Columbia, SC

Like many communities, Columbia is facing serious health-related challenges, including rising costs, growing incidence of chronic disease, and unequal access to healthcare services—particularly in the low-income Eau Claire community, where one in three residents is uninsured. In 2010, local leaders from Eau Claire and across the city forged a coalition to improve health, increase access to care, decrease costs for citizens and providers, and achieve sustainable, long-term improvements.

The coalition, called Healthy Columbia, includes the South Carolina Health Care Association, Blue Cross/Blue Shield, Eau Claire Cooperative Health Centers, the South Carolina Department of Health, Select Health, Palmetto Health, Providence Hospital, the University of South Carolina, local government, and key community and religious organizations.

With hands-on coaching and support from ReThink Health, leaders of Healthy Columbia dedicated months to outreach—identifying, recruiting, and preparing leaders to take collective action. They conducted 130 meetings with individuals, a town hall assembly, and 35 house meetings that involved 750 local residents. At every stage, Healthy Columbia’s leaders engaged increasing numbers of people who were eager to listen to their ideas, and who represented new potential leadership.

Central to the campaign was a community covenant, a joint public commitment among all stakeholders to work together to address their failing health system. This covenant reflects the realization that chronic disease—not people or institutions—is the enemy. It also unites providers, community members, and payers around a commitment to reduce and prevent chronic disease and increase the use of primary care. In signing the Covenant:

  1. Providers pledge to make primary care more accessible by extending doctors’ office hours, improving transportation to health care facilities, and using more volunteer health coaches;
  2. Residents pledge to take better care of their health, and to use primary care services for non-emergency needs; and,
  3. Hospitals and insurers pledge to reinvest savings from decreased emergency room use into the campaign’s efforts at prevention and primary care.

Rethinking the Regional System for Health

Since Healthy Columbia’s launch, more than 4,000 Eau Claire residents have pledged to improve their health, and more than 3,000 have pledged to support their community in improving health. Extended clinic hours have increased healthcare access, and additional screening programs are providing services and referrals to more than 900 people. New teams of health coaches are focusing attention on wellness programs and the importance of primary care supported in part by an Innovations Grant from the Centers for Medicare & Medicaid Services.

Providers and payers have committed to reinvest a share of savings in the community, which will have a voice in how the savings are reinvested. Diverse stakeholder groups have formed new relationships and are creating structures that will assume responsibility for the stewardship and governance of the program and the wise investment of resources. Above all, Healthy Columbia has proven transformational by enabling stakeholders with different perspectives to work together to improve health and care in their community. As a result of the success in Columbia, a new, cross-institutional state innovation center is incorporating ReThink Health’s approach into their work and bringing these tools to communities across the state of South Carolina.

I have done things for people, I have done things to people, but I have never done things with people. This makes all the difference.” –Rick Foster, a physician and member of Healthy Columbia leadership group