Hennepin Health Newsletter: January 2016


January 2016



Ross Owen

Julie Bluhm
Clinical Program Manager

Jim Redmond
Social service navigator


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Hennepin Health is an innovative health care delivery program that was launched in January 2012.

The program is a collaboration between Hennepin County Medical Center (HCMC), NorthPoint Health and Wellness Center (NorthPoint), Metropolitan Health Plan (MHP), and Human Services and Public Health Department (HSPHD) of Hennepin County.

Hennepin Health members receive care from a multidisciplinary care coordination team. Other innovative features include a common electronic health record, and tiered care that is based upon a member’s identified needs.

Find eligibility and enrollment information at the MNsure website.


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Access Clinic reduces costs and improves patient care

Access Clinic

While much of Minnesota was standing at convenience store counters imagining lucky combinations of birthdates and anniversaries meant to unlock the 1.3 billion dollar PowerBall jackpot, the Hennepin Health (H.H.) Access Clinic team was thinking of a different set of numbers. 

Instead of dreaming of inventive ways to spend money, they were thinking about how they had managed to reduce health care costs by approximately $1.9 million. 

The H.H. Access Clinic achieved this reduction—over a thousand dollars per member per month—by transitioning patients away from the use of emergency services and hospitalizations, and toward the use of a permanent primary care physician.  Not only did costs decrease, but patient care improved.   

The H.H. Access Clinic works with patients who use the emergency department for routine services such as treatment of mild illness, chronic conditions, and mental health or chemical health symptoms.  Some of these patients are “super-users,” who come to the emergency department multiple times per month.  In many cases these patients have never had a permanent primary care physician.

A main objective of the H.H. Access Clinic is to assist patients with obtaining routine health services in a non-emergency setting.  According to H.H. Access Clinic physician Anne Hust, in 2015 the clinic’s goals were to reduce emergency department care by 30 percent, and in-patient hospital care by 30 to 50 percent, while increasing the use of out-patient care. 

The H.H. Access Clinic’s year-end results were even better. 

The H.H. Access Clinic tracked service costs for 266 members who had a minimum enrollment with Hennepin Health of three months, and a maximum enrollment of 12 months.  They found that after patients met with them, emergency department use decreased by 42 percent and in-patient hospitalizations by 44 percent.  This resulted in a 56 percent cost reduction for these services.   

While these costs decreased, out-patient costs increased by 13 percent.  The increase was due to patients receiving more services from primary care physicians instead of from the emergency department.  The cost of regular primary care is much cheaper than emergency care, which means that the 13 percent increase equates to just $8 per member per month.      


For a patient, the H.H. Access Clinic is much like a convenience store that provides for a one-stop shop experience.  Rather than sell newspapers, milk, and lottery tickets, however, the H.H. Access Clinic meets patients’ health-care needs through an inter-disciplinary team of providers. 

A patient who attends the H.H. Access clinic may spend several hours there receiving services.  That patient may start by meeting with a medical provider, who may then refer to a psychologist or chemical-dependency counselor.  Since patients no longer have to make these appointments with a variety of providers several months into the future, the risk of missing them is greatly reduced. 

The H.H. Access Clinic team also has members who work in the community such as clinical coordinators, community health workers, in-reach workers, and social service navigators.  These workers reduce outside barriers to patient care such as assisting with housing, transportation, filling prescriptions, or coordinating services. 

H.H. Access Clinic physician Danielle Robertshaw believes in the importance of having a team-based approach with a client.  “A patient may share different things with different people so better care can be provided.  If outside providers can’t get housing right away, at least somebody is touching [the patient] about it, and in the back of their head they know somebody is doing something for them.” 


The team-oriented approach allows health-care providers to better know their patients, which in turn improves client care. 

While traditional health service members also attempt to know their patients, it can be more difficult.  These providers tend to be more fragmented, with medical physicians, psychologists, and chemical-dependency counselors rarely sharing the same building.  Also, some clinics see several hundred patients per day.     

The H.H. Access Clinic team meets each week to discuss high-need patients.  At this meeting team members identify ways to overcome patient barriers to traditional primary care.  Solutions can range from getting a patient a bus pass for appointments to helping them find a place to live. 

Licensed Psychologist Cameron Weaver points out that there is a difference between co-located care and a truly integrated care.  “I’m not just a psychologist down at the end of the hall.  Half of the patients we talked about this morning I haven’t met, but their names are still familiar to me.”

When patients show stability with attending regular visits at the H.H. Access Clinic and no longer use emergency services to meet their basic health care needs, they are transitioned to a more traditional primary care clinic and provider. 

By providing integrated care that transitions clients from using emergency services to standard services, the H.H. Access Clinic improves health care and reduces costs.  For patients and providers alike, that’s almost as good as winning the lottery. 

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RISE client spotlight


A movie audience would love Peter R.  They would see him not as an ultra-handsome leading actor like George Clooney, but as one of their own.  They would see him as an everyday man like a brother, cousin, or friend who was beat up by his own doing.  They would see him as a person who leaned into that defeat and stood back up.  They would love his comeback story.

Peter wears an Orange County Choppers hat while he speaks about his life.  He pauses often, and looks at his hands.  He names his favorite movies—The Usual Suspects, Reservoir Dogs, True Romance—then describes being a boy riding dirt bike in rural Pennsylvania, and being a man riding a 1700 Kawasaki in urban Minnesota. 

He tells how he’s struggled with anxiety and depression, used heroin, lost his job, turned a wife into an ex, and became homeless.

His pain from these experiences is palpable.  It covers him as much as the Lucky Dog t-shirt he wears.  You see it in his eyes.  You see it in his trembling hands.

What’s also apparent about Peter is that he has a belief life can get better.  He has a plan.  He’d once had 10 years of sobriety and knows he can do it again.  A movie audience would see this lack of self-pity and in their hearts they would cheer for him.   

Peter began the process of healing himself over a year ago by entering chemical-dependency treatment.  He started managing his physical and mental health needs at NorthPoint Health and Wellness Center.  While there he received a case manager who referred him to RISE Employment Services.    

RISE Employment Services helps about 3500 people a year who have disabilities or barriers to employment and housing.  For over 40 years RISE has worked to develop partnerships with hundreds of businesses. 

RISE has a specific program dedicated to serving Hennepin Health members called Employment Pays.  They bring clients like Peter into a “progressive, supportive, and collaborative environment that fosters meaningful growth and provides opportunities to live a life filled with purpose.”

Programs such as Employment Pays are an important way to improve healthcare.  According to Modern Healthcare (November, 2015), the Minnesota Health Department reported that clinical care determines only 10 percent of health outcomes while social and economic factors determine as much as 40 percent.

Caitlin and Peter

When Peter came to RISE he was assigned to Caitlin Engen, an employment consultant.  In a movie she’d probably be played as a high-octane taskmaster like Sandra Bullock.  She is not high-octane.  She is patient, tolerant, and knowledgeable. 

At first, Peter was not ready for RISE.  He came for an intake, but was still homeless and new in chemical-dependency treatment.  The pain of losing his job and family was still fresh.  He had to settle his mind and focus on staying sober. Several months later, he came back.

When Peter returned to RISE he and Caitlin revamped his resume, practiced interviewing, searched the internet, and sent out applications.  Within a day they heard something back but it didn’t work out.  The next wait was longer, nearly two months.  Then Panera Bread called and offered Peter a job. 

“Peter is unique,” Caitlin says.  “He knew what he needed to accomplish.  He took charge of himself.” 

Peter now lives in a group home.  He has qualified for a voucher program that will subsidize rent and utilities for his own apartment.  As a part of the program he will receive help with managing and saving his money.     

After two months on the job Peter is thinking about his future.  He wants to become a manager at Panera.  He wants a place for him and his two dogs.  He wants a dependable truck.   

Peter sees himself as a simple guy who focuses on what’s in front of him.  He never went to college but has always held a job.  “I’m hard-working, a good friend most of the time, open-minded, and funny.  I try to do the next right thing.”

A man like that doesn’t need to be the next George Clooney.  A man like that just needs to be the best Peter R. that he can.    

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2015 highlights

Thanks for supporting Hennepin Health in 2015. Here are a few of our accomplishments:

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Quarter 2

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Funded behavioral health and mental health integration at the Hennepin County Mental Health Center

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