Providers Address Charitable Care

February 2, 2004
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GRAND RAPIDS — Even doing something for nothing can occur in a more efficient manner.

Using that basic premise, a coalition of hospitals, physicians and osteopaths in Kent County are working to better coordinate the free health care they provide annually to low-income people who can’t pay their medical bills.

Doing so, they argue, can ultimately contribute to containing the escalating costs of health care by keeping people healthier, or by not allowing their condition to become so acute that they end up in the emergency room, ringing up a bill that goes unpaid.

“If we can do this right and get people into the proper situation, we do more with less,” said John Mosley, senior vice president at Spectrum Health, which is among the players working to establish Project Access in Kent County.

“We’re got to use our resources more wisely,” Mosley said.

Established in Buncombe County, N.C., in 1996, Project Access is a model that allows health-care providers to better coordinate, track and divide the charity care that they already provide. The model has been proven effective in 23 communities across the state, organizers say.

Bringing central coordination to charity care relieves physicians and hospitals of the administrative burden, such as the time-consuming process of finding a specialist to which to refer a patient for charity care, and assures the responsibility gets shared equally among participating providers. The goal is to make sure that people who are without health insurance can still see a doctor when they are sick or injured, preventing their condition from becoming more acute and costly.

“It’s a matter of how do you get these patients plugged into the system?” said Jeffrey Stevens, D.O., president of the Kent County Osteopathic Association.

Kent County has an estimated 74,000 residents, or 12.8 percent of the population, that are without health coverage. About 50,000 of them are low-income persons who would qualify for Project Access.

Project Access, which organizers hope to have operating by mid-year, will seek to better coordinate primary and specialty care, lab work, inpatient and outpatient care, low-cost medications, and translation and transportation services for uninsured persons in Kent County.

One of the primary goals of Project Access is to reduce the number of uninsured people going to hospital emergency rooms, steering them instead to a lower-cost visit to a primary-care physician.

At Metropolitan Hospital in Grand Rapids, 8 percent of the total emergency room cases in the 2003 fiscal year involved patients without health coverage. Saint Mary’s Mercy Medical Center reports an uninsured ER caseload of 17 percent.

The charity care now delivered in Kent County is done in a “fairly fragmented approach,” said Bruce Springer, M.D., president of the Kent County Medical Society and a staff physician at Spectrum Health’s Blodgett Campus. Bringing better coordination can help to keep uninsured persons healthier by having their condition treated before it becomes chronic, he said.

“We’re going to be able to get to people who are falling through the cracks,” Springer said.

Involved in Project Access in Kent County are Spectrum Health, Metropolitan Hospital, Saint Mary’s Mercy Medical Center, the Kent County Medical Society, Kent County Osteopathic Association, Cherry Street Health Services, Kent Health Plan, the Grand Rapids Medical and Educational Research Center and the Heart of West Michigan United Way.

In neighboring Muskegon County, the Muskegon Community Health Project is working to set up Project Access locally.           

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