Expansion into North St. Louis County is in the works for CareSTL Health. The federally qualified health center (formerly known as Myrtle Hilliard Davis Comprehensive Health Centers) has four locations in the City of St. Louis and began providing healthcare in the county through school-based clinics in Jennings, Riverview Gardens, Hazelwood and Ritenour school districts.
“Our patients have ‘flighted’ to North County,” said Angela Clabon, CEO of CareSTL Health. She estimates one-third of its patient population lives in North County. Expansion, she said, is all part of the health center’s strategic plan.
“As a patient-centered medical home and as a federally qualified health center, our reimbursement is linked to enhancing the healthcare outcomes versus fee-for-service,” she said. “What that means is: we get paid on the health of our community and no longer on how many patients we see. It’s a huge transition, and we are in the midst of it.”
By opening non-school-based locations in North County, CareSTL Health can do something emergency rooms cannot – offer primary health care for North County communities in areas where doctors are in short supply.
“We are working very aggressively to put healthcare services near Christian Hospital,” Clabon said. “And I am well aware that they have a huge amount of uninsured patients that visit their emergency room, and we will be flooded with uninsured patients, because that is who we are. If those patients in those communities are without health care, that means those are the families of the children in the school district that we are responsible for now.”
Christian Hospital Foundation supported the opening of CareSTL Health school-based clinics in the Hazelwood and Riverview Gardens school districts. Clabon said Jennings and Ritenour’s school clinics were opened without funding support.
Clabon said the new clinic near Christian Hospital may open in October.
“And we are also looking to expand near the Bellefontaine area, a little deeper into Spanish Lake, so that the children and the families in Hazelwood have direct access and the children and the families near Riverview have direct access,” Clabon said. “The goal is to be able to access healthcare within a mile.”
The move and the funding are both risky and exciting. Clabon said they have been advised that such a move may not be sustainable in the long run. However, CareSTL Health serves a population that is primarily uninsured and underserved and they are gambling on behalf of those patients’ health.
“If we improve the health of the community, we should increase our reimbursement rates by receiving incentive payments for having a healthy community,” Clabon said.
Clabon said a St. Louis Regional Health Commission report a couple of years ago discussed how underserved North County communities were. It is an issue that she said all federally qualified health centers are looking to address. Currently, Betty Jean Kerr People’s Health Center has a free-standing clinic location on West Florissant and one inside a Schnucks grocery store in Ferguson.
“We’re working our way to what that footprint may look like, and we still may not address the shortage of healthcare providers,” Clabon said. “They are short almost 25 to 35 family practitioners or internists. We can only bring two to three, so it’s a huge thing in the community.”
With hospitals losing funding and uncertainties with the Affordable Care Act and Medicaid, Clabon said it takes a team effort to solve the community’s health needs.
Claybon added that all of the health center CEOs – Dwayne Butler at People’s, Allen Freeman at Affinia, and Robert Massie at Family Care – are all at the table trying to address this issue together.
“They all have their own way of getting there,” she said, “but we all are trying to rise to the cause of helping North County.”