Stepping Up When Insurance Falls Short
Where can a patient at high risk for poor health outcomes turn when she needs something her insurance or Medicaid won’t pay for? Northeastern Vermont Regional Hospital’s Community Connections program has partnered with other local service providers to win a VHCIP sub-grant to create Flexible Funding for Integrated Care. When patients can’t afford items or services that would improve their health, this pilot program provides money that will make the difference.
Already Flexible Funding for Integrated Care has improved health outcomes for a number of people in Northeastern Vermont:
- A patient with diabetes could not read her glucometer or insulin syringe and could not afford a pair of glasses. The program paid for her glasses, and now her A1c is in control.
- A 32-year-old quadriplegic was returning to Vermont and needed support. The program made connections with Vocational Rehabilitation and primary care.
- A young disabled mother of two needed a new wheelchair. She got assistance with filing a Medicare appeal.
- A Health Coach makes regular home visits to six out of 34 clients, and has arranged Flexible Funding for Integrated Care for four of them.
- The Elks Club and other community groups are partnering with the Health Coach and health care providers to distribute “recycled” durable medical equipment to those who need it.
A substantial number of essential services and types of equipment are not covered by Medicare or Medicaid, posing problems for lower-income patients in Northeastern Vermont. A surprising number of clients are ineligible for existing case management services, and many more are not ready to make changes in their care. The Flexible Funding for Integrated Care program can step in to fill these gaps.
Partners in Population Health Transformation
The Northeastern Vermont Regional Hospital’s Community Connections program partnered with Northern Counties Health Care, Rural Edge Affordable Housing, the Support and Services at Home (SASH) Program, the Northeastern Vermont Agency on Aging, and Northeast Kingdom Community Services to apply for the VHCIP sub-grant. The collaboration among these diverse organizations is a model for the kind of interdisciplinary health care reform that will make progress toward achieving the Triple Aim.