Portico is a program based in St. Paul, MN that works to help low-income uninsured people in two ways.  First, they do outreach into these communities to see who is eligible for publicly funded healthcare coverage and they help them apply.  For those who aren’t eligible they offer a free program that provides primary care.  This component is about the first service, the second service is covered in “Provider Funded Primary Care to the Uninsured: Portico Healthnet II.”

Portico coordinates and conducts outreach efforts in hard-to-reach communities to educate people on available health care programs. Portico’s multilingual, culturally competent Community Health Workers forge relationships with community agencies, churches, schools, public health agencies, workforce centers, and others to reach as many people without health insurance as possible with information about available health care programs.

Portico provides personal assistance with the enrollment and renewal processes for Minnesota Health Care Programs. Working one-to-one with community members who are uninsured, Community Health Workers help people understand and complete the many forms the state requires to apply for programs such as MinnesotaCare, Medical Assistance and General Assistance Medical Care. They also assist families in finding the verification information necessary to complete the forms, making photocopies, supplying postage, and providing translation and interpreter services as needed.

The outreach efforts are funded by a combination of philanthropic grants, government aid, and HMOs who benefit from enrollees.  As the program has matured, the vast majority of the funding has come from this last category.  Portico has become a trusted intermediary in the community and the HMOs have turned to them to provide outreach and marketing.  Portico is a non-profit, but they are fulfilling a role normally played by a marketing department for the HMOs.

Portico expects to enroll 2,500 people in publicly funded healthcare this year in Minnesota.

Business Model: 

HMOs that are paid with public money to give care to low-income individuals grant money to a community group to do outreach in their target community to sign up people for their services.  Government money in the form of entitlements drives this business model.

Assumptions: 

• The community group can sign up enough people to justify the expense to the HMOs. 
• The government will continue to pay for the increased numbers added to their healthcare rolls.

• Optimizing intermediation between patients and providers