Referral for Health Care and Supportive Services
HRSA Service Definition
Description:
Referral for Health Care and Support Services directs a client to needed core medical or support services in person or through telephone, written, or other type of communication. This service may include referrals to assist eligible clients to obtain access to other public and private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer’s Patient Assistance Programs, and other state or local health care and supportive services, or health insurance Marketplace plans).
Program Guidance:
Referrals for Health Care and Support Services provided by outpatient/ambulatory health care providers should be reported under the Outpatient/Ambulatory Health Services category.
Referrals for health care and support services provided by case managers (medical and non-medical) should be reported in the appropriate case management service category (i.e., Medical Case Management or Non-Medical Case Management).
Number of Clients Served, Units Provided, Expenditures, Cost per Client and 3 Year averaged Cost per Client (based on actual expenditures)
| Year | 2016 | 2017 | 2018 | 2019 | 2020* | 2021* | 2022* |
|---|---|---|---|---|---|---|---|
| Referral for Health Care Clients | 2,265 | 2,208 | 2,207 | 2,074 | 1,236 | 1,238 | 1,373 |
| Referral for Health Care Units (hotline call) | 2,265 | 2,208 | 4,684 | 2,293 | 1,493 | 1,642 | 2,291 |
| Referral for Health Care Dollars | $356,077 | $492,713 | $437,238 | $499,149 | $547,240 | $508,905 | $505,335 |
| Referral for Health Care Allocation | $520,329 | $512,425 | $544,325 | $612,108 | $623,346 | $633,201 | |
| Over/ Underspending | $27,616 under | $75,187 under | $45,520 under | $64,868 under | $114,441 under | $127,866 under | |
| Referral for Health Care Clients | 392 | 382 | 73 | ||||
| Referral for Health Care Units (digital ¼ hour*) | 3,576 | 3,767 | 802 | ||||
| Referral for Health Care Dollars | $133,132 | $82,290 | $80,970 | $45,520 | |||
| Referral for Health Care Allocation | $82,241 | $81,039 | $81,202 | ||||
| Over/ Underspending | $49 over | $69 under | $35,682 under |
*The client and service units were not broken out.
Funding by Part, and info on any other payers
| Total Part A Funds (Formula + Supp.) | MAI | Total Part B Funds (Formula + Supp. NJ) | Total Part B Funds (Formula + Supp. PA) | Total Part C EIS Funds (State & Local) | Total Part D Funds (State & Local) | Total Part F Funds | |
|---|---|---|---|---|---|---|---|
| Last Year Allocation | $633,201 | ||||||
| Current Allocation | $639,879 |
Consumer survey info 2017 n=392
| n | Used in the last 12 months | Needed but did not get (last 12 months) | |
|---|---|---|---|
| Referral for Health Care and Support Services | 139 | 89.2% | 10.8% |
Unmet need
For the purposes of this document, need is based on the response of a consumer when asked if there was a service they needed. MMP interviews patients in care and asks consumers if they need a service and if they receive it. Client services unit data identifies needs at the time of initial intake.
| 2015-18 MMP Percent with a Need (uninsured) | 2021 Client Services Unit Need at Intake | |
|---|---|---|
| Referral for Health Care and Support Services | - | - |
Recipient Service Considerations
Health Care and Support Services
This service includes a confidential helpline and computer lab with digital health literacy classes focused on entitlements and benefits information. Client Services Unit Medical Case Management intakes are also included in this service category.
The number of clients utilizing these services increased by 135 (10.9%) since the previous year, and 649 (39.5%) more encounters and quarter hours were provided. However, expenditures declined by 0.7%.