SBIR Phase I: Reaching "unreachable" Medicaid Members and Building Bridges to Care

拟议的活动有哪些更广泛的影响？这个SBIR第一阶段项目重新定义了医疗补助接受者获得医疗保健的方式。超过7500万低收入美国人通过医疗补助获得医疗保险，但这些人固有的社会经济障碍使他们很难驾驭这一体系。许多人面临住房不安全、粮食贫困、药物滥用和缺乏支持等挑战，这进一步抑制了获得基本保健的能力。如果没有更早的干预，最脆弱的人往往会依赖医院急诊科提供护理--这是一个恶性循环，对卫生保健组织和患者来说都是代价高昂的。越来越多的社区组织(CBO)，如食品储藏室、流动医疗诊所、资源中心和庇护所，已经成为生存的接触点。然而，作为资源有限的非营利组织，社区组织缺乏记录保存和报告的基础设施。拟议的技术通过一个免费和可配置的基于网络的应用程序解决了CBO的数据管理需求，该应用程序在所服务的客户上建立纵向概况。反过来，该应用程序通过在各自的成员访问CBO时向护理管理团队发出警报，为卫生保健组织创造价值，并建立了一种早期和预防性参与形式的渠道。这项拟议的技术将医疗保健组织的覆盖范围扩展到医疗补助成员居住的社区。这需要为CBO配备一个免费的客户管理应用程序，通过简化的数据报告提高组织的带宽和获得资金的机会。在后端，匹配引擎接收来自医疗保健组织的成员登记文件，并查询CBO数据库以获得唯一链接。当发现匹配时，卫生保健组织的护理管理团队会收到关于难以接触到的成员和脆弱成员的状态和位置的通知。随后，他们可以与直接服务于医疗补助成员并拥有更牢固关系的CBO工作人员进行双向交流。为CBO工作人员提供有关最佳做法的指导，以吸引他们的客户并有效地作为护理团队的延伸。这种方法在全国至少有40万个CBO，有可能激活现有基础设施的庞大网络，并极大地改善那些接受医疗补助的人的护理协调。在本提案期间，将实施端到端解决方案，将医疗补助成员与其各自的医疗保健组织联系起来，并将社区组织转变为技术支持的医疗保健网关。此外，拟议技术的可行性将在第二阶段的审议中进行评估。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

What are the broader impacts of the proposed activity? This SBIR Phase I project redefines how Medicaid recipients access health care. Over 75 million low-income Americans receive health care coverage through Medicaid, but socioeconomic barriers intrinsic to this population make it difficult to navigate the system. Many face challenges including housing insecurity, food poverty, substance abuse and lack of support that further inhibit the ability to obtain basic health care. Without earlier interventions, the most vulnerable individuals are prone to rely on hospital emergency departments for care - a vicious cycle that is costly to health care organizations and patients alike. Increasingly, community-based organizations (CBOs) such as food pantries, mobile health clinics, resource centers and shelters have emerged as survival touch points. As non-profits with limited resources, however, CBOs lack infrastructure for recordkeeping and reporting. The proposed technology addresses the data management needs of CBOs through a free and configurable web-based application that builds longitudinal profiles on the clients served. In turn, this application creates value for health care organizations by alerting care management teams when respective members visit a CBO and establishes a channel for earlier as well as preventive forms of engagement. The proposed technology extends the reach of health care organizations into the communities where Medicaid members reside. This entails equipping CBOs with a free client management application that improves organizational bandwidth and access to funding through streamlined data reporting. On the back-end, a matching engine ingests member enrollment files from health care organizations and queries the CBO database for unique linkages. When matches are found, care management teams at health care organizations receive notifications on the status and location of difficult to reach as well as vulnerable members. Subsequently, they can communicate bidirectionally with CBO staff that directly serve Medicaid members and have stronger relationships. CBO staff are provided with guidance on best practices to engage their clients and effectively serve as extensions of the care team. With at least 400,000 CBOs across the country, this approach has the potential to activate a vast network of existing infrastructure and dramatically improve care coordination for those on Medicaid. During this proposal period, an end-to-end solution will be implemented that links Medicaid members to their respective health care organizations and transforms CBOs into technology-enabled gateways to health care. Furthermore, the feasibility of the proposed technology will be evaluated for Phase II considerations.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.