Building Engagement to Address Complex Needs
BEACN improves coordination of care for individuals who are frequent visitors to Emergency Departments (EDs).
These patients are likely to
Have serious mental health and physical health issues,
Be homeless or without stable housing,
Need a range of additional services to address financial, employment and transportation barriers.
Hospitals are increasingly treating these “complex care” patients, and they account for a disproportionate share of healthcare costs. BEACN addresses this challenge through both systems change and clinical care projects.
Project BEACN is piloting improvements to the healthcare system so that complex care patients are proactively identified and receive coordinated services.
These efforts are coordinated with BHN’s Adult Emergency Room Enhancement program (ERE). These improvements include:
Electronic information sharing including alerting systems so if a complex care patient visits one hospital’s ED, other hospitals (including those in a different health system) will be notified
Development of a standard, high-quality care plan for complex care patients
Case staffings across hospital systems and community providers to better coordinate care
Clinical BEACN provides a “care transition team” to complex care patients through a subcontract with Places for People.
These patients receive case management services, flexible funds to meet short-term needs, and housing support for up to 12 months.
Treatment stipends are provided to the provider agency for up to six months while applications are made for Medicaid or other payor sources.
Data from this project is closely analyzed to determine the impact on patient outcomes and hospital costs.
Project BEACN is funded by the Missouri Foundation for Health.