School of Medicine, University of Louisville, Louisville, KY 40202, USA.
Passport Health, 5100 Commerce Crossings Dr, Louisville, KY 40229, USA.
Int J Environ Res Public Health. 2020 Jul 14;17(14):5079. doi: 10.3390/ijerph17145079.
We describe an effort to improve the care of Medicaid and uninsured individuals through a three-way partnership between a Medicaid managed care insurer, front-line providers, and an academic university. The project provided annual funding over eleven years, for research, pilot programs, and demonstration projects. Projects were provider-driven in design and methods. The Medicaid-managed care insurer-funded proposals were vetted by a neutral university team experienced in grant writing and community-based research and scored by a community-based review panel. The grant program ran from 2007 to 2018, funding 41 projects, totaling USD 2,097,842. The partnership of an insurer, a university, and frontline providers was not only viable and sustainable for over a decade, but also flexible, free of project selection issues, and well-received by all stakeholders. Funded providers worked in both urban and rural settings and included hospitals, community non-profits, outpatient clinics, academic and community health partnerships, and public health agencies. The projects generally reflected common issues in the Medicaid and uninsured population needs, such as childhood obesity, and they were consistent with the targeted goals of the program. Broad health foci included child and/or maternal health, chronic conditions, mental health, preventive health, screening, system effectiveness, special populations including refugees, Latinos, and rural individuals, and substance use disorders. Details of the awarded grantee goals, the grants management process, and lessons learned from the partnership are presented. The partnership triad model was effective and stable, with each partner adding unique value. The use of the academic institution to administrate the program provided an arms-length relationship between the insurer and the providers in project selection and allowed assistance to less experienced researchers in community settings.
我们描述了一种通过医疗补助管理式医疗保险公司、一线服务提供者和学术型大学之间的三方合作来改善医疗补助和无保险人群护理的努力。该项目在十一年期间提供年度资金，用于研究、试点项目和示范项目。项目在设计和方法上由服务提供者驱动。由医疗保险管理式医疗保险公司资助的提案由一个在拨款撰写和基于社区的研究方面经验丰富的中立大学团队进行审查，并由一个基于社区的审查小组进行评分。该拨款计划从 2007 年持续到 2018 年，资助了 41 个项目，总计 2097842 美元。保险公司、大学和一线服务提供者的伙伴关系不仅在十多年的时间里是可行和可持续的，而且具有灵活性，没有项目选择问题，并且得到了所有利益相关者的好评。受资助的服务提供者在城市和农村地区开展工作，包括医院、社区非营利组织、门诊诊所、学术和社区卫生伙伴关系以及公共卫生机构。这些项目通常反映了医疗补助和无保险人群需求中的共同问题，例如儿童肥胖问题，并且符合该计划的目标。广泛的健康重点包括儿童和/或产妇健康、慢性病、心理健康、预防保健、筛查、系统有效性、特殊人群（包括难民、拉丁裔和农村人群）和物质使用障碍。本文介绍了授予受让人的目标、拨款管理过程以及从伙伴关系中吸取的经验教训的细节。三方合作伙伴关系模式是有效的且稳定的，每个合作伙伴都增加了独特的价值。利用学术机构来管理该计划在项目选择方面为保险公司和服务提供者之间提供了一种保持距离的关系，并为社区环境中的经验不足的研究人员提供了帮助。
