Access: Specialty Care
Despite expanded coverage under the Affordable Care Act, it is estimated that 10% of Milwaukee’s population will remain uninsured. In 2012, the Partnership launched the Specialty Access for Uninsured Program (SAUP) to replace a fragmented care delivery ‘system’ with a managed, more cost-efficient model of care. Its goals are to provide specialty care that is:
- Clinically appropriate
- Distributed equitably among health systems
The lessons learned from SAUP are helping inform important changes in the health care delivery system, including the implementation of accountable care for defined populations.
The SAUP has guided 10,851 referrals for specialty care since 2012
The SAUP model is being implemented in three adult health systems in Milwaukee County and nine safety net clinics that serve as medical homes for the uninsured. Each participating safety net clinic is matched with one or more hospital/health system to coordinate access to specialty services. This model serves to improve care delivery and transition care management.
- Safety net clinics identify eligible patients and provide primary care, medication access, benefit counseling, enrollment assistance and navigation support.
- Hospital/health systems each secure a network of specialists, and provide inpatient and outpatient specialty services. All usual and customary consultation, testing and treatment are ‘covered’ under SAUP, with no out-of-pocket costs to patients.
The SAUP program is a unique collaborative effort to improve care and reduce fragmentation. We have learned a great deal about process improvement and removing barriers to care across the community.Dr. Tom Jackson
Bread of Healing Clinic