Ballad Health unveils unprecedented effort to expand access to healthcare for people who are uninsured

Appalachian Highlands Care Network a national model for how rural health systems can transform to improve health, reduce cost

Ballad Health, an integrated health improvement organization serving a region in Northeast Tennessee and Southwest Virginia the size of New Hampshire, today unveiled a major, coordinated effort to increase healthcare access for low-income uninsured people, aiming to reduce health disparity and inequity.

Recognized earlier this year by Forbes Magazine as one of the 29 best workplaces in America for diversity, Ballad Health is committed to ensuring everyone in its service area can access the services they and their families need. This announcement also comes on the heels of the recently announced transformation of Greeneville Community Hospital West, in Greeneville, Tennessee, to serve as a residential treatment center providing safe family housing, treatment and social support for women who are pregnant and who suffer from substance use disorders harmful to their unborn children.

The new Appalachian Highlands Care Network is designed to bridge care gaps, improve health and reduce avoidable healthcare cost and utilization. The program includes all Ballad Health hospitals, outpatient services and physician practices, along with a regional network of non-Ballad Health care providers and primary care services offered through regional safety-net clinics, health departments and federally-qualified health centers.

“For years, individual health departments, safety-net clinics and healthcare providers have done what they can to care for uninsured, resource-limited people,” said Ballad Health Chairman and Chief Executive Officer Alan Levine. “But to truly improve the health of our communities and reach those who need our help the most, we all have to come together and work cooperatively and collaboratively. Because of the merger creating Ballad Health, and the resulting investment into a common technology platform, Ballad Health has the scale and technology to facilitate this massive effort, along with our partners at East Tennessee State University and many other great organizations.

“The Appalachian Highlands Care Network represents the first regionwide, coordinated effort to bring organization and technology to address the problems faced by individuals without health insurance in our community. Part of what makes the Appalachian Highlands one of the best places in America to live, work, play and raise a family is that we have a culture of caring for each other. This effort is a natural result of the scale of Ballad Health working in partnership with incredible partners such as ETSU, the University of Virginia’s College at Wise, Project Access and our region’s other safety-net healthcare and social service providers.”

The new network was adapted from Appalachian Mountain Project Access, part of a national model of care that has served parts of the Appalachian Highlands, mainly Washington County, Tennessee, for many years. In addition to more than $75 million Ballad Health spends annually providing access to care for people with serious financial limitations through uncompensated care, charity care and unreimbursed Medicaid, the health system is also making significant investments into Project Access across the health system’s entire 21-county service area – the entire Appalachian Highlands.

Through Project Access, and now the Appalachian Highlands Care Network, uninsured patients who need specialty or diagnostic care are referred to the program from providers, hospitals, health departments, community clinics and faith-based centers. The network enrolls members based on a financial assessment, conducts social needs assessments and schedules necessary medical appointments, procedures and testing. The regionwide program has operated in a pilot mode since Sept. 1 and will continue to increase the number of individuals its serves month over month.

“For many years, Project Access and our regional safety-net providers have put forth a Herculean effort to provide free or reduced-cost primary care services for the uninsured in our region,” said Todd Norris, senior vice president of community health and system advancement for Ballad Health. “After listening to safety-net providers about additional unmet needs in the community, Ballad Health is responding by making new investments that allow the Appalachian Highlands Care Network to provide expanded access to specialty diagnostics, consults and procedures, as well as enhanced care coordination and management for individuals with chronic conditions.”

“Ultimately, this will be a new model of care delivery for the Appalachian Highlands that shows what is possible when we all work together to solve a community-wide problem,” said Brooks Blair, executive director of Project Access. “We are very pleased with the level of support Ballad Health is providing and the essential partnerships we have with so many other regional providers. Our goal is to grow the network to completely fill the care gaps that exist.”

One such patient with an urgent medical need is Paul Blevins, a Washington County, Tennessee, resident who began experiencing chest pains earlier this year. Worried about his symptoms, but lacking health insurance, Mr. Blevins was reluctant to seek care for fear of exorbitant medical bills.

“After several weeks and the urging of my friends and family, I decided to go to the Washington County Health Department,” Mr. Blevins said. “There, I met a nurse who would change my life – literally.”

The nurse connected Mr. Blevins to Project Access, which facilitated appointments with ETSU Physicians, Ballad Health Medical Associates and other Ballad Health facilities. He was diagnosed with severe aortic stenosis and had four blockages removed during a cardiac catheterization. But he still needed open-heart surgery, and due to poor dental health, he needed extractions before that could be safely conducted.

Once again, Project Access stepped in and found a clinic that performed the extractions, enabling him to receive his life-saving surgery – all at no cost to him.

“I can never thank these people enough,” Mr. Blevins said. “What they do is worthy of everyone’s support and gratitude.”

Blair estimates the amount of donated care Mr. Blevins received is valued at more than $327,000. As the Appalachian Highlands Care Network continues to grow and evolve, more patients like him will receive the care they need, and the program’s development will follow three distinct phases:

• Phase 1, care coordination, will meet care gaps for essential services. It will focus on expanding Project Access and Ballad Health offerings regionally to connect people with diagnostic and medical care, with an emphasis on those in need for treatment for urgent and complex medical conditions.

• Phase 2, care management, will utilize a care team model that includes community health workers and care managers to aid people with complex conditions, chronic disease or behavioral health issues and social needs. It will identify patients through referral sources, Ballad Health data analytics and case management, and it will provide isease and medication management services and counseling to prevent harm and unnecessary hospital encounters.

• Phase 3, prevention and self-management, extends the Appalachian Highlands Care Network to healthier, uninsured populations. The ultimate goal of this final phase will be to improve health literacy and healthy behaviors, while consistently ensuring people receive the care they need in the most appropriate setting.

Through each phase, Project Access will continue working with established safety-net partners, such as Crossroads Medical Mission, The Health Wagon, Healing Hands, Friends in Need and Providence Clinic, along with regional health departments. Notably, the Appalachian Highlands Care Network will enable Project Access to reach into Virginia for the first time. This investment into Southwest Virginia follows the creation of the Appalachian Highlands Community Dental Center, created during the formation of a new dental residency program funded in Southwest Virginia by Ballad Health.

“This is a tremendous leap forward for our region, as we’ll be able to more readily provide patients with the level of services that are clinically warranted without delay and without financial barrier concerns,” said Linda McClure, regional primary care director of the Northeast Tennessee Regional Health Office. “It literally could mean the difference between a patient pursuing and following through with their recommended plan of care or not, and it will make all the difference in their overall health status and quality of life.”

Patients who will qualify for the Appalachian Highlands Care Network include those who do not have access to health insurance and whose income is at or below 225% of the Federal Poverty Level.

When those patients are referred to the program through a safety net clinic or other provider, they take part in an enrollment process that further evaluates their eligibility and medical needs, as well as their potential need for social services or other assistance.

“Project Access has long been a champion of us when our backs are against the wall, especially when a patient’s needs exceed what we’re able to provide. They go above and beyond to link that patient to the next level of care,” McClure said. “The development of the Appalachian Highlands Care Network is very, very exciting, as there are a lot of other, less urgent medical needs that still warrant evaluation and further care, and this will open the door for these needs to be served.”

Ballad Health and the Appalachian Highlands Care Network will continue to keep the community apprised of progress and growth, as they expand the capability for patient volumes and referrals.

To see if you qualify for network services or for more information, please visit Project Access. A video recording of the press conference announcing the Appalachian Highlands Care Network is available here, and a video message from Dr. Marta Wayt, an internal medicine physician with Ballad Health Medical Associates and medical director of Providence Medical Clinic, is available here.