Bon Secours Baltimore Health System - West Baltimore Primary Care Access Collaborative

Overview

As the result of a three-year multi-faceted Maryland state planning effort to address health-related challenges, the Maryland Community Health Resources Commission and Department of Health & Mental Hygiene has funded a four-year, $5 million Health Enterprise Zone initiative, the West Baltimore Primary Care Access Collaborative (WBPCAC).

Under BSBHS' leadership, WBPCAC is a partnership of more than a dozen prominent institutions working together to strengthen the health care system, improve access to care, and reduce persistent and profound health disparities in a large section of West Baltimore. The mission of the Collaborative is to create a sustainable, replicable system of care to reduce health disparities, improve access to health care, reduce costs and expand the primary care and community health workforce.

The Collaborative is focused on four Baltimore neighborhoods in four zip codes that have some of the highest disease burden and worst indicators of social determinants of health in Maryland. The WBPCAC set and attained several specific and quantifiable goals to improve primary health care in its target areas.

Impact

By March 31, 2016, WBPCAC:

• Successfully connected 1,125 high utilizers to community health workers and provided prolonged support to 450 high utilizers. Community health workers completed 4,725 encounters via home visits, phone, health screenings, and clinic visits.

• Successfully connected 100 high utilizers to a primary care provider.

• Increased by 66 the number of community members who receive health care career training that can support primary care practices.

• Provided state tax credits to providers to attract and retain those who were employed in the West Baltimore Zone.

• Increased by at least 3 percent the number of residents who were screened for hypertension and diabetes.

• Completed biometric screenings with at least 10 percent of the fitness class participants.

The readmission rate among those enrolled in the initiative is currently 12 percent, down 6 percent since the inception of the program.

Lessons Learned

The initiative originally focused on targeting 86,000 residents to shifting its focus to only targeting 1,125 high utilizers, as they had the worst outcomes and added the highest cost to the health care system. There is a huge demand for nutrition, cooking, and fitness classes in the West Baltimore community. Providing scholarships to students who are pursuing careers in health care and gaining employment opportunities in the Zone will build a local workforce pipeline.

Future Goals

By March 31, 2017, WBPCAC will have reduced by 2.5 percent diabetes, hypertension, and CVD-related preventable ED visits. The Collaborative also will have documented the workforce status composition and the capacity building needs of the provider practices.

Contact: Judith Carmichael
Director, Marketing & Public Relations
Telephone: 410-371-4142
Email: judith_carmichael@bshsi.org