ACCESSING AND UTILIZING HEALTH CARE

WHY ACCESSING AND UTILIZING HEALTH CARE?

Accessing health services can increase overall health status and quality of life while preventing diseases, disability, and premature death in a community.1 Respondents to the CHA Survey identified “Access to Health Care” as the #4 overall health need in Hendricks County,2 and partners identified it as the #2 health improvement priority area for Hendricks County.3

Almost 50% of CHA Survey respondents faced at least one challenge to receiving health care.2 Additionally, during focus groups and town hall meetings, participants identified access to health services, which includes lack of health services in rural areas of the county, affordability of care, and health insurance, as one of their top concerns.4 Lastly, participants in the Forces of Change Assessment identified both threats (lack of public transportation and available health care providers) and opportunities (telemedicine technology) around access to health care in the county.5

In addition to the public identifying access to health care as an issue, secondary data shows additional barriers to accessing and utilizing health care. A total of 13% of the adult population and 6.7% of the youth population lack health insurance.6,7 Additionally, screening rates for health conditions remain low, ranging from 66.6% (mammography screening for Medicare recipients) to 79.6% (cervical cancer screening for females).8,9 Lastly, over 12% of adults lack a consistent source of primary care.10

Additional information about accessing and utilizing health care can be found in the 2016 Hendricks County Community Health Assessment.


PRIORITY AREA LEADERS AND PARTNERS

PRIORITY AREA LEADER:  Betsey Thompson, Hendricks Regional Health

PRIORITY AREA PARTNERS: Hendricks Regional Health, MDWise, Hope Healthcare Services, First Light Home Care, Home Health Care Solutions, Managed Health Services, IU Health West, Kindred Healthcare, Hendricks County Health Department, Hendricks County Senior Services


2016-2016 WORK PLAN

GOAL: By December 31, 2018, decrease the percentage of Hendricks County adults who lack a consistent source of primary care from 12.49% to 10% as reported by the Behavioral Risk Factor Surveillance System.

SHORT-TERM OBJECTIVE:  Through December 31, 2018, host two health literacy and provider fairs every year with Hendricks County residents who have health insurance but lack a primary care provider as reported by the Accessing and Utilizing Health Care work group.

STRATEGIES:

Identify populations most likely to lack a primary care provider, primary care providers currently accepting new patients meeting the needs of those populations, and presenters who can discuss health literacy with those populations.

Identify locations where populations congregate (e.g. college campuses) and determine needed resources to execute events.

Schedule events at identified locations, secure primary care providers and presenters to participate in the events, and gather resources to provide incentive for resident attendance.

Develop messaging, identify marketing outlets, and market events to target populations.

MID-TERM OBJECTIVE: By December 31, 2017, develop a cost-of-care database of health and wellness care services in Hendricks County as reported by the Accessing and Utilizing Health Care work group.

STRATEGIES:

Identify the availability and cost of health and wellness care services and community agencies and/or programs that provide health care and/or social service assistance in Hendricks County.

Identify the best method for maintaining and distributing the database to the public.

Develop searchable database entries that include the name and description of the services, populations eligible to use the service, and cost to use the service.

Develop messaging, identify marketing outlets, and promote the database to hospitals, health care providers, social service agencies, and the general public.

LONG-TERM OBJECTIVE: By December 31, 2018, enroll 1,000 uninsured (i.e. no insurance anytime within the last 12 months) Hendricks County adults into health insurance as reported by the Accessing and Utilizing Health Care work group.

STRATEGIES:

Identify populations and/or areas within Hendricks County that lack health insurance.

Identify locations where populations congregate (e.g. college campus) and/or available public spaces or community centers.

Host and market health insurance enrollment events at those locations.

Develop messaging and marketing materials informing target populations where they can go to enroll in health insurance or who they can speak with about enrolling into health insurance.

Distribute health insurance enrollment materials and information to key community partners who interact with target populations (e.g. food pantries, township trustees).

GOAL: By December 31, 2018, decrease the number of preventable hospital stays among Hendricks County Medicare recipients from 60 discharges per 1,000 recipients to 55 per 1,000 as reported by the County Health Rankings.

SHORT-TERM OBJECTIVE:  Through December 31, 2018, vaccinate 500 Hendricks County Medicare recipients and/or older adult residents per year against pneumonia and/or influenza as reported by the Hendricks County Health Department.

STRATEGIES:

Identify areas of the county where Medicare recipients live and/or where high numbers of flu-like illness and pneumonia are recognized.

Identify pneumonia and/or influenza vaccine providers in Hendricks County who accept Medicare, determine their costs, and promote their services to Medicare recipients.

Host pneumonia and/or influenza vaccine clinics at locations in the county with high Medicare populations, high illness rates, and/or lack nearby immunization services (e.g. senior services, rural communities).

Input all vaccinations into the Children and Hoosiers Immunization Registry Program.

MID-TERM OBJECTIVE: By December 31, 2016, at least one urgent care facility in Hendricks County will accept payment on a sliding scale as reported by the Accessing and Utilizing Health Care work group.

STRATEGIES:

Identify all urgent care facilities in Hendricks County and determine the cost to treat ambulatory care-sensitive conditions and types of health insurance accepted by urgent care facilities.

Meet with urgent care facilities’ administrative staff to discuss how lowering the cost of care may increase patient use of their facilities while lowering emergency room visits and hospitalization rates, and options for developing a sliding scale for patients seeking care for these conditions.

Work with participating urgent care facilities to draft policies and procedures for sliding scale payments.

Develop messaging and marketing materials, and distribute information about sliding scale facilities to hospitals, health care providers, social service agencies, and the general public.

LONG-TERM OBJECTIVE: By December 31, 2018, provide health and wellness screenings to 1,000 Hendricks County Medicare recipients and/or older adult residents as reported by Hendricks Regional Health.

STRATEGIES:

Identify areas of the county where Medicare recipients live and/or where there are high rates of patients who return to the hospital for preventable causes (e.g. low glucose level).

Identify home health agencies, screening providers, and other wellness/health maintenance groups and develop a resource list with available services.

Host mobile health and wellness screening events at target locations throughout the county.

Develop messaging and marketing materials, and distribute information about screening events to hospitals, health care providers, social service agencies, and the general public.


COMMUNITY RESOURCES

Hope Healthcare Services

Hope Healthcare Services provides medical and dental care to Hendricks County residents without health insurance.

Partners in Care Clinic

The Partners in Care Clinic at Hendricks Regional Health provides primary health care services to adults living in Hendricks County who do not have health insurance or who receive Medicaid. The clinic also provides women’s health services, prenatal care, and delivery.

Hendricks Regional Health

Hendricks Regional Health is a full-service hospital in Danville with an emergency department (ER) and services in primary and urgent care, orthopedics, sports medicine, cardiology, women’s health services, cancer, pediatrics, childbirth and surgery.

IU Health West

IU Health West is a full-service hospital in Avon with an emergency department (ER) and services in primary and urgent care, cancer, critical care, diabetes and endocrinology, gastroenterology, health and vascular care, infectious diseases, radiology, maternity, neurology, orthopedics, and pain management.

Hendricks County Health Department – Nursing Division

The Hendricks County Health Department provides immunizations to children and adults with or without insurance; free HIV/STD testing every third Thursday of the month; free tobacco cessation program for pregnant women and their partners through BABY & ME – Tobacco Free™; and TB testing for a fee or limited billing.

Hendricks County Senior Services

Hendricks County Senior Services provides personal care services, transportation, and information and referral for health care and insurance, and maintains a limited medical equipment loaning closet for Hendricks County older adults and their caregivers.

Indiana Rural Health Association

Indiana Rural Health Association provides information and services to businesses and organizations providing health services to rural areas in Indiana.

Hendricks County Division of Family Resources

The Hendricks County Division of Family Resources assists residents with applying for health coverage through Medicaid.

MDWise

MDWise provides health insurance plans and enrollment help for Hoosier Healthwise and the Healthy Indiana Plan.

Managed Health Services

Managed Health Services is a managed care entity serving the Health Indiana Plan, Hoosier Healthwise, Children’s Health Insurance Program, and Hoosier Care Connect.

Covering Kids and Families

Covering Kids and Families is a statewide organization committed to ensuring that all children and families eligible for Medicaid programs are enrolled.

Hoosier Healthwise

Hoosier Healthwise (HHW) is the State of Indiana’s health care program for children, pregnant women, and families with low income.

Healthy Indiana Plan (HIP)

HIP is an affordable health insurance program from the State of Indiana for qualified uninsured adults.

Indiana Medicaid

Medicaid provides health care coverage to nearly 1 million Indiana residents, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

Indiana Medicare

Medicare is a federal health insurance program for adults age 65 and older and for people under age 65 with qualifying disabilities.

Federal Health Insurance Marketplace

The Marketplace helps people without health coverage enroll in a health insurance plan or other health care coverage based on eligibility.

Need a service not listed above? Contact us at HendricksHealthPartnership@gmail.com or (317) 745-9618 to find out if other services may be available to serve your needs.


 REFERENCES

1. Healthy People 2020. (2016). Access to health services: overview. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services.

2. Hendricks County Health Partnership. (2015). 2015 Hendricks County community health assessment survey results: Microsoft Excel spreadsheet.

3. Hendricks County Health Partnership. (2015). Hendricks County community health improvement process priority area voting and discussion results: Microsoft Word document.

4.  Hendricks County Health Partnership. (2015). Public meetings and key informant interviews summary: Microsoft Word document.

5. Hendricks County Health Partnership. (2015). 2015 Hendricks County forces of change assessment – brainstorming and threats and opportunities discussion results: Microsoft Word document.

6. County Health Rankings and Roadmaps. (2015). Indiana 2015: uninsured adults. Retrieved from http://www.countyhealthrankings.org/app/indiana/2015/measure/additional/3/data.

7. Kids Count Data Center. (2016). Uninsured children under age 19: Indiana. Retrieved from http://www.datacenter.kidscount.org/data/tables/5644-uninsured-children-under-age-19?loc=16&loct=2#detailed/5/2292-2383/true/36,868,867,133,38/1536,1537/12236.

8. Community Commons. (2016). Community health needs assessment health indicators report – clinical care: cancer screening – mammogram. Retrieved from http://assessment.communitycommons.org/CHNA/report?page=4&id=511&reporttype=libraryCHNA.

9. Community Commons. (2016). Community health needs assessment health indicators report – clinical care: cancer screening – pap test. Retrieved from http://assessment.communitycommons.org/CHNA/report?page=4&id=510&reporttype=libraryCHNA.

10. Community Commons. (2016). Community health needs assessment health indicators report – clinical care: lack of a consistent source of primary care. Retrieved from http://assessment.communitycommons.org/CHNA/report?page=4&id=504&reporttype=libraryCHNA.