NYC Health + Hospitals, Duke University School of Medicine, Durham, North Carolina (Dr Jiménez); NYC Health + Hospitals, New York (Ms Kress and Dr Katz); and Health + Hospitals, NYU Grossman School of Medicine, New York (Dr Long).
J Public Health Manag Pract. 2024;30(5):E239-E246. doi: 10.1097/PHH.0000000000001915. Epub 2024 Jul 22.
Millions of people living in the United States are excluded from health insurance due to income or immigration status. These 2 groups are more likely to lack access to health care or a regular source of care.
NYC Health + Hospitals is addressing this need with NYC Care, a health care access program. The program is designed to be the single point of access for uninsured care citywide and includes a membership card, a 24-hour customer service line, and direct access to primary care medical homes. Health care is coordinated across NYC Health + Hospitals using integrated electronic referrals and a medical record system.
The program uses a single enrollment process across safety net health care resources of NYC Health + Hospitals. A 24-hour call center was established to answer questions, make primary care appointments, and make warm handoffs to enrollment staff. Once eligibility is confirmed and patients are enrolled, they are mailed a membership card, a member handbook, and offered a primary care appointment. A multipronged public awareness campaign including citywide, multilingual marketing and outreach via community-based organizations was essential to build trust.
NYC Care had 119 203 members at the end of June 2023. Fifty-eight percent had not seen a primary care doctor in the NYC Health + Hospitals system in the prior 36 months. In total, 76 439 had completed 1 or more primary care visits; 53.1% of enrollees with diabetes had improved hemoglobin A 1c , and 73.4% of enrollees with hypertension had improved blood pressure control after 6 months of enrollment.
NYC Care demonstrates that municipalities can improve access to care for the uninsured by simplifying steps to affordable health care services, connecting patients directly to patient-centered medical homes, and improving the patient experience. A comprehensive public awareness campaign is also crucial.
由于收入或移民身份，美国有数百万民众无法获得医疗保险。这 2 类人群更有可能无法获得医疗保健或常规的医疗服务。
纽约市健康医疗系统（NYC Health + Hospitals）通过 NYC Care 项目来满足这一需求，这是一项医疗保健获取项目。该项目旨在成为全市范围内无保险人群获取医疗服务的单一入口，其中包括会员卡、24 小时客户服务热线，以及直接进入初级保健医疗之家的通道。NYC Health + Hospitals 通过整合电子转诊和病历系统来协调医疗服务。
该项目在 NYC Health + Hospitals 的所有医疗资源中使用单一的注册流程。设立了一个 24 小时呼叫中心来解答问题、预约初级保健，并将患者转介给注册工作人员。一旦确定符合条件并为患者注册，就会向他们邮寄会员卡、成员手册，并提供初级保健预约。通过全市范围的多语种营销和社区组织外联等多管齐下的公众意识宣传活动，对于建立信任至关重要。
截至 2023 年 6 月底，NYC Care 有 119203 名成员。其中 58%的人在过去 36 个月内没有在 NYC Health + Hospitals 系统中看过初级保健医生。总共有 76439 人完成了 1 次或更多次初级保健就诊；在登记后的 6 个月内，73.4%的高血压患者和 53.1%的糖尿病患者的血红蛋白 A1c 得到了改善。
NYC Care 表明，地方政府可以通过简化获得负担得起的医疗保健服务的步骤，将患者直接与以患者为中心的医疗之家联系起来，并改善患者体验，从而改善无保险人群的医疗服务获取。全面的公众意识宣传活动也是至关重要的。
