Health & Medicine

UK program saves sick Kentucky residents thousands in hospital bills. Here’s how.

A University of Kentucky program to help chronically ill Eastern Kentucky residents manage their health has reduced hospital visits for participants by double digits and saved them thousands of dollars in health care costs, according to a new study.

Roughly 2,000 residents across 30 Eastern Kentucky counties who live with chronic diseases and health issues, including asthma, diabetes, hypertension, depression and obesity, participated in the pilot program, which was a collaboration between Kentucky Homeplace — a program under the umbrella of UK’s Center of Excellence in Rural Health — and WellCare Kentucky.

Kentuckians, particularly those in the Appalachian region, have historically struggled with high rates of chronic diseases, many of which stem from an increasing prevalence of obesity among residents. Disproportionately high rates of illness means more hospital visits and higher rates of medical debt.

In Eastern Kentucky, roughly 35 percent of residents owe an average of $850 in medical debt. Some counties have more residents who owe on medical bills than who don’t, according to the Urban Institute.

The goal of the two-year endeavor, which began in 2016, was to connect participants — most of whom were women around the age of 59 — with the tools to best manage their diseases independently, without necessarily visiting a hospital, said Dr. Fran Feltner, the health director at the UK Center in Hazard.

That happened by providing them with six-week health coaching classes, where they learned about best practices for eating healthy, medication use, preserving mental health, and tips for communicating with doctors.

Every participant was also given a $10 gas card each week to help them get to and from each meeting, as adequate transportation often prevents many from accessing health services, Feltner said.

Researchers then followed them for a year. They found that each person saved an estimated $2,300 in health care because they didn’t have to visit hospitals as often, according to data presented for the first time on Thursday. Emergency room visits for people with diabetes, for example, dropped 16 percent and hospital admissions were reduced by 29 percent, saving that population more than $3,400, each.

Those with asthma and diabetes visited the ER 22 percent less than they did the previous year, and asthmatic participants saved about $2,300 in hospital costs.

To Feltner, these findings illustrate two crucial points: “When people have direct education and support from a trusted health care provider, they can better manage their chronic conditions.”

Secondly, “sometimes all it takes to make sure a patient makes it to an appointment is a tank of gas. When we remove barriers like transportation, suddenly health care is more accessible,” she said.

Kentucky Homeplace and its community partners will continue the program for at least another year, as WellCare has agreed to fund transportation costs for a second batch of roughly 2,000 participants to attend classes, she said.

From there, it’ll be incumbent on the center to continue providing health literacy in a region with little to no public transportation.

Long term, Feltner said, “Until we figure out this transportation issue, we have to find another way to reach them.”

Alex Acquisto covers health and social services for the Lexington Herald-Leader and She joined the newspaper in June 2019 as a corps member with Report for America, a national service program made possible in Kentucky with support from the Blue Grass Community Foundation. She’s from Owensboro, Ky., and previously worked at the Bangor Daily News and other newspapers in Maine.