Presented at Enroll America's 2016 State of Enrollment conference.

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From the ER to Primary Care: Effective
Strategies for Connecting Enrollees to Care

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Panelists Introductions:
• Lorena Sanchez, Director of Programs for
Sacramento Covered
• Andrea Ravitz, Director of Marketing for
Access Health CT
• Jaspreet Malhotra, Program Specialist for
Michigan Primary Care Association
• Madiha Tariq, Public Health Manager for
ACCESS Community Health & Research
Center
Welcome and Overview

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SACRAMENTO COVERED

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Sacramento Covered
Patient Navigation Program Data*
*Data is for Dignity Health Patient Navigation Program.

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Sacramento Covered
Patient Navigation Program Goals
The health care industry is complex, but we keep
our goals simple:
 Ensure patients can access primary care
 Decrease dependency on EDs for primary care
 Improve quality of care
 Reduce uncompensated care costs

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Sacramento Covered
Patient Navigation Program
Patient Navigators in local hospital emergency departments
• Connect with people in need
• Understand their needs
• Take the connection one step further:
o Link to primary care & specialty services
o Transportation needs
o Identify other social service needs
o Follow-up

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Sacramento Covered
Formula for Success
Innovative partnerships help residents gain access to
coverage and care.
Collaborative partners create tailor-made approaches to
meeting community need. Partners include:
• Local hospitals
• Health plans
• Medical groups
• County Medi-Cal Office
• FQHC’s
• Providers

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Sacramento Covered
More Work To Be Done…
Transportation Programs
• Taxi vouchers
• Uber, Lyft, etc.
• Organization vehicles
Clinic Partnerships
• Working with local community clinics to coordinate
patients’ care

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ACCESS HEALTH CT MODEL

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Access Health CT

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Access Health CT

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Access Health CT

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Access Health CT

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Access Health CT

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Access Health CT

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Access Health CT

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Access Health CT

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EXPANDING THE CHW ROLE TO
INCLUDE ENROLLMENT ASSISTANCE

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MI Primary Care Association
Integrating CHW and Enrollment Roles
Experts in System Navigation, Education, and Advocacy

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MI Primary Care Association
Getting Started – Cross Train

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MI Primary Care Association
Expanded Data Tracking Tools
http://www.mpca.net/OEReport

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MI Primary Care Association
PRAPARE Assessment
• Identifying root causes of poor health outcomes
• Focus is on assessing and documenting patients’
risk of poor health
• Guide the patients goals and actions

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MI Primary Care Association
All
Row Labels Not Completed Completed
Education Interest Assessment 39 19
Employment Interest Assessment 36 34
Healthcare Referral 180 105
Health Insurance Assistance 14 14
Health Insurance Education 101
Housing Referral 82 39
HouseSafe Wellness Assessment 7 4
Legal Referral 9 5
Medication Equip Assistance 84 128
Social Com Service Ref 278 193
Social Network Assessment 18 2
Stress Coping Assessment 130 59
Transportation Assistance 99 73
Veteran Benefit Edu Referral 2 3
Grand Total 1079 678
Top 5
Row Labels Not Completed Completed
Healthcare Referral 180 105
Health Insurance Education 101
Social Com Service Ref 278 193
Stress Coping Assessment 130 59
Transportation Assistance 99 73
Grand Total 788 430
PRAPARE Data

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MI Primary Care Association
PRAPARE Data
0
50
100
150
200
250
0
50
100
150
200
250
300
Not Completed
Completed

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MI Primary Care Association
Understand Coverage

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MI Primary Care Association
Social Media
Campaign

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MI Primary Care Association
Social Media
Campaign

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MI Primary Care Association
Sustainability
• Continued commitment to assist
consumers access healthcare
• Improved screening of consumers for
health coverage needs
• Increased capacity to address the social
determinants of health and improve health
outcomes

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BRIDGING HEALTH DISPARITIES:
THE ACCESS MODEL

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ACCESS Health Coverage Initiative
• Clients Assisted: 16,162
• Language Assistance: 76%
• Electronic Application Submissions: 75%
• Certified Navigators: 4 FT 4 PT
• Events: 233
• Current weekly clients: 100-150
• Weekly clients during open enrollment: 350
• Off-Site Enrollment Sessions: 77
• Enrollment Satellite Offices: 14
• Web Based Reporting
• Partnered with CMS to help translate the Coverage to Care booklet in
Arabic and were nationally recognized.
Navigator Program

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ACCESS Health Coverage Initiative
Does having coverage
mean we are healthier?

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• Reasons why community
doesn’t enroll/reenroll:
• Trust
• Fear of the unknown
• Cost
• Our underlying goal is
improved health outcomes
• Being patient advocates
ACCESS Health Coverage Initiative

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ACCESS Health Coverage Initiative
80% OF PATIENTS WILL FORGET WHAT
THEIR PROVIDER SAID
50% OF WHAT PATIENTS REMEMBER
IS RECALLED INCORRECTLY

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ACCESS Health Coverage Initiative

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ACCESS Health Coverage Initiative
Effective Health Communication is a Shared
Responsibility
Patient Responsibility:
To ask questions
To provide full & honest information
Service Provider Responsibility:
To provide a welcoming environment that allows
patients to share information freely
ACCESS provides services to help develop skills in
the client to effectively communicate with the
provider

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ACCESS Health Coverage Initiative
Case Study

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ACCESS Health Coverage Initiative
• Navigator’s role is to address social
determinants of health
• One Stop Shop
• Cross Training over departments
• Loyalty to agency, not just the program
Care Coordination

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ACCESS Health Coverage Initiative
• Client-centered service
• Care is not as valuable if social determinants of health
are not addressed
• Every staff member plays a role in care
• Every staff must be a community leader/advocate
• Community Partnerships make our work easy
• Important to capture the impact through programmatic
evaluation, community feedback and research
Conclusion

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EXERCISE AND DISCUSSION

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Exercise and Discussion
Participant Exercise:
Let’s say you are going to create a pilot
project back home. Pick which program you
just learned about and describe how you would
incorporate a similar program back home.
What would the structure look like for a 30 day
pilot?

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THANK YOU!
Contact information for today’s panelist:
Erin Knott: eknott@enrollamerica.org
Lorena Sanchez: LSanchez@sacramentocovered.org
Andrea Ravitz : Andrea.Ravitz@ct.gov
Jaspreet Malhotra: jmalhotra@mpca.net
Madiha Tariq: mtariq@accesscommunity.org