Regional Commission Made Up of Diverse Stakeholders Enhances Access to Coverage and Services for Low-Income Residents, Reducing Readmissions and Emergency Department Visits

Snapshot

Summary

The St. Louis Regional Health Commission is a diverse consortium of collaborating stakeholders (providers, civic leaders, community activists, and local and State government officials) that provides strategic direction and policy recommendations to improve the quality and efficiency of health care services available to all St. Louis residents regardless of their ability to pay. To that end, the Commission sets up task forces and committees to tackle specific high-priority issues and administers a coverage model for adult residents who do not qualify for Medicare or Medicaid, using Medicaid Disproportionate Share Hospital funds (available through a Medicaid waiver) and local tax money to pay community health centers and other providers for outpatient services. The Commission also created several separate nonprofit membership organizations of providers that collaborate on projects to improve the quality, efficiency, and coordination of physical, mental, and public health services. Through these efforts, the Commission has enhanced access to coverage, medical and dental care, and medical homes for low-income residents, which in turn has led to reductions in readmissions and inefficient use of the emergency department. Based on a retrospective analysis, the Commission believes its efforts also played a role in improvements in selected health outcomes.

Evidence Rating(What is this?)

Suggestive: The evidence consists of post-implementation data on the number of low-income residents gaining access to health coverage; the number of medical and dental visits by low-income residents; the number of individuals connected to a medical home; comparisons of readmission rates among those connected to a medical home with the regional average; comparisons of inappropriate emergency department visits by newly enrolled individuals with the area average; and a 10-year retrospective analysis of health outcomes in the St. Louis region between 2000 and 2010.

Use By Other Organizations

The Detroit Wayne County Health Authority, Mid-America Council in Kansas City, and Healthy San Francisco administer similar programs designed to improve health and bolster the local safety-net system.