Hospitals and Partners Hit Milestone in Healthy Outcomes Plan – REVISED

Over 10,000 participants enrolled in statewide program to improve health

Columbia, S.C. - South Carolina's hospitals and their partners have enrolled 10,611 individuals in Healthy Outcomes Plans (HOPs) as 2015 gets under way. Established as a partnership between the South Carolina Department of Health and Human Services (SCDHHS) and the state's Medicaid-participating hospitals, HOPs are an element of the "Medicaid Accountability and Quality Improvement Initiative" program that has appeared in the two most recent state budgets.

Through the HOP program, more than 10,000 individuals are now receiving continuous and coordinated care that is managed by a personal physician who serves as the patient's primary connector to the health care system. Each participant is provided with treatment grounded in an individualized care plan that has been designed to divert high-utilizers of health care services away from emergency rooms or other inpatient units and toward more appropriate and less expensive settings.

"This program has been so successful because of the strong partnerships we've developed with the hospitals and health care workers in South Carolina," said Governor Nikki Haley. "We have 46 HOP programs in our state with 58 hospitals participating in those programs statewide. This program is another example of a South Carolina Medicaid success story and another reason to celebrate across the state."

Each hospital that participates in the Medicaid program in South Carolina plays a part in HOP, either individually, or else through collaboration with other participating hospitals. Enrollment is expected to exceed 12,700 by July 1, 2015.

Thornton Kirby, president and chief executive officer of the South Carolina Hospital Association, said, "We are proud of our state's hospitals and their valuable partners for making great strides to improve the health of high-risk, uninsured patients in their communities. HOP extends the efforts we began in 2009 with the AccessHealth SC networks, funded with help from The Duke Endowment, to improve care coordination and access to services along the health continuum. We are encouraged that HOP will influence the costs of healthcare and the health of patients enrolled in HOP throughout the state."

Through HOP, South Carolina's hospitals have developed community-based plans in association with 68 primary care safety net providers (including Federally Qualified Health Centers, Rural Health Clinics, and free clinics), 19 behavioral health clinics, and many other social service organizations serving the uninsured. These partnerships extend beyond traditional healthcare providers to address other economic and social conditions-like housing, transportation and food security-that may influence a participant's health. Results are shared with physicians at the assigned medical homes and are incorporated into participants' care plans.

"We know that hospitals spent much of the first year developing the infrastructure and care models needed to support this new approach," said SCDHHS Interim Director Christian L. Soura. "Now in their second year, HOPs will continue to enroll participants, while further enhancing their partnerships in order to improve the health of participants. This program shows that we can work together to bolster the health of South Carolinians, while controlling the per-capita cost of health care delivery and improving the patient's experience of care."

About the South Carolina Department of Health and Human Services

The South Carolina Department of Health and Human Services provides health care benefits to more than one million South Carolinians. Its mission is to purchase the most health for our citizens in need at the least possible cost to the taxpayer.

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