LOUISVILLE, Ky. and TAMPA, Fla. — A pilot program in eastern Kentucky designed to remove barriers to healthcare services has shown promising results, including a reduction in emergency room (ER) visits and hospital admissions among a group of nearly 2,000 rural Kentuckians.
WellCare of Kentucky, a WellCare Health Plans, Inc. company, partnered with Kentucky Homeplace, a program of the University of Kentucky’s Center of Excellence in Rural Health, to help Kentuckians with chronic diseases like asthma and diabetes access health coaching to manage their conditions. The partners announced initial findings from the program at UK’s Center of Excellence in Hazard on Oct. 3.
Through the partnership, 22 community health workers from Kentucky Homeplace provided a variety of six-week health coaching workshops throughout eastern Kentucky. All program participants were diagnosed with chronic diseases such as asthma, diabetes, high blood pressure or obesity. Participants met weekly with trained community health workers to help take steps toward improvement in nutrition, medication use, exercise, communication, decision-making and more. Classes covered topics from diabetes management to mental health, first aid, CPR and beyond.
“Community health workers saw a real change in members once they had the tools to improve their health and the confidence to know how to use them,” said Kentucky Homeplace Director Mace Baker. “No matter what challenges they were facing, this holistic approach to meeting a variety of needs equipped participants with the tools they needed to better manage their health.
A key component of the 30-county program was to provide participants with gas cards to ensure transportation issues did not prevent them from attending health-coaching classes. A year after the program, Kentucky Homeplace reported participants had a 10% reduction in ER visits, a nearly 13% reduction in non-emergency ER visits and a 23% decrease in inpatient admissions. Additionally, hospital inpatient days dropped by more than 27%. WellCare estimates the cost of healthcare for program participants fell by 13.5% – or nearly $2,300 per year.
WellCare further analyzed the results of the program by comparing the participants’ healthcare service utilization one year pre- and post-interaction and found sizeable reductions in healthcare utilization. Among members with diabetes, ER visits dropped by 16% and hospital admissions were reduced by nearly 29%. Costs fell by 16.9%, or $3,424 per member, per year. Members with both asthma and diabetes showed 22% fewer non-emergency visits to the ER. Reductions were even greater among groups with a variety of chronic conditions like asthma and COPD.
“These findings illustrate two crucial components of better healthcare. One, when people have direct education and support from a trusted healthcare provider, they can better manage their chronic conditions,” said Dr. Fran Feltner, health director at the UK Center of Excellence in Rural Health. “Second, sometimes all it takes to make sure a patient makes it to an appointment is a tank of gas. When we can remove barriers like transportation, suddenly healthcare is more accessible.”
“We know when people have trouble putting food on their tables or paying their water bill it’s difficult to focus on managing their health,” said Ben Orris, COO for WellCare of Kentucky. “When we can close those gaps in care – helping people get reliable transportation, healthy food and a safe place to live we can see real progress in health outcomes and lowered healthcare costs.”
Each Kentucky Homeplace community health worker is trained as an advocate to provide access to medical, social and environmental services and to deliver education on prevention and disease self-management. Top services received during this partnership with WellCare included free or reduced-cost healthcare, health literacy, food pantry assistance and utility assistance. Over the two-year program, 1,903 WellCare members with chronic diseases also received referrals through WellCare’s Community Connections program to more than 9,000 social services ranging from health literacy classes to food pantries to utility assistance programs.