Delta Health Systems Implementation Program - Applicant Organization Information: Sparta Community Hospital District (SCHD), 818 E Broadway, St. Sparta, IL 62286, Critical Access District Hospital with 6 Rural Health Clinics, spartahospital.com Project Director –Jennifer Barbour, Director of Marketing & Relations, 618-443-1467, barbour.jennifer@spartahospital.com. Key Staff TBH; one (1) Chronic Care Management Lead Coordinator, and three (3) Chronic Care Management Coordinators. Project Title & Goal: SCHD’s Chronic Care Management Program – has the goal to reduce or eliminate health disparities and improve patient health outcomes in underserved rural population. The target population resides in the Southwest Illinois counties of Randolph, Washington, St. Clair, Jackson, and Perry Counties. SCHD will transform its Chronic Care Management (CCM) delivery to better serve the rural underserved population in Randolph County, IL, and surrounding areas. This initiative aims to address health disparities by improving access to care, providing tailored services, and promoting health equity. The project will focus on expanding primary and preventative care, behavioral health screenings, immunizations, and chronic disease management. Key objectives include to develop and implement an internal CCM program by hiring and training CCM coordinators, developing policies, procedures and marketing strategies, and ensuring data integrity and reimbursement processes; improve patient outcomes for population health management by increasing early intervention and reducing avoidable ED visits, enhancing chronic disease screening and management, and improving behavioral health screenings and referrals; and reduce healthcare costs by increasing enrollment in the ACO, developing measurable objectives to track outcomes, and decreasing PMPM costs for ACO members. Expected outcomes include improved population health management and health outcomes; enhanced capacity for value-based care and population health management; financial savings passed on to low-income patients; increased patient satisfaction and engagement. SCHD will utilize the TruBridge EMR system and i2iTracks’ population health management platform to track and improve patient outcomes. Data will be collected and analyzed to inform decision-making and identify opportunities for improvement. SCHD has the capacity and experience to serve rural populations. Over the past 30 years, SCHD has worked steadily to add primary care clinics in the rural communities that surround its facility. A mobile health clinic, made possible by the availability of Rural Health Clinic funds during the COVID-19 pandemic, also increased access to primary care among rural, traditionally underserved populations. The proposed project builds upon that work to bring healthcare into underserved, rural communities, and improve care for disproportionately impacted populations. The total project cost is $631,257.33, with SCHD providing in-kind support of $231,257.33. The requested funding of $400,000.00 will cover personnel, fringe benefits, travel, supplies and other necessary expenses to implement the CCM program.
