The Oahu Healthcare Sector Partnership pilot project to reduce emergency room utilization by homeless individuals has resulted in an average 67 percent reduction in ER visits through collaborative care and sharing information between facilities.
“As a community, we all have a role to play in addressing pressing issues, including homelessness,” Sherry Menor-McNamara, Chamber of Commerce Hawaii President & CEO said. “The Chamber and the University of Hawai‘i leveraged our unique ability to convene public and private stakeholders to improve healthcare outcomes while also benefitting Hawaii’s healthcare providers. We look forward to continuing our work to expand community-based, innovative care solutions such as this one.”
“As a leader in the community with a strong stake in the success of our state, the University of Hawaiʻi convened the Healthcare Sector Partnership with the Chamber of Commerce Hawaii to find ways we can work together with the health care community to create a healthier Hawaiʻi,” UH President David Lassner said. “This project shows how successful public and private industry partnerships can achieve more for all of us.”
“Kalihi-Palama Health Center is on the forefront of serving the most vulnerable populations across Oahu,” Dr. Emmanuel Kintu, Chief Executive Officer & Executive Director of Kalihi-Palama Health Center said. “This pilot project connected our providers with stakeholders from across the healthcare system through the shared goal reducing ER visits without compromising the quality of care patients receive. Working together, we were able to achieve dramatic improvement in patient care for a relatively low cost. Solutions like the Healthcare Sector Partnership pilot program will allow more patients to access appropriate, quality healthcare services. We thank the Chamber of Commerce Hawaii and the University of Hawaii for bringing everyone together to develop this common solution.”
“The Queen’s Care Coalition recognizes the critical support a medical home such as Kalihi Palama provides for their communities’ medically fragile patients,” Dr. Daniel Cheng, Medical Director, Queen’s Care Coalition at the Queen’s Medical Center said. “The holistic approach to care that Kalihi Palama utilizes goes beyond the acute medical needs and incorporates social determinants of health. Through the collaboration between our two organizations, we have broken down the frustratingly siloed healthcare system between hospital and community health center. This has enhanced the quality and effectiveness of care for these patients by re-anchoring them to their medical home and decreasing their reliance on fragmented ER care.”
In June 2016, UH and the Chamber created the Sector Partnerships to bring together business leaders, and related service, government, and education providers from targeted industries to collaborate on opportunities and common needs and address the sector’s most critical priorities.
In 2018, the sector’s Systems Integration Team launched a pilot project through partners Kalihi-Palama Health Center (KPHC) and The Queen’s Medical Center (QMC) to coordinate care to reduce the number of unnecessary emergency room visits by a high-utilizer homeless Medicaid/Medicare population. This target population frequents emergency rooms, which is a very expensive form of healthcare, especially when that level of care may not be necessary.
The pilot launched two cohorts of individuals. Cohort A was established in January 2018. It had 17 individuals with a total of 145 ER visits in the baseline period. Cohort A’s ER visits dropped from 145 to 55, or a 62 percent reduction in visits.
Cohort B was established in February 2018. It had 18 individuals with a total of 88 ER visits in the baseline period. Cohort B’s ER visits dropped from 88 to 25, or an almost 72 percent reduction in visits.
Both cohorts took part in interventions that included identification, engagement, motivational interviewing, education, collaboration and care coordination. Each care team brought together all key parties involved with the patients and ensured that the care team was pulling in the same direction. The team shared pertinent information and, as needed, collaborated to enhance or modify care plans. The goal is to get the patient to seek and access care at appropriate level facilities in an efficient manner.
The pilot also improved patient satisfaction with their care. The population of United Health Care members who had KPHC as their primary care provider had a Star Rating of 1.85 out of 5.0, however since working collaboratively with QMC and other care facilities, the Star Rating for this population rose to 3.9 out of 5.0. The Centers for Medicare & Medicaid Services uses the Star Ratings Program to measure a number of healthcare outcomes and qualify healthcare plan performance.
A third and fourth cohort were recently added to Kalihi Palama Health Center and one cohort has been added with QMC and the Waikīkī Health Center.