Annual Report 2008
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Opening doors to specialty medical care ANNUAL REPORT 2 0 0 8 Letter from Executive Director and Board President t is exciting to see what can happen n KCPA’s robust case management program The pages that follow highlight our work in when a local community tackles a removes logistical and financial barriers 2008 and our progress in tackling a tough Inational problem like health care for for our patients and volunteer providers. problem. More importantly, this report those in need. A Project Access model is recognizes those who have invested their often the solution. Throughout the United n KCPA screens all patient referrals to time and resources in a promise—a shared States, more than 50 communities have ensure that appropriate tests and vision of a stable, vibrant and healthy developed their own Project Access models. paperwork are completed BEFORE the community. From Newport, California, to Asheville, uninsured patient goes to see a specialist. North Carolina, to Anchorage, Alaska, each Project Access is unique to meet the needs n Nearly $5 million of medical of a local community. However, all Project care was donated in 2008. KCPA Rosemary Aragon Accesses have common principles of a leverages our donation dollars and Board President, coordinated charity system for low-income provides our funders with a 15:1 King County Project Access vulnerable patients that is shared across return on their invested dollar. a broad field of health care providers. Although King County Project Access n We are growing to meet the demand (KCPA) shares a similar mission to other for our services. Since our inception we Sallie Neillie programs across the country, we’re especially have recruited more than 280 volunteer Executive Director, proud of the elements of our program physicians, six community hospitals King County Project Access Rosemary Aragon that set us apart from similar efforts: and a host of other medical services Board President such as lab tests, x-ray and others. 2 Our Vision: King County Project Access is developing a system to provide specialty services for eligible low-income uninsured and underinsured patients in King County. The system encompasses a full range of specialty services and involves major medical resources in the community as collaborating partners. Our Purpose: To facilitate, through licensed health care professionals and institutions, on a volunteer basis, the provision of medical services to low-income, uninsured individuals and other individuals experiencing challenges with accessing health care services in the community; To develop collaborative partnerships with other key stakeholders in King County with the goal of improving access to essential health services for the uninsured and underinsured; and Rosemary Aragon Sallie Neillie Board President Executive Director To promote fair and appropriate access to health care and related services, particularly for those who are uninsured or underinsured. 3 We open doors to specialty medical care for the uninsured. or King County Project Access Project Access model has been successful (KCPA), opening doors means in more than 50 communities in the By spreading the workload Fremoving the logistical and United States. By spreading the workload fairly, no single practice or financial barriers experienced by both fairly, no single practice or physician is physician is overburdened. patients and physicians in helping overburdened. Volunteer specialists donate patients access needed specialty care. up to two new patient appointments every For physicians, we remove the “hassle month and partner hospitals donate all By arranging for the necessary factor” in wanting to volunteer. KCPA related services. Specialty physicians who laboratory and imaging services as well screens all patient referrals to ensure volunteer with KCPA stay with KCPA. as qualified interpreters, we remove many that appropriate tests and paperwork For patients, our robust case of the barriers that prevent patients from are completed BEFORE the KCPA patient management services help them navigate keeping their appointments with medical goes to see a specialist. No wonder the the maze of disconnected systems to specialists. In the commercially insured access specialty care. Without KCPA, if a population, a no-show rate of 15 percent specialist agrees to see a patient for free, or higher is common for both primary care KCPA screens all patient referrals to the patient might have to arrange his and specialty care visits. The no-show rate ensure that appropriate tests and own tests, transportation and interpreter, for Medicaid and uninsured patients can paperwork are completed BEFORE the as well as pay up-front laboratory and be 30 percent or higher. When patients KCPA patient goes to see a specialist. imaging costs. This is a tremendous barrier are referred to providers through KCPA, for the patients we serve and a frustration more than 93 percent of them keep their for the physician who wants to help. appointments, a 6.8 percent no-show rate. 4 “Project Access makes it easier to do the right thing… provide needed care to the uninsured.” Rayburn Lewis, MD Executive Director and Medical Director, Swedish Medical Center/Ballard Campus “I got care I would have never gotten myself… I had no idea that anything like this existed.” Janet, KCPA patient 5 We serve the lowest income, most ethnically diverse populations in King County. n 2008, the 1,115 patients served by King All of our patients have household County Project Access represented the income less than 200 percent of the Nearly 80 percent of patients Icommunity around us. They were all ages, federal poverty guidelines ($44,100 live at or below 150 percent but more than 90 percent were between annual income for a family of four). of the federal poverty level the ages of 18 to 65; nearly 5 percent are Nearly 80 percent of patients live at or ($33,075 for a family of four). older than 65. Patients are referred to us below 150 percent of the federal poverty from safety net providers throughout level ($33,075 for a family of four). King County and all of the patients The patients referred through patients referred to KCPA speak English, referred are uninsured or underinsured. Project Access need care in more than 19.9 percent speak Spanish. More than 13 In 2008, 197,000 (10.5 percent) of King 20 different medical specialties. The top percent speak one of 21 other languages. County residents were uninsured. requests for specialty care in 2008 were for KCPA continues to serve a very diverse gastroenterology, hand surgery, neurology, population—24 percent of our patients orthopedics and physical therapy. In 2008, identify as Hispanic or Latino; another 24 KCPA successfully made appointments percent identify as White or Caucasian; while Patients are referred to us from for more than 86 percent of our patients. 8.6 percent are Asian/Asian American, 7.9 safety net providers throughout King Often this includes making detailed percent of our patients are African American, County and all of the patients referred arrangements for qualified interpreters and 2.6 percent identify as Native American. are uninsured or underinsured. as well as an appointment with a medical specialist. While 66.5 percent of the 6 “I couldn’t bend over to tie my shoes or put on my socks.” That’s how Daniel described the hip pain that developed over 30 years working full- time in an auto body shop. “It took a toll on me, my knees, my hip, my body,” he says. Daniel saw a doctor at a community clinic for a few years to deal with the pain. Eventually, it became unbearable and in 2008 his doctor referred him to King County Project Access (KCPA). Now Pended 30 Populations Served Daniel has a new hip and he’s looking for part- time work doing estimates for body shops. He says, “I’m 85% better than I was before. I Pended Caucasian 405 24% feel very thankful, very blessed. It touched me dearly that they could help me out in this way.” Enrolled Other or Latino/ 1,085 Unknown Hispanic 33% 24% Enrolled Total Referrals: 1,115 607 Total Referrals: 1,012 Native Asian/ American African/ Asian 2.6% African American American 8.5% 2007 2008 7.9% 7 Enrolled = Patient qualies for KCPA services Pended = Unable to enroll due to lack of complete eligiblity or medical information Enrolled = Patient qualies for KCPA services We are growing to meet the increased demand. ast year’s number of 726,000 uninsured for our services. In 2008, more than Washington residents has spiked 21 210 physicians, representing multiple In 2009, KCPA saw a 71 percent Lpercent to a record 876,000 in 2009. In health systems, were part of the Project increase in the number of patients fact, nearly one in five people between the Access system of volunteer providers served in first quarter 2009, ages of 19 and 64 have no health insurance. and hospitals throughout King County, compared to first quarter 2008. The length of time people go without including the following participants: insurance coverage has also increased. Recent numbers indicate that nearly three- n Evergreen Healthcare n Swedish Medical Center— quarters of these Washington residents The Mother Joseph Clinic were uninsured for six months or longer. n Eye Associates Northwest, PC In addition, Washington residents n The Polyclinic on public subsidized health insurance n Group Health Cooperative— (Medicaid, Basic Health Plan) continue to Central and Bellevue Campuses n Valley Medical Center experience challenges in finding the care they need, especially specialty care services. n NW Gastroenterology Associates n Virginia Mason Medical Center As the number of uninsured and underinsured patients continues to n Overlake Internal Medicine Associates— In 2008, KCPA served 1,115 patients. In increase, King County Project Access must Gastroenterology 2009, KCPA saw a 71 percent increase in the grow to meet the increased demand number of patients served in first quarter n Pacific Medical Centers 2009, compared to first quarter 2008.