Access Healthcare – Following our recent acquisition of Mediserve Solutions, the captive operations of Brighton Health Group, we are pleased to announce the opening of our 19th delivery center in Mumbai, India on January 01, 2019. The new center in Mumbai will support the healthcare provider. and payer business processes, including revenue cycle operations, claims management, customer service and digital health plan services.
On December 26, 2018, we announced the acquisition of the Mediserve team and began the exercise of circulating offer letters and onboarding new team members to our roster. Our Chief Operating Officer, Amitabh Vartak, was joined by Jacob Jessuron, Vice President, Human Resources, and Chandranathan Udayakumara, Senior Director, in welcoming the nearly 200 strong team to Access Healthcare. At the town hall meeting, Amitabh also introduced Shakeel Ansari, Lead Director – Access Healthcare, who will lead our Mumbai Delivery Center. The session of the municipality was followed by a question and answer session. We had a great interaction with our new Mumbai team.
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The majority of the 200-strong team have already switched to Access Healthcare lists and are up and running from our new delivery site. About 33 team members working on inbound contact center processes will move onto our roster as soon as the MPLS circuits are implemented in the next 6-8 weeks.
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We would like to thank all of our shared services functions for working tirelessly to get the new facility up and running on time on 01 January 2019. Access to health care is usually defined as the ease with which someone can get the medical care they need. There are a number of factors that can limit access to healthcare, although it is true that most of them are related to social, cultural, economic and geographical issues.
While there are many ways to close access gaps in each category, we’ve highlighted a few examples of provider programs from around the country that are making a difference.
Going to the doctor is not always as easy as it seems. Consider, for example, senior citizens. If unable to drive, seniors are left to rely on friends and family for rides or use community-provided transportation to get to their appointments. This pain point is improving thanks to the rise of ride-sharing services like Lyft and Uber, but some health centers are looking for ways to further influence: can positively impact long-term care outcomes.
In one such example, Henry J. Austin, an integrated care site in Trenton, New Jersey, is partnering with Uber Health this month to provide free transportation to patients in need.
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Henry J. Austin CEO Cammy Alley says that while only 20 to 25 percent of patients struggle with transportation, those who do — mostly older people or mothers with multiple children — often find public transportation difficult.
“We’re trying to create a system that will help fill the gaps when all other modes of transportation are not available to our patients, and hope that we can really help them get to us when they need it,” Allie explains.
Uber Health Henry J. Austin provides a dashboard that case managers can use to organize patient transportation to appointments. Patients have the option to text Uber Health when they want to be picked up.
Improving access to health care can also take the form of active patient education in community settings. For example, this summer, Bon Koo, director of the Health Design Lab at Thomas Jefferson University, partnered with Esperanza Health Center, a federally qualified health center (FQHC) in North Philadelphia, as well as Sunday Suppers, a nonprofit. organization, designed a six-week course focused primarily on teaching families how to prepare and eat healthier meals.
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“If we can teach families to cook healthier, in the long run it will be the best way to prevent diabetes, hypertension, and other obesity-related problems,” Ku says.
Language barriers are still highly regarded as a major barrier to access to healthcare. For some patients, limited English proficiency (LEP) makes it difficult to understand treatment options and medication storage instructions. The Joint Commission requires hospitals to provide interpreters for patients seeking care, but that requirement can be met by tapping existing bilingual staff members. Hiring permanent translators is not always a practical solution due to the cost and lack of compensation for translators and the number of languages sometimes required.
In addition to relying on volunteer interpreters, some hospital systems have turned to technology solutions that connect healthcare providers directly with local, on-site interpreters to eliminate agency costs and inefficiencies. These apps work like ride-sharing apps, in that when a provider sends a request, local translators ping their smartphones and can respond. Lehigh Valley Health Network (LVHN) began using such an app in 2016 with surprising results. Before publication, only 17 percent of staff translators were engaged in client translation. After implementing the tool, translator engagement increased to 93 percent.
Another option available to hospitals is remote simultaneous medical interpretation, where the clinician and patient use a headset connected to an interpreter at a remote location. Interactive video platforms like Stratus Video provide hospitals and healthcare centers with a variety of options for accessing certified interpreters.
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Two ways to improve access to health care through proximity include partnerships with ambulatory surgery centers and open clinics. Both come with their own costs, but with more patients looking for convenience, the cost may be worth it.
Noticing that the 30 urgent care appointments opened were filled by 9 a.m. each day, Annapolis Internal Medicine, a primary care practice, opened a clinic for confirmed patients just below the main practice. The Annapolis Internal Medicine Clinic, staffed by four nurse practitioners, is open extended weekday hours and most of Saturday.
“Because the walk-in clinic is an extension of our regular office and is not considered urgent care, the patient’s out-of-pocket costs have not changed,” said Yvette Perry, supervisor and compliance manager. When we really measured and assessed the demand, we realized we were way short of where we needed to be,” Perry said. Now, Perry said, the clinic’s satisfaction rate has remained fairly high, most recently at 98.22 percent.
When it comes to scheduling outpatient surgeries, it can take months to find an open operating room. In some areas, the only option for outpatient surgery is a large medical center, where operating rooms are chronically booked to capacity.
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For example, the University of Kentucky Louisville Medical Center has 1,000 beds, but the surgery center is usually booked months in advance. To rapidly expand ambulatory access without affecting the volume of inpatient surgeries, UK is partnering with Surgical Care Affiliates, which operates more than 200 ambulatory surgery centers across the country. The joint venture between UK and Lexington Surgery Center opened in mid-November 2018 and hosts eight operating rooms and four procedure rooms.
The UK has identified four high-volume, low-acuity surgeries that are ideal for an outpatient setting, including gastroenterology, ophthalmology, pediatric ENT and plastic surgery. Christy Willett, director of public affairs at UK Medical University, said the surgery center had since added endoscopy services. “We continue to review opportunities to move to a surgery center that is a good fit from a cost and patient access standpoint,” Willett said.
Despite historic gains in health insurance coverage thanks to the ACA, 27.4 million nonelderly people were uninsured in 2017, according to the Kaufman Family Foundation. And the higher costs affect many who are in or nearby. poverty line.
As a result, some providers and clinics are adopting direct primary care through a membership model designed primarily for patients who do not carry insurance. Patients pay a modest monthly fee (typically $50 to $80) for a generous allotment of appointments (often same day) and access to providers via phone, email and live chat. In most cases, routine tests and procedures are included, but some practices offer certain services at discounted rates.
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While it certainly cannot replace insurance, a direct primary care membership model can increase access for patients who would otherwise forgo medical care due to out-of-pocket costs.
In another example of addressing economic barriers to health care access, Esperanza Health Center on Chicago’s Southwest Side launched a culturally competent colorectal cancer screening program four years ago to increase preventive care among Hispanic immigrants. Esperanza turned to a less invasive and more cost-effective test known as a Fecal Immunochemical Test, or FIT kit. The quick and accurate test is performed at patients’ homes and requires no preparation.
Esperanza offers the FIT kit free of charge and provides both instructions for use and test samples in its in-house laboratory. Since the program began, Esperanza has increased colorectal screening rates to more than 70 percent of patients who request the test, at a much lower cost than colonoscopy alone.
All of these examples show how providers and care centers identify specific problems that hinder their community’s access to health care. Whether it’s helping patients get to their appointments or taking a deep dive into why a certain segment of the population
