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CMW Sneak peek: Improving access to care for the self-pay population

Case Management Weekly, August 13, 2008

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Across our nation, many face the challenge of finding, keeping, and affording medical insurance.

In Tucson, AZ, case managers and others at St. Mary’s Hospital’s ER screen daily to locate and help those who are uninsured or who have no primary care provider and are using the ER for routine healthcare. These patients are provided information about eligibility for Medicaid, sliding-fee health centers, and the State Children’s Health Insurance Program (SCHIP) access in the community. Then patients receive follow-up to encourage eligibility assessments and enrollment at the local St. Elizabeth’s Health Center.

This project demonstrates success with about 19% of the referred patients completing eligibility and establishing care either through Medicaid, SCHIP, or sliding-fee care with team follow-up. Case managers can create systems within their organizations and communities to optimize awareness and enrollment in government-funded programs for the uninsured who qualify, therefore helping to decrease the numbers without access to healthcare.

Check out the July 2008 issue of Case Management Monthly to get the full story, and check out all the benefits of being a Case Management Monthly subscriber!

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