​​​

Hospital Community Partnerships.pngHospital-Community Partnerships

For a number of years, the Maryland Community Health Resources Commission has funded hospital-community partnerships that have served vulnerable Maryland residents and high–cost users of the health and hospital system.  Residents served in CHRC-supported projects are predominantly low-income, un/underinsured, have complex health and social service needs and lack access to community-based health care services.  Many of the CHRC-supported projects increase the capacity of safety net community-based providers to serve more individuals and in doing so, help reduce avoidable hospital utilization.  In turn, the reduction in hospital costs assists the state’s implementation of the Medicare Hospital Payment Model.

In addition to its grant-making activities, the CHRC, along with the Health Service Cost Review Commission, The Maryland Hospital Association, And the Maryland Department of Health, hosted four regional forums in 2015 to highlight a number of promising hospital-community partnerships and innovative intervention strategies, to discuss the lessons learned and challenges confronted during implementation, and to develop strategies through which these programs could be sustained and spread. The CHRC released a report in 2016 authored by Frances B. Philips, RN, MHA entitled “Sustaining Community-Hospital Partnerships to Improve Population Health: Recommendations on sustaining innovative models” (attached) which highlighted five CHRC-funded hospital-community collaborations and promoted the capacity and sustainability of Maryland’s safety net providers to deliver health care services in underserved communities.

Examples of CHRC-Funded Hospital-Community Partnerships

  • West Cecil Health Center, a Federally Qualified Health Center, received a two-year grant in 2017 to implement an expanded dental program in Cecil County, a dentally underserved area of the state, through an innovative partnership involving the University of Maryland Dental School and Union Memorial Hospital.  Under a cooperative agreement, West Cecil has agreed to take over operations of the Dental School's clinic, which will maintain its status as a clinical teaching site with five pre-doctoral students and four hygiene students.  Union Memorial Hospital, who owns the clinic building, is providing fiscal support and referrals from their emergency department and Comprehensive Care Center.

     

    Anne Arundel Health Department received a two-year grant in 2017 to expand access to emergency dental services for low-income adults in Anne Arundel County, with a particular emphasis on diverting preventable dental-related ED visits.  The target population is low-income Medicare and Medicaid adults.  The program is working closely with University of Maryland Baltimore Washington Medical Center and Anne Arundel Medical Center, who will serve as a referral sources through their emergency department.

     

    La Clinica del Pueblo, a Federally Qualified Health Center, received a three-year grant from the CHRC in 2016 to open a new comprehensive health center in Hyattsville.  The program involves a partnership with Doctors Community Hospital and provides a comprehensive list of services including primary care, specialty care, radiology, case management, behavioral health services, insurance assistance, and health education.  The opening of the new health center in Hyattsville involves a public-private partnership, as La Clinica del Pueblo received $1,376,535 in additional funding from sources including the U.S. Department of Health and Human Services, CareFirst BlueCross BlueShield, The Cafritz Foundation, The Meyer Foundation, and The Split Rock Foundation.​​​

     

    Charles County Health Department received a three-year grant in 2016 to support an innovative “public health-EMS-hospital” partnership that seeks to address over-utilization of EMS and ED services in Charles County by assisting frequent ED/EMS users to manage their chronic conditions in a primary care setting or at home.  Clients are supported by a Mobile Integrated Healthcare team comprised of a paramedic, a nurse practitioner, and two community health workers.  The program is a collaboration among the Charles County Health Department, Charles EMS ($64,000), and Charles Regional Medical Center ($150,000), each of which is supporting the project financially.

     

    The Lower Shore Clinic a behavioral health provider in Wicomico County, received a two-year grant in 2016 to support the CareWrap Program.  CareWrap was also supported by Peninsula Regional Medical Center ($92,233).  The public-private partnership enabled the Lower Shore Clinic to support a CareWrap Team that enrolled individuals with chronic health needs, who are frequently admitted or treated in the emergency room at Peninsula Regional Medical Center, into longitudinal support including primary care and ancillary services in the community.  The program increased access to primary and behavioral health services for individuals with behavioral health and complex medical conditions and assisted Peninsula Regional Medical Center in reducing its readmission rates.  Chesapeake Regional Information System for our Patients (CRISP) calculated a six-month pre vs six-month post comparison for the patients in the program and concluded that the CareWrap program achieved $923,594 in cost avoidance (the grant from CHRC was for $120,000).  This includes the cost of appropriate health care services to help patients' well-being during the six months post data. 

     

    Calvert County Health Department received a three-year grant in 2015 to support “Project Phoenix,” which aimed to provide SUD treatment, including medications, and address social determinants of health facing individuals with substance use disorders.  Calvert Memorial Hospital partners with the health department by referring individuals to the program, and working with the Calvert County Health Department’s epidemiologist, monitors hospital utilization data.

     

    Access Carroll, Inc., a free clinic operating in Westminster, MD, provides health care to underserved areas and at-risk populations in the community.  They have received three grants from the CHRC: (1) in 2007 to provide primary and specialty health care services to low-income, uninsured residents of Carroll County; (2) in 2011 to provide dental services to low-income residents of Carroll County; and (3) to transition the organization from a grant-based billing model to billing both Medicaid and private payers.  Access Carroll partners with Carroll Hospital Center and the Carroll County Health Department, which provide more than half of the current core staff as in-kind donations to the community. 

ADDITIONAL RESOURCES

Using Pay-For-Success To Increase Investment In The Nonmedical Determinants Of Health - by Ian Galloway

Maryland's Triple Aim Roadmap - by Carmela Coyle

Successes and Challenges in Community Health Improvement