Health leaders team up to tackle access to care

About one of every eight Missourians lacked health insurance in 2007 and 2008, according to the U.S. Census Bureau.

Faced with that daunting figure - which could grow amid economic pressures and high unemployment rates - local health leaders are working to expand affordable access to medical care.

Without access to care, patients with nonacute conditions often seek help through local emergency rooms, but there are some affordable options to traditional care gaining ground in the Ozarks, including walk-in clinics.

"They are a very good option for patients instead of the ER," said Brian Casey, office manager and spokesman for Springfield-based Family Medical Walk-In Clinics.

And it's not just the uninsured who are looking for better access to affordable care.

Health insurance premiums for American families with employer-sponsored health plans rose 5.5 percent to $13,375 in 2009, according to the White House Forum on Health Reform Report.

As insurance costs rise, many employers are switching to plans with higher deductibles, which leaves employees responsible for more out-of-pocket costs.

"With these increased costs, many patients seek an alternative for urgent care," Casey said.

Creating access to care

Family Medical Walk-In Clinics introduced its Affordable Care Solutions program three years ago at its five clinics. For a $50 monthly fee, program members have access to $30 office visits for urgent care, primary care and non-operative orthopedic services.

That $30 fee covers most on-site clinical tests and treatments, including X-rays, intravenous fluids and sutures, and in-house lab tests, such as rapid strep testing and urinalysis, as well as other medical services.

"For three years, we have not changed our program. It's still $50 a month for membership," Casey said. This consistency has enticed more than 800 people to sign up for the program, including patients with chronic medical needs who need regular attention from a doctor.

Springfield-based CoxHealth has branched out into the retail setting, opening four southwest Missouri locations of The Clinic at Walmart.

Prices at the clinics start at $25 for a basic physical and $50 for treatment of common illnesses. The clinics accept CoxHealth network-affiliated insurance, as well as Medicare, Medicaid, cash, checks and credit or debit cards.

CoxHealth's clinics at Walmart have been so well-received that the health system is planning a fifth location in Branson, said Tom Luthy, administrative director of CoxHealth Regional Services clinics.

So far, each clinic averages about two patients per hour, Luthy said, with patients seeking basic services such as checkups, immunizations, screenings and treatment of minor injuries for patients at least 18 months old.

"Some of them are CoxHealth patients and some are people who choose to pay cash because it's convenient," he said.

St. John's did not return calls seeking comment for this story, but other affordable access options in southwest Missouri include the Jordan Valley Community Health Center, which accepts public and private insurance and has sliding-scale fees for self-pay patients, and a medical clinic run by The Kitchen Inc. that provides care for low-income families.

In July, Jordan Valley moved from West Kearney Street to a new $8.2 million building at 440 E. Tampa Street. The move allowed the clinic to expand its services for women. Clinic officials said at the ribbon cutting that Jordan Valley Community Health Center has served more than 35,000 southwest Missouri residents, including 11,550 children, in the last three years.

In 2008, more than 8,400 patients were treated through The Kitchen Inc.'s medical clinic, which also filled 47,239 prescriptions last year, according to past Springfield Business Journal coverage.

Still unmet needs

Even with the advent of programs such as Family Medical Walk-In Clinics' Affordable Care Solutions and the fee-based Walmart clinics, there are people who cannot get the care they need.

The Kitchen CEO Rorie Orgeron told Springfield Business Journal this summer that the clinic is turning away about 220 people a month because it doesn't have the means to provide services.

"That number doesn't include the people who come by and see how crowded it is in the waiting room and drive off," he said.

In July, health care leaders formed the Springfield-Greene County Regional Health Commission to explore long-term help for the medically underserved, but Executive Director Carmen Parker Bradshaw said in a press conference that it will take about two years to assess the situation before coming up with concrete solutions.

The commission is operating with an annual budget of $327,000 for two years, getting funding from local partner agencies and a matching grant from the Missouri Foundation for Health.

"This organization is not a direct service delivery agent or a conduit for health care services; rather, it is a clearinghouse that will assess, evaluate and implement agreed- upon collaborative health care efforts in southwest Missouri," said commission chairman Kevin Gipson, director of health with the Springfield-Greene County Health Department, in a news release.

With the uncertainty of what lies ahead for health care-in terms of reform talks and what will be provided and paid for- CoxHealth's Luthy said the clinic model shows great growth potential for providing affordable access to care.

In fact, Luthy said Walmart has asked CoxHealth to consult with two dozen other health care systems around the country to share the knowledge they have gained.

"I don't want to say, 'Count the number of Walmarts,' but there is certainly a lot of opportunity," Luthy said.[[In-content Ad]]