Diabetes Healthy Outcomes Program (DHOP): Healthy Outcomes for Uninsured Diabetic Patients at Hamilton Health Center

The Highmark Foundation (Foundation) is a charitable organization, a private foundation and an affiliate of Highmark Inc. that supports initiatives and programs aimed at improving community health. As a thought leader in public health and human service initiatives, the Foundation's greatest success is uniting regional, national and global organizations with like missions to raise awareness and stimulate long-term and systemic change. The Foundation fulfills its mission by awarding high-impact grants to charitable organizations and hospitals that spearhead programs aimed at improving community health. Central to the Foundation's mission is identifying and continuously re-evaluating our region's prevailing health care needs. By doing so, the Foundation remains at the forefront of the region's health care issues, well-equipped to pinpoint issues that most urgently need support. The Foundation seeks to support organizations and programs that establish a strong community compact, demonstrate new and sustainable ways to solve health problems, illustrate effectiveness of early intervention and preventive health programs and advance health equity. Diabetes is one of many public health issues the Foundation continually supports through grantmaking.

The issue of diabetes is being addressed in Pennsylvania through comprehensive approaches and/or programs. Hamilton Health Center (HHC), a Federally Qualified Health Center located in Dauphin County, Pennsylvania established diabetes as one of two clinical priorities, and established clinical targets for this disease in its most recent health plan. HHC is working to meet or exceed national outcome standards established for this disease. One of which is to reduce to 9% the population identified as having HbA1C levels greater than 9.5%. At baseline 20% of the HHC population had HbA1c levels greater than 9.5%. The primary goals of this two-year program were to improve the health outcomes of 200 uninsured diabetics thereby reducing modifiable risk factors such as dietary intake, physical inactivity, and overweight through proper referrals for and management of the disease; and reduce emergency room encounters through consistent medical visits at no cost to the patient.

To eliminate barriers to participation, the wrap-around services provided by this program equipped low-income predominantly minority diabetic patients with tools to develop educational strategies necessary to manage their disease. Patients were able to schedule all appointments (ophthalmology, dental, podiatric, physical, etc.) during the same visit. The overall strategies were:

1. Assist patients with developing greater confidence in their ability to manage diabetes. 2. Improve health outcomes as a result of having access to comprehensive coordinated medical care and treatment at no cost to the patient. 3. Collaborate with community-based organizations that provide program and services to strengthen medical care and services received at HHC. 4. Provide access to medically necessary services including routine preventive screenings, exams, and diabetic education at no cost to the patient.