CMA

The Voluntary Care Network was established by Access HealthColumbus in 2004 to help vulnerable people access primary and specialty care through a decentralized or “virtual” network. In return for their participation, doctors obtain the benefits of a centralized scheduling and patient tracking system, a central staff that coordinates primary/specialty referrals, interpreters, access to affordable prescription drugs, transportation services, and a system that assists patients with enrollment in public insurance programs and other social services.

• Patient Responsibility Standards: all patients voluntarily sign an agreement that outlines their responsibilities for receiving help from a coordinated system of health care services. Additionally patients are responsible for affordable out-of–pocket expenses.
• Identification Card: each patient receives a unique identification card that provides a mechanism for coordinating health services.
• A Regular Source of Care: all patients are educated about the importance of having a regular source of health care. If a patient does not have a primary care doctor, care coordinators assist with establishing this patient-doctor relationship. For the purposes of maintaining continuity of care all patients must establish a regular source of care.
• Coordination of Services: care coordinators help patients reduce barriers to health services (transportation, language assistance, access to affordable prescription drugs and eyewear).

In 1997, a study was commissioned to focus community attention on the access problems of the uninsured and to assess the range of services available to uninsured persons. The study concluded that the capacity in Franklin County for both inpatient and outpatient services appeared adequate, but that providers operated in isolation from each other and did not effectively coordinate existing resources.

During the following year, another report looked at the barriers to health care for the uninsured; these barriers included not knowing where to go, inconvenient hours, transportation barriers, and the perception of the uninsured that they were stigmatized by health care professionals. Both reports concluded that although adequate resources existed, there was a need for a strong and cohesive health care delivery strategy in Franklin County and Columbus.

A community wide consortium called Access HealthColumbus was created to address the issues raised by both studies. The Columbus Medical Association and Foundation invested $1.5 million into Access HealthColumbus, while the Osteopathic Heritage Foundation invested $500,000 for the start up of this consortium. In addition to this funding, Access HealthColumbus was awarded a 3 year Federal Healthy Communities Access Project (HCAP) grant.

In 2003, Access HealthColumbus established the infrastructure to support a care coordination incubator, called the Voluntary Care Network. The goal of the care coordination incubator was to demonstrate the ability to incrementally build an organized voluntary care network to link low-income uninsured residents living on the Southside of Columbus with medical homes and improve access (reduce delays) to specialty care. A key milestone was accomplished in October when all four hospital systems in Franklin County agreed to collaborate with Access HealthColumbus. In return for their participation in the Voluntary Care Network, doctors obtained the benefits of a centralized scheduling and patient tracking system, a central staff that would coordinate primary and specialty referrals, interpreters and transportation services, and a system that assists patients with enrollment in public insurance programs and other social services.

• Conduct a pilot in a specific geographic region (Southside) to demonstrate Access HealthColumbus’ ability to organize a system of charitable/subsidized health care for low-income uninsured Franklin County residents
• Organize a Voluntary Care Network with primary, specialty, and hospital health care services
• Establish program policies and procedures; and the infrastructure to support program operations and data management
• Design and implement support services
• Enroll low-income uninsured clients and coordinate health care services
• Promote value of regular source of health care and continuity of care to clients
• Reduce delays to specialty care services
• Build relationships

In 2005, enrollment in the Voluntary Care Network was expanded to include low-income uninsured people residing on the near Westside of Franklin County, in an effort to broaden client diversity. Along with this expansion, the Outcomes Phase of the care coordination incubator began. This phase was critical in order to provide the care coordination incubator with enough time to demonstrate solid outcomes that could be used to sustain a broader systemic solution.

• Improve reported client health status
• Increase the percent of clients reporting a regular source of care
• Assess and compare reported client no-show rate for medical appointment
• Decrease in emergency room visits

The results of the outcomes study showed health outcomes measurements that exhibit that after participating in the care coordination incubator (known as the Voluntary Care Network) for 24 months patients reported improved health status, increase in having a regular source of care, a 5.6% no show rate for medical appointments, and a 42% decrease in emergency room visits.

In 2008, the Access HealthColumbus Board decided that it was time to integrate the Voluntary Care Network into the community and conducted a feasibility study to determine the best fit for this program in the community. The feasibility study findings indicated that The Physicians Free Clinic would be the best fit.