| As the healthcare debate rages on in Washington, | | | | provides access to diagnostic services, specialty care, |
| D.C., one organization in DuPage County, Illinois has | | | | prescription medication and hospital services for each |
| found a way to bring together hospitals, physicians, | | | | member. |
| government and human services agencies to provide | | | | A person is eligible to become a member of Access |
| healthcare for that county's rising number of | | | | DuPage if he or she has resided in DuPage County for |
| low-income, medically-uninsured residents. | | | | at least 30 days; is under age 65; has a household |
| Established in 2001 with the help of 14 organizations, | | | | income below 200% of the Federal Poverty Level, has |
| Access DuPage, located in Carol Stream, Illinois a | | | | no medical insurance; and is not eligible for public health |
| western suburb of Chicago, began providing healthcare | | | | insurance programs such as Medicaid or Medicare. |
| to qualified residents, referred to as members, in | | | | Qualified applicants are enrolled in the Access DuPage |
| February 2002. Today, Access DuPage is comprised | | | | program for a period of one year, after which they |
| of 225 organizations and last year served over 13,000 | | | | must reapply for membership in the program and their |
| DuPage County residents who would otherwise have | | | | eligibility criteria must be re-verified. |
| no access to affordable healthcare. The organization | | | | Some members pay a $5 co-payment per office visit, |
| will serve well over that number by the end of 2009. | | | | according to Endress. If diagnostic services are |
| The direct cost of operating Access DuPage has | | | | required, members with a proper physician's order can |
| averaged slightly more than $400 per member, per | | | | obtain these without charge at any hospital in DuPage |
| year, but this year, the cost has dropped to $363! | | | | County. |
| How is this possible? Richard Endress, President of | | | | "The vast majority of the services received by |
| Access DuPage, believes the organization's success is | | | | Access DuPage members are contributed at little or |
| due in large part to the culture of collaboration that | | | | no cost by physicians, hospitals and other partners," |
| exists among all entities involved. "We can get a lot | | | | said Endress. "The direct cost of operating Access |
| further in addressing a complex problem such as | | | | DuPage is aproximately $363 per member, with |
| caring for the medically uninsured by working together | | | | approximately 52% of these costs going toward the |
| rather than by working separately," said Endress. | | | | purchase of prescription medications from the |
| As a vice president of Central DuPage Hospital in | | | | organization's pharmacy benefit manager. Additionally, |
| Winfield, IL for 16 years, Endress saw first-hand the | | | | 26% of the direct cost underwrites the operations of |
| increasing need to find a way to bring healthcare | | | | the various clinics and practices that serve as "medical |
| providers and governmental entities together to | | | | homes" for Access DuPage members and 22% |
| develop a cost-effective continuum of medical care | | | | operates the program," he said. |
| for the low-income, medically-uninsured residents of | | | | The upfront funding to pay for these direct costs is |
| DuPage County. In the late 1990s, he witnessed a | | | | provided by seven DuPage County hospitals, DuPage |
| number of failed attempts to develop a program for | | | | County government, Community Memorial Foundation, |
| the county's uninsured. He contends that these efforts | | | | State of Illinois Bureau of Refugees and Immigrants, |
| failed for several reasons including the fact that some | | | | the United Way of the DuPage Area, DuPage County |
| key partners were not at the table, and issues arose | | | | townships, and other small grants and miscellaneous |
| over turf. | | | | income. |
| With coalition partners including hospitals in DuPage | | | | The cost effectiveness of this program is clear. Both |
| County, physician practices, townships, foundations, the | | | | the age-adjusted hospitalization rates and use rates of |
| DuPage County Board and other county health and | | | | Emergency Rooms are about 70% of national rates, |
| human services departments, as well as numerous | | | | and the total cost of care, if typical managed care |
| community organizations, Access DuPage has been | | | | rates were paid for the donated services, is about |
| able to provide a full range of medical services to | | | | 20% less than the average cost of individual |
| each member, including assigning each member a | | | | employer-sponsored health care premiums. Those |
| "medical home," and then providing access to a | | | | numbers speak for themselves. |
| continuum of more intensive services, if required. A | | | | This program is successful because all of the players |
| "medical home" provides members with primary care, | | | | came to the table ready to work together; they came |
| a sustained relationship, care in the context of family | | | | to give and take, and to create a culture of |
| and community, support to take responsibility for | | | | collaboration that allows Access DuPage to take care |
| personal health, entry to the broader health system | | | | of those individuals in our communities who are most in |
| and coordination of care with those components of | | | | need. |
| the broader health system. The continuum of care | | | | |