An analysis of access to health care for the underinsured and uninsured in the St. Louis area over the last five years reveals greater provider collaboration and overall improvements, despite challenges due to clinic closures and loss of health insurance coverage.
These are the conclusions of the St. Louis Regional Health Commission’s new report, “Progress Toward Building a Healthier St. Louis.” According to the report, access to primary medical care improved in “regional safety net institutions” by six percent, representing more than 33,000 additional patient visits.
So-called safety net institutions are working collaboratively to get health and dental care to the underinsured and uninsured in the St. Louis region. They include 24 community clinic locations, including Family Care Health Centers, Grace Hill Neighborhood Health Centers, Myrtle Hilliard Davis Comprehensive Health Centers, People’s Health Centers, Community Health-In-Partnership Services, Community Health-In-Partnership Services, Health Care for Kids, La Clinica Health Center, St. Louis ConnectCare, John C. Murphy Health Center, North Central County Health Center and South County Health Center.
A complete listing of the clinics can be found on the “Direct Assistance” page under the “Resources” link at www.stlrhc.org.
Despite the closure of four hospital-based primary care clinics since 2003, the remaining 24 sites report a 14 percent increase in volume – representing 75,000 patient visits. Some of those clinics now offer some evening hours (although fewer sites are offering Saturday hours).
Dental care utilization soared by 40 percent (19,558 visits) since 2002, according to the report. Robert Fruend, chief executive officer of the commission, said rolling primary care sites into federally-funded sites accounts for the increase in dental care.
“ConnectCare affiliated their primary care sites with Grace Hill and Myrtle Davis comprehensive care [that] are part of a federal program, which enabled us to pull down additional federal funds,” Fruend said.
“With those funds we were able to hire an additional eight dentists at the former ConnectCare health centers and reopen dental chairs that have been closed for years. That’s a real benefit of working collaboratively to improve access across the region.”
The report highlighted improvements in access to special and urgent medical care as well, with increases in the number of patients seen for specialty care, shorter wait times for specialty appointments and a greater variety of sub-specialty services offered, such as GI endoscopy, rheumatology, nephrology and endocrinology.
As the commission moves forward, major areas of focus include transforming behavioral health, technology and funding for the health clinics.
“We found a real link between the mental health needs of folks and being able to treat their physical health needs,” Fruend said.
In addition, Fruend said creating an electronic link between the health centers will generate better and faster service by health providers.
“By linking all of our health centers electronically with the emergency rooms in areas of highest need for uninsured and Medicaid patients, we can develop a much more integrated and seamless system of care for those patients,” Fruend said.
For example, emergency room doctors would have access to a patient’s visit history and current medications while allowing their primary care providers to reach out to patients for follow-up care.
Fruend said the commission is also working hard to preserve and enhance financing to all the health centers.
“We still have a chronically under-funded health system in our town, and we need to do a better of job of finding the funding to support our providers in what they do,” he added.
Fruend said for persons in St. Louis or St. Louis County who need to see a doctor and are uninsured or underinsured, the clinics are there to fill the void.
“They should contact one of the local community health centers,” Freund said.
“There is a sliding-fee scale, but no one is turned away because of their inability to pay. Everyone is served regardless of their ability to pay.”