Improving Health Care for the Uninsured

Improving Health Care for the Uninsured

In North Carolina and South Carolina, estimates show that as many as one in six people are uninsured. Gaining momentum in several communities is an effort to integrate health providers serving the uninsured into collaborative networks that improve access to more comprehensive health care services.

Melanie Matney, executive director of AccessHealth SC, talks about her work in the following interview, which has been edited for clarity and length.
The Duke Endowment has played a pivotal role in developing statewide resources to help communities across the Carolinas as they form networks of care. Two organizations grew from that work: Care Share Health Alliance in North Carolina and AccessHealth SC in South Carolina. They’ll help leverage existing resources and offer technical assistance as local collaboratives begin working together.

What brought you to AccessHealth SC?

I started out thinking that I wanted to go to medical school and be a doctor, but after working for a while in a primary care practice, I realized that I might not exactly want to be a doctor. At the same time, I was volunteering at a free medical clinic in Columbia, S.C., and that’s where my desire to help the uninsured came into play. That’s where it became a human problem for me.

When did you start working with AccessHealth?

I officially started in June of 2008.

Is AccessHealth modeled on any national program?

The medical home model of providing care is a well-known best practice. However, providing statewide technical assistance to help develop medical home networks is limited. Since getting involved, I have learned that I have colleagues in both Virginia and Georgia.

When you talk about “patient-centered care,” what exactly does that mean?

It is a whole shift in the way you think about things. It’s about putting the patient in the center of the circle – the patient is at the center of purpose.

Why does that work better?

If you don’t have health insurance and you see a billboard that says, “Go get screened for colon cancer,” you may not be able to coordinate the resources needed for the screening. If we thought about the patient first, we would have all the backup resources for that patient and a central place for them to call and get access to those resources.

What is the goal?

There are two main categories of goals. One is to change the way that patients and providers use the health care system and make sure they are using health care resources in the most efficient and effective way possible. The second main goal is to improve quality – not just quality of care, but quality of life.

Do you see every county in South Carolina eventually having a patient-centered care network?

Yes. We would like for every county to be participating.

How will this improve life for low-income, uninsured people in South Carolina?

For these networks, their whole mission is to help people get care at the right place, at the right time. I heard a statistic that only one-third of the people in our country who have diabetes know they have diabetes. If you can go out there and get that other two-thirds, imagine the impact that you could have on their health.

AccessHealth is still in its infancy. How will we know when or if it’s successful?

We have a very comprehensive evaluation plan. In my mind, when you start a project there are two things you really need to have in mind from day one. The first is an evaluation plan and the other is a sustainability plan. The evaluation plan drives the sustainability plan.

The first thing that we did was create an evaluation committee and they created an evaluation plan. The entire committee put a lot of thought into how to demonstrate the effectiveness of what we are doing. The plan measures process, impact and outcomes for AccessHealth SC and the networks. Their ultimate goals are to improve the way that people gain services from health care delivery systems and to improve health quality of life. Has there been a change of utilization and quality? If there hasn’t, then there probably is not a need for us to be around.

Contact Us

Lin B. Hollowell III
Director of Health Care
704.969.2132

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Related Work

Area of Work

  • Access to health care

Program Area

  • Health Care

Areas of Work

  • Prevention and early intervention for at-risk children

    To equip children and families with skills to ensure that children reach developmental milestones to lead successful lives.

  • Out-of-home care for youth

    To drive child welfare systems toward greater accountability for child well-being.

  • Quality and safety of health care

    Improving the quality and safety of health care delivery

  • Access to health care

    Improving health by increasing access to comprehensive care

  • Prevention

    Expanding programs to promote health and prevent disease

  • Academic excellence

    Enhancing academic excellence through program and campus development

  • Educational access and success

    Increasing educational access and supporting a learning environment that promotes achievement

  • Campus and community engagement

    Promoting a culture of service, collaboration and engagement among schools and communities

  • Rural church development

    Building the infrastructure and capacity of United Methodist churches to enhance ministry and mission

  • Clergy leadership

    Strengthening United Methodist churches by improving the quality and effectiveness of church leadership

  • Congregational outreach

    Engaging United Methodist congregations in programs that serve their communities

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