Dr. Mark Hernandez is the chief medical officer for the Community Care Collaborative. The CCC is described as "a multi-institutional, multi-provider system of health care envisioned to provide a coordinated continuum of services to a defined patient population" for Travis County on its web site, https://communitycarecollaborative.net.

The primary mission of the CCC, Hernandez, said, is to provide integrated delivery health care to uninsured and under-insured Travis County patients.

Dr. Hernandez graduated from the Baylor College of Medicine in 2003 and completed his residency in Internal Medicine at University Medical Center Brackenridge.

In 2011, he was appointed medical director for the UMCB hospitalist group and the hospital ambulatory clinics. Hernandez holds academic appointments with The University of Texas, Southwestern University and UT Medical Branch.

What is integrated delivery?

Integrated delivery is simply taking into account all those other pieces of health care and making sure that to the consumer of health care, the system is seamless. What we don't want is more complexity in an already complex situation. What we want to do is create connections between all the various elements of health care—whether that's transportation, whether that's the facility, whether that's education for the patient—so that they can be empowered and able to care for themselves in a home or work environment.

How does that occur?

There's a lot of stuff happening to make that work but it's all in the background. It's not necessary for consumers to know how much work is happening on the other side of the curtain to make the experience for them seamless. It only matters that it's seamless.

Who are your primary patient groups?

We work inside a particular space, which is the unfunded and underfunded, but the lessons learned and the systems built will work just as well in commercial and Medicare populations. As we gain success with the work we're doing, I expect that that work will begin to bleed over into the commercial sector because those challenges are the same regardless.

How is the Community Care Collaborative funded?

Frankly, we provide that care through organizations that provide charitable dollars and through tax funds. So Central Health (i.e. Travis County Hospital District) taxes all property in Travis County and uses those tax dollars specifically to care for the uninsured and under-insured. Through the Collaborative, those dollars are in a common bucket and we use those dollars to purchase care for the uninsured and under-insured. We know that bucket of money will not grow infinitely; it's not going to grow to whatever the need is. And yet the need is huge—so we had 211,000 uninsured people in Travis County in 2012. About 135,000 of those people were uninsured and living at 200 percent or less of the U.S. poverty level. So there's a lot of need.

How will integrated delivery affect providers? We're beginning to change the way we pay our service providers. Instead of it being about 'How many patients did you see?', it's 'What kind of outcome did you get?' We believe that if you achieve those things—better quality of health care delivered, better experiences by the patients—that's what we care about.