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Houston's Healthcare Solutions

The Challenge:

In the Houston area, 72 percent of the uninsured are employed by small employers who do not offer health care coverage, or whose coverage options are unaffordable. Without access to insurance, and making too much money to qualify for sliding fee base scales in safety-net clinics, these families tend not to get health care on any kind of routine basis. When they do get it, it is through an ER where their true primary as well as chronic conditions are not addressed.

The Solution:

The Community Benefit Corporation's Neighborhood Health Centers represent a model designed as a medical home for the growing segments of the uninsured who actually are employed. The Centers charge just slightly over costs. First opened in 1993, they can provide enormous savings for families without benefits or whose premiums are more in out-of-pocket costs than they can handle. The goal of the Neighborhood Health Centers program is to provide uninsured citizens with a medical home for their routine care and prevent their cases from escalating needlessly to emergency centers.

The Neighborhood Health Centers provide a place for 46-year-old Gladys Lopez to receive a sick visit, have a well-woman exam, have her hypertension diagnosed, and then have this chronic disease managed. A place for 68-year old Juan Redondo to be seen for hypertension, return for education and management, find he is also diabetic, and then have both chronic diseases managed. A place for Joe Medrano to bring his wife, father, and son for routine sick care and annual visits.

All three of these people are working and uninsured. They began to obtain their healthcare in emergency rooms when they were referred to the Neighborhood Health Center. The Center is a cash clinic where patients are charged a flat $48 for the office visit. Recommended prescriptions are always generic. Lab prices are priced just slightly over costs. At the Centers, the patients feel safe, cared for, and respected and are able to manage their chronic and acute illnesses more affordably and conveniently.

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The Challenge:

Houston is home to the world's largest medical center. People come from all over the world to obtain the highest quality care, based on the latest research. Unfortunately, a large portion of Houston's own residents face barriers to accessing these world-class services. In Houston's Harris County, 1.1 million of the 3.5 million residents have no health insurance. Fifteen percent of the nation is uninsured; 32 percent of Houston's population is uninsured. More than half of all patients entering emergency centers are seeking care that could be provided in a community-based clinic, overcrowding emergency facilities and delaying care for the truly critically ill.

The Solution

The Community Benefit Corporation's Emergency Center Navigator program places a healthcare coordinator within the emergency center to help uninsured patients begin the process of obtaining a medical home as well as provide guidance on navigating through future healthcare concerns.

Manuel Salinas is one of more than 1,000 patients helped by Memorial Hermann Southwest's Emergency Center Navigator since the pilot program began in January 2008. When uninsured patients seek care at the hospital's Emergency Center, the Navigator connects them with lower-cost community healthcare providers who can provide a medical home for future health needs. She follows up with each patient to ensure that they have used the referral and are satisfied with the care they've received, averaging three contacts per patient.

By establishing an ongoing relationship with a primary care physician at a city or community clinic, patients stay healthier through preventive care while lowering their overall healthcare expenditures. The Emergency Center Navigator Program will be extended to Memorial Hermann-Texas Medical Center and Memorial Hermann Northeast Hospital during the 2008 fiscal year and, eventually, to other Memorial Hermann hospitals.

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The Challenge:

Harris County is the third most populated county in the nation. The population is an ethnic melting pot of 42 percent Anglo, 34 percent Hispanic, 17 percent African American, and 6 percent Asian. Over the next five years, the Hispanic population will increase to 37%. This has an additional significant public health impact as residents of Hispanic descent have lower rates of health insurance coverage than other sectors of the population. Forty-nine percent of Houston's Hispanic community is presently uninsured. Many citizens new to the area or long-time residents are unaware of the available medical care resources or how best to access them, resulting in overcrowding of emergency centers.

The Solution

The Community Benefit Corporation's Neighborhood Health Centers represent a model designed as a medical home for the growing segments of the uninsured who actually are employed. The Centers charge just slightly over costs. First opened in 1993, they can provide enormous savings for families without benefits or whose premiums are more in out-of-pocket costs than they can handle. The goal of the Neighborhood Health Centers program is to provide uninsured citizens with a medical home for their routine care and prevent their cases from escalating needlessly to emergency centers.

The Neighborhood Health Centers provide a place for 46-year-old Gladys Lopez to receive a sick visit, have a well-woman exam, have her hypertension diagnosed, and then have this chronic disease managed. A place for 68-year old Juan Redondo to be seen for hypertension, return for education and management, find he is also diabetic, and then have both chronic diseases managed. A place for Joe Medrano to bring his wife, father, and son for routine sick care and annual visits.

All three of these people are working and uninsured. They began to obtain their healthcare in emergency rooms when they were referred to the Neighborhood Health Center. The Center is a cash clinic where patients are charged a flat $48 for the office visit. Recommended prescriptions are always generic. Lab prices are priced just slightly over costs. At the Centers, the patients feel safe, cared for, and respected and are able to manage their chronic and acute illnesses more affordably and conveniently.

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