Partnerships for health: Addressing culture and access in rural and urban settings

The benefits of Assured Access center on access to quality health care for those who may otherwise slip through the cracks of the health care system.  This highly effective and tailored program was designed to meet the needs of both members and providers with no budgetary increase to Hennepin County.  Assured Access is not medical insurance, but rather a program that works with clinics offering sliding fee services.  Assured Access confirms the household income level of applicants, determines the percent of the Federal Poverty Guideline (FPG), and provides members with a card similar to those used by traditional Health Maintenance Organizations (HMOs).  This card works as their key to sliding fee scale clinics, which can provide care at a discount of 25 – 100%.

During its inception, Assured Access was less effective due to a complex eligibility process and significant delays in processing timelines created by incomplete forms and misunderstandings regarding program requirements. In order to ensure an easily accessible application process and a simplified process for providers, the application was reduced from 7 pages to 1, made available in multiple languages in on-line format and the verification process streamlined. Changes in the Assured Access Program have resulted in a reduction in processing time from 30 to 45 days to our current standard of less than 10 days.

Currently, Minnesota’s other 86 counties use a system which pieces together healthcare access through a variety of clinics, non-profit organizations and free services for the under/uninsured.  Oftentimes patients are forced to “cobble together” healthcare, receiving their discounted immunizations one place, dental another, primary care another and urgent care another.  This can be an exhausting process which increases the wait time for appointments and creates hardships for those individuals who need care.  Hennepin County’s Assured Access program takes care of the application process for multiple clinics including dental and mental health, and the delivery of care can begin as soon as the patient arrives at the clinic with his or her Assured Access card in hand. Assured Access can easily be adapted to fit other counties. It simply acts as the connection between patient and provider, eliminating the confusion, processing, and billing that the clinics would have to otherwise undergo on site.  Additionally, the Assured Access program allows for retroactive coverage which can cover healthcare costs incurred up to three months prior to the application date. 

The Assured Access program encourages patients to actively seek medical attention when needed and to participate in preventative health care as well.  Preventative health care, such as immunizations and regular check-ups improves the health and quality of life for clients who may otherwise avoid or wait to seek medical attention due to lack of funds.  Assured Access’ service is indispensable for those who need it and no other county in Minnesota has such a program in place.  When quality health care can be combined with increased efficiency and decreased costs, the model should be replicated across Minnesota, such as the case of Assured Access.