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History

1995
     The concept to create the network came from our President & CEO Jeff Palmer. At the time, he was the Executive Director of East Liberty Family Health Care Center (FQHC) and had observed several real-life situations where his patients and their children were in need of a more coordinated system of care that would enable them to access multidisciplinary services. Mr. Palmer presented

 

the idea to his board as the fifth item on a strategic plan for the health center, and it was approved in December 1995.

1996
     In May 1996, Mr. Palmer held a community meeting for 120 local providers, advocates, elected officials, clergy and citizens and presented his vision for a network that would:

  1. Coordinate care for high-risk populations across disciplines.
  2. Improve health and reduce system costs (inpatient, emergency room visits).
  3. Receive a percentage of the cost savings.
  4. Use the cost savings to pay for health care for the uninsured and reduce dependence on grants and government funding.

    To accomplish this, three distinct programs would be developed to provide:

    1. Case management and outreach services.
    2. Basic coverage to the uninsured using a network of providers.
    3. Discount prescriptions using physician dispensing and the federal 340B program.

    A strategic planning committee, made up providers, advocates and other volunteers, was then created and began meeting two to three times per month, (at 7am) for two consecutive years, to develop the business plan, by-laws and basic corporate structure for the network. Mr. Palmer subsequently presented the business plan to the leaders of Pittsburgh-based foundations that funded health care and requested start-up funds to build the network.

    The network’s initial funders became the Forbes Fund, Jewish Healthcare Foundation, McCune and Richard King Mellon Foundation, who provided not only financial resources but also human capital to create a new model of care.

1998
    Operations began on March 15, 1998 with Mr. Palmer and an assistant in a one-room office in Monroeville, Pennsylvania.

    By the fall of 1998, twelve interested agencies representing a combination of medical, social and behavioral health safety-net providers joined the Network, bringing high-risk patient experience and the grassroots relationships needed to reach the Network’s target population.

1999
     In May 1999, the region’s largest Medicaid HMO, Gateway Health Plan, contracted with Coordinated Care Network to provide Preventive Case Management services to over 5,000 members. This program ran for almost five years through January 31, 2004, and was subsequently replaced with the 340B Poly-Pharmacy Member Case Management program.

2000
     In June 2000, (the former) UPMC/Best Health Plan became the second Medicaid HMO to contract with Coordinated Care Network for its Preventive Case Management services. Serving approximately 10,000 patients, this program ran through December 2001.

    Overall, the Network’s Preventive Case Management services reduced inpatient and emergency room utilization by 18% & 24% respectively (per 1,000 population), and became a national model. Both the University of Pittsburgh Medical Center Health Plan and Gateway Health Plan adopted Preventive Case Management models of care internally and operate them today as a standard of practice.

2001
     In March 2001, Coordinated Care Network received a prestigious national Community Access Program (CAP) grant from the Health Resource and Service Administration, a branch of the federal government, for implementation of the 340B Physician Dispensing and Mail Order Program. Metro Family Practice, who joined the Network in August 2001, became the first Federally Qualified Health Center to implement the program.

2002
     Zoar NewDay, a treatment program for women, was approved for membership and joined the Network in February 2002. Coordinated Care Network also expanded and moved its offices to a 5,500 square foot space in Monroeville, Pennsylvania in order to house the central pharmacy and mail order facility.

    Metro Family Practice launched the 340B Physician Dispensing and Mail Order Program in September 2002. Since then, 45 others have contracted (including the University of Pittsburgh Medical Center) and nine sites are currently operational.

2003
     Mr. Palmer presented the concept for the 340B Poly-Pharmacy Member Case Management program, initially referred to “HiRx Case Management,” to Gateway Health Plan in May 2003 as a way to reduce pharmacy and inpatient costs through a combination of case management and 340B mail order services. Gateway agreed in principle to identify their high pharmacy utilizers and refer them for case management under a special model involving Metro Family Practice and CCN’s case management department and mail order facility.

    In November 2003, the Pennsylvania Department of Public Welfare formally approved the 340B Poly-Pharmacy Member Case Management contract at which point operational and implementation planning were accelerated.

2004
     The 340B Poly-Pharmacy Member Case Management Program officially launched on May 1st, 2004.

     As a result, health care facilities in other states have requested CCN to replicate this model for their Medicaid populations, and the state of Pennsylvania is currently working on a pilot to apply the model to Medicaid fee for service recipients.

 

 
 

"CCN, for me, makes the case that good business combined with a charitable mission can change practice, be sustainable, and help those most in need."

-Jeff Palmer
President & CEO
Coordinated Care Network

 

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