In response to growing concerns about health care access for the uninsured and underinsured, the federal government (Bureau of Primary Health Care) provided grants to communities in 45 states to develop community-level solutions. Over 400 million dollars were invested over a period of 5 years (2000-2004) through the Healthy Communities Access Program (HCAP).
The purpose of HCAP was to “assist communities and consortia of health care providers and others they represent to develop or strengthen integrated community health care delivery systems that coordinate health care services for individuals who are uninsured or underinsured and to develop or strengthen activities related to providing coordinated care for uninsured or underinsured individuals with chronic conditions”. www.bphc.hrsa.gov/cap
From experience gained in the HCAP program and ongoing work of communities across the nation, a framework for “providing better care to more people at less cost” emerged. This framework included the concept of eight critical activities, which generate cost savings that can be reinvested into the system to increase health care access for everyone.
8 Critical Activities
- Outreach and enrollment into existing programs/ services
- Connect individuals and families to “health homes” with coordinated services
- Assure access to affordable prescription drugs
- Implement chronic disease management (and case management programs)
- Provide coverage for low-wage workers
- Organize donated clinical care services
- Ensure adequate and stable safety-net medical provider capacity
- Prevention and wellness services
For more information about the proposed framework for improving community health see the following documents:
Working draft of position paper (2/20/2007) (PDF)
Working draft of member organizations' application of "8 Critical Activities" in their regions.
8 Critical Activities and Phases of Community Development (PDF)
