBA A patient s story best describes the value of Project Access Dallas. Imagine a local hospital leader faced with a friend s request to help an uninsured relative. The relative just received a cardiac diagnosis made during a recent ED visit for chest pain. The condition wasn t serious enough to require admission, but the patient was told it was urgent enough to deserve attention by a physician within the next 1 to 2 weeks. With no health insurance, the patient turned for help to a relative involved in healthcare administration. A few phone calls later, the patient had an appointment with a local PAD charity clinic s primary care physician. That physician deemed the condition urgent, and the patient was scheduled to see a volunteer PAD cardiologist, who performed a stress test and echocardiogram in the office. Within 2 weeks the patient went from an ED visit to cardiac catheterization and a diagnosis of coronary artery disease needing bypass surgery. Amazing as it seems, the final chapter of the story has the patient receiving bypass surgery at Parkland Hospital, without having had a heart attack. As you will see in this annual report, the value of hundreds of similar stories is measurable. The value to the patients and their families is priceless!

6 In 21, Omar Jackson was on vacation in the Dominican Republic. Although he recently had been laid off from his job of 25 years in the telecommunications industry, he was hopeful that a new job was on the horizon. He had solid work experience, an education from Cornell University, and the desire to work. Surely, he d be fine, he thought. Jackson s trip and life changed in an instant. At 48, he suffered a stroke during his vacation. He immediately got on a plane back to Dallas, but he doesn t know how he had the presence of mind to get to the airport, book a flight home, and then go straight from the airport to a hospital. His insurance coverage from his previous job expired when he d been in the hospital for 2 weeks. Then his savings ran out. Although he wasn t physically ready to leave the hospital, he was out of money and saw no alternative. That was until the hospital enrollment coordinator for Project Access Dallas came into Jackson s room to tell him about the program. But he was wary; he had been in the hospital for 3 weeks and was looking for options, ACTIVE ENROLLEES The decrease in number of PAD enrollees reflects efforts to align the number of active patients with the capacity of the physician volunteer network. PHYSICIAN VOLUNTEERS Project Access Dallas gained 24 physician volunteers in 211 and improved communication with volunteers through a monthly newsletter.* ANCILLARY & SPECIAL REFERRALS The decrease in number of referrals reflects efforts active patients with the capacity of the physician v 4, 3, 2, 3,984 2,847 2,5 1,875 1,25 1,913 2,81 2,227 4,5 3,375 2,25 2,894 4,46 3,279 1, 1,62 1, ,125 2,

7 but not like this. He didn t need or want a handout. Eventually, he conceded that he needed help, and he enrolled in the program. I didn t realize how down and out I was, he says, recalling his initial hesitation about enrolling in PAD. But, now I can t imagine where I d be without it. When he was released from the hospital after a 2-month stay, he spent some time in outpatient rehab, but he couldn t drive, he couldn t cook and he couldn t get up the stairs to his secondfloor apartment. He needed help in every facet of his life, and PAD came through. PAD helped him change apartments, provided access to food, and drove him to all his doctor s appointments including a few rehab appointments in Euless. I would never be able to do it without PAD, Jackson says. They have done everything for me. They even helped me apply for disability income; I had no idea I could get something like that. Jackson grew up in New York City and moved to Dallas in He says, It was 77 degrees here in December. I ve only been back to New York once. While he s enjoyed his time in Dallas, his family and most of his friends still are in New York. PAD is my family and support system here, he says. A lot of that feeling of familial support comes from the staff at Healing Hands Clinic. He describes his experiences with the clinic as great, very attentive and very thorough. He says that the clinic s physician, Mary Beth Felty, MD, called him one evening at home, just to check on him. I couldn t believe it. No one calls me at night! And she just wanted to give me some feedback, he says. Jackson has been back to the emergency room only once since his initial visit after he suffered a fall and needed stitches on his head. He s getting the medical attention and the care that he needs from PAD and his medical home to get back on his feet and return to his normal life. He s applying for jobs and again looking forward to the future. From here, the future looks pretty bright. TY to align the number of olunteer network. COMMUNITY HEALTH NAVIGATED ENROLLEES The number of navigated enrollees increased after PAD added pharmacy navigation for patients of private physicians ( in 21 vs. 145 in 211).** PRESCRIPTIONS FILLED The rise in number of prescriptions filled is consistent with our focus on enrolling patients who have comorbidities, in conjunction with a higher first-quarter patient enrollment and a larger annual pharmacy allowance. DONAT The increase i by all PAD part procedures an 1,6 1,2 1,334 1,521 32, 24, 25,551 31,926 1,, 7,5, 8 16, 5,, , 11,26 11, ,5, 3,742,87 28

8 PHYSICiAN VOLUNTEERS OF THE YEAR PRIMARY CARE Sarah Helfand, MD Pediatrics Sarah Helfand, MD, a PAD volunteer since 22, works tirelessly at Healing Hands Ministry. According to her peers, she inspires others to volunteer to serve the working poor of Dallas County. Dr. Helfand serves on the PAD Leadership Committee at Methodist Medical Center and on the DCMS board of directors. She participates in DCMS community events, such as doing physicals at health fairs, answering questions in the Ask the Doctor booth, and volunteering on Medical Missions Day. SPECIALTY CARE Howard Weiner, MD Gastroenterology Howard Weiner, MD, has volunteered with PAD since 22. He has offered unlimited appointments in PAD s most needed specialty this year, seeing as many patients as PAD could send. Since the inception of Project Access Dallas, Dr. Weiner has been influential in getting support from the leadership at Presbyterian Hospital of Dallas. He is an exceptional volunteer and a great leader for Project Access Dallas. * PAD also began contacting physician offices that had seen a PAD patient within the previous 3 days to answer any questions and to obtain feedback. We successfully encouraged peer-to-peer recruitment with a contest focusing on a top-needed specialty. ** We experienced a significant increase in episodic referral patients (537 in 21 vs. 892 in 211), despite a significant drop in the number of full-time navigated patients (797 in 21 vs. 484 in 211). Primarily, the large increase in episodic patients served resulted from increases in the capacity of our Community Health Navigation program (addition of a donated van, increased capability of our CHN staff due to CHW training and certification, and increased capacity to provide certain types of durable medical equipment, such as CPAP and oxygen therapies). We transported almost twice as many patients in 211 as in 21 (675 vs. 343) and provided several kinds of durable medical equipment to more than 15 patients in 211, compared to fewer than 2 patients in 21. ED SERVICES s a result of improved data collection and reporting ners. Services included office visits, diagnostic d surgeries. 9,76,967 2, 1,5 OPERATING EXPENSES PER PATIENT Operating expense per patient increased in 211. This is consistent with resizing the program to meet network supply, and providing new services and staff to assist with patient care. 1,966 9.% 8.% DIABETES CARE MANAGEMENT Diabetes Equity Project: Diabetic PAD Enrollees participating in DEP had a 15% INCREASE in disease control. (Average HgbA1c ) HgbA1c 8.7% 4,474,528 5,512,44 1, ,31 1,87 7.% 6.% 7.4% Baseline After 12 Months