Care Coordination: Connect to Care Program

Connect to Care Program

For many years, nearly half of emergency department (ED) visits in Milwaukee County have been for non-emergencies, with many of those visits made by uninsured or underinsured individuals lacking a primary care provider. Recognizing the need to address this issue, the Milwaukee Health Care Partnership (MHCP) launched the Emergency Department to Medical Home Program (EDMH) in 2009, which has since been rebranded as the Connect to Care Program.

This program provides a pathway for referral and discharge staff in emergency departments, inpatient, and community settings to schedule, in real-time, follow-up appointments for patients to receive the primary care services and other health resources they need before they leave the point of care.

The Connect to Care Program aims to improve health outcomes by:

• Decreasing avoidable emergency room visits and related hospitalizations
• Reducing duplicative emergency room tests and procedures
• Connecting high-risk individuals with primary care health homes and other health resources

In 2023, the Connect to Care Program expanded its scope by bringing on additional referral and receiving partners and offering opportunities to schedule additional services, including behavioral health, substance use, and dental care for patients of all ages.

Referring organizations now include:

• ED and inpatient hospitals
• Mobile health units
• Community-based clinics
• Health department clinics
• Community paramedics

Receiving organizations now include:

• Milwaukee County Federally Qualified Health Centers (FQHC)
• An FQHC Look-a-Like clinic
• Community-based substance use clinics
• A community-based health clinic for uninsured individuals

Since its inception, the Connect to Care Program has scheduled more than 60,000 appointments. This initiative not only ensures timely and appropriate care for high-risk individuals but also optimizes the efficiency of health care resources in Milwaukee County.

The Connect to Care Program continues to evolve. With the ongoing support of its partners and stakeholders, the program is well-positioned to further enhance health care access and improve health outcomes in Milwaukee County. Future plans include expanding the network of referral and receiving partners and exploring technological solutions for better patient management and care coordination.

For more information about the Connect to Care Program and how you can get involved, contact Kate Graham at kgraham@mkehcp.org.

Feature

The Robert Wood Johnson Foundation’s focus on appropriate emergency department use provides key lessons learned by regional alliances in their Aligning Forces for Quality communities – including Milwaukee – as they work to transform local health care and provide models for national reform.