A model of care for the uninsured population in Southeastern North Carolina

BACKGROUND Cape Fear HealthNet is a unique collaborative model that was established to address coordination of care for low-income, uninsured individuals in the Lower Cape Fear Region of North Carolina. This model involves a centralized referral network to direct uninsured clients to medical homes among safety-net providers, a system for specialty referrals, and a short-term episodic or urgent care clinic (HealthNet Clinic) to address immediate or urgent health needs. METHODS We provide a descriptive analysis of patients seen in the episodic care clinic during the period August 2010 through July 2012. RESULTS Our data suggests that, compared to county population estimates, the HealthNet Clinic patients were more likely to be people of color, and a higher percentage of clinic patients had chronic diseases or lifestyle determinants of chronic diseases, such as diabetes, obesity, or smoking. Almost half of clinic patients (43.7%) required some type of laboratory or diagnostic service; less than 10% of clinic patients were referred to a specialty provider. Findings from this study can inform community collaborative efforts and planning by other safety-net providers to help leverage limited resources and increase access to care among uninsured individuals in North Carolina. LIMITATIONS Patient characteristics cannot be generalized to all uninsured individuals in the region, as there are other safety-net providers in the Lower Cape Fear region, and their clinical data were not included in this analysis. CONCLUSIONS The Cape Fear HealthNet collaborative model is successful in directing patients, many of whom have significant chronic illness burdens, to a medical home in the community safety net.