VIP/CHAP

What is the Voluntary Initiative Program (VIP)?

VIP is a state-wide network of physicians and other healthcare providers who have agreed to provide free or low-cost services to uninsured Delawareans who participate in the Community Healthcare Access Program (CHAP). VIP is built on the premise that patients who have access to a physician are healthier and therefore less costly to the healthcare system as a whole.

VIP coordinates with CHAP in servicing those Delawareans who are uninsured, are at or below 200% of the Federal Poverty Level, and who cannot or do not qualify for any public health coverage.

As part of the eligibility process, CHAP patients go through a financial screening, which includes application for public health coverage. If it is determined that the patient is ineligible for public health coverage, the patient is then considered for enrollment in CHAP. The letter that patients receive when they’re denied public coverage notes an 800 number (800-996-9969 option 3) for uninsured patients which they can call to seek linkage to medical services through CHAP or other state programs.

Patients enrolled in CHAP are guided to establish a primary medical home either at one of Delaware’s Community Health Centers or with one of the physicians in private practice who participates in the VIP network.

The assignment of CHAP patients to VIP physicians is based on criteria communicated by the participating primary care physician or by the patient.

After assignment to a primary health home, a VIP Coordinator continues to provide centralized support to the patient and physician practice to access a wide array of medical sub-specialty services and discounted ancillary services through community hospitals and special arrangements with ancillary providers for radiology, laboratory etc.

A Pharmacy Care Coordinator works with patients to find the most appropriate discounted drug program to match the medications the patient takes (See Pharmacy Assistance Program).

What is the Community Healthcare Access Program (CHAP)?

CHAP is a program administered by the Delaware Health Care Commission in partnership with the Medical Society of Delaware. The purpose of CHAP is to provide a medical health home and continuum-of-care services to the working poor uninsured who are ineligible for state medical assistance programs.

CHAP reduces inappropriate use of hospital emergency departments for routine preventive and sick care visits and encourages age- and gender-appropriate preventive health screenings.

Medical services are provided in the community through Community Health Centers and the Voluntary Initiative Program (VIP). Each Community Health Center has a CHAP Community Care Coordinator who acts as an identifier of CHAP-eligible patients and an enrollment facilitator. In most cases when the patient is enrolled in the program, the Community Health Center then becomes their health home. Community Care Coordinators are also located at most hospitals in the state and at the Medical Society of Delaware. These Care Coordinators identify and enroll CHAP patients and in turn refer them to Community Health Centers or the VIP.

VIP is a program developed and overseen by the Medical Society of Delaware which is comprised of private physicians and other healthcare providers statewide who voluntarily accept CHAPpatients into their practices and serve as their health home or provide medical subspecialty services. CHAP recipients are usually charged a nominal fee by the physician or provider for services based on their income.

What are the Benefits of Participation to Patients and Physicians?

CHAP provides a universal financial screening mechanism and collects health status information on every enrollee. Physician providers and their office staffs benefit by not having to duplicate financial screening activities. A CHAP-enrolled patient has already been determined ineligible for Delaware medical assistance (Medicaid) and has been assigned an income code based on the Federal Poverty Guidelines. This income code can serve as a convenience to doctors’ offices who want to administer discounts using a sliding fee scale.

Also, a CHAP enrollee’s health status is re-surveyed annually with results communicated to both patients and their physicians. CHAP assesses improvement in individual health status as a result of having access to a regular source of primary medical care, and it also evaluates the financial savings that occur in the health system as a result of less inappropriate use of the emergency room and perhaps hospitalization length-of-stay.

According to annual health status evaluation results for CHAP patients, VIP patient utilization indicates:

· Decreased use of hospital emergency departments

· Increased preventive screenings for pap smears, mammograms, flu shots and colorectal screenings

· Dramatically increased self-reported perception of health status and satisfaction with the health system.

At the end of 2007, close to 5,000 low-income uninsured individuals were enrolled in CHAP, obtaining health services at either a VIP physician’s private office or at a Community Health Center.

If you are a physician or other healthcare provider currently assisting uninsured patients, we want to add your practice to the growing list of VIP members as recognition of this important contribution. Through your participation in VIP, your practice can refer your established uninsured patients to the CHAP at 1 (800) 996-9969, option 3.

Contact Information for VIP and CHAP

Physicians: For further information on VIP or CHAP, or to enroll in VIP, please contact the VIP Program Office, Wheeler & Associates, at (302) 744-9267, or email betsy@managetool.com.

Patients: To enroll in CHAP, please call 1 (800) 996-9969, option 3.

To contact the VIP Pharmacy Coordinator, please call (302) 366-1143 or toll free at (866) 996-CHAP (2427)