Case StudiesHelping clients respond to the evolving healthcare needs of the community.
Sacred Heart Health SystemSet up a federally facilitated insurance marketplace in San Antonio and El Paso.
TST & Associates helped Sacred Heart Health System, part of Ascension Health, land and startup a $4.5 million three-year grant from the Centers for Medicare and Medicaid Services (CMS), to set up a federally facilitated insurance marketplace in two cities, San Antonio and El Paso. These navigators assisted consumers, many of whom never had health insurance, in enrolling for coverage through the healthcare marketplace.
The services were provided through Daughters of Charity Services of San Antonio and Centro San Vicente in El Paso, Texas, both affiliates of Ascension Health. TST had less than 60 days to make the complex program operational, far less than what is usually allotted for a program of its size. Duties included hiring 18 staff members, training and certifying them, promotion of the exchanges, contracts, and back office and reporting procedures. In the end, the program was stood up in 42 days, just in time for the Nov. 1, 2015 enrollment date.
During the three month-enrollment period, CMS insurance navigators helped 7,000 people obtain insurance from the healthcare exchange. TST & Associates continues to provide ongoing technical assistance in program operations and grants administration to the program.
MOM Care, AlabamaCreated a managed care organization for prenatal care and delivery for low-income mothers.
MOM Care is a program that provides maternity care to low-income mothers in Mobile County, Alabama. This $45 million program, funded by the Alabama Medicaid Agency, created a managed care organization for prenatal care and delivery through the University of South Alabama Health System. The initial three-year contract provided approximately $15 million per year.
TST & Associates principal Mike Trainor was part of the bid development team and got the program up and running, handling contracting and network development during the startup phase. He also managed the development and deployment of the data collection system. Trainor eventually served as the program’s interim executive director, overseeing facility remodeling, equipping the office and making the initial staff hires.
The successful MOM Care program is still in operation after more than a decade.
Marillac Community Health Centers, LouisianaDesigned a program to integrate behavioral services into the operation of four clinics.
TST & Associates was responsible for obtaining $2.8 million in funding from the Health Resources and Service Administration to design a program to integrate behavioral health services into the Marillac Community Health Centers in New Orleans.
The need for behavioral health services, which includes mental health and substance abuse, has grown due to insurance coverage through the Affordable Care Act. The best practice setting for these services is the primary care setting, the most cost-efficient and effective avenue to deliver behavioral care and manage chronic disease.
To incorporate these services into Marillac’s primary care centers, TST first performed research to determine the best evidence-based models for delivery of services that supported the SBIRT approach (screening, brief intervention, referral and treatment).
Using the program model designed by TST, Marillac put the model into place, integrating an enhanced level of behavioral services into the operations of four clinics.