Sarah Bush Lincoln leads the way: "Partners in Health" one year later

[Padraig18]

Author's note: This article will appear in our local newspaper this coming Friday

MATTOON-- February 23rd, 2004 marked the beginning of a new partnership between Sarah Bush Lincoln Health Systems and those people in its service area who lacked health insurance. On that date, Sarah Bush Lincoln inaugurated its innovative 'Partners in Health' program with high hopes, and one year later, those hopes seem to have been justified. The program was the brainchild of Drs. Cornelius Whalen and Brian Young, medical staff members at Sarah Bush.

"As Chief of the Medical Staff, I served as an ex-officio member of the board of trustees; at our meetings, I was absolutely shocked at the financial drain uninsured and under-insured patients were creating on the health system's resources. On the basis of my own experience, I knew that we served many individuals who, because they had no health insurance, waited longer to seek appropriate medical care and were, as a result, far more ill than those who did receive timely medical care. I decided to begin a review of the case histories of those who made up our indigent-care population.

I'd only begun my review when Brian (Dr. Young) heard about what I was doing, and offered to help me; I soon found out that this was his 'pet issue', and his understanding of the problem exceeded my own. I welcomed Brian's help and we began a three month-long study that involved hundreds of hours of our own time and at least that many hours from the medical-records' and finance office staffs. What we discovered was not terribly surprising-- our medically-indigent patients arrived here for treatment far more ill than was the norm for those who had adequate third-party or private financial resources to pay for care.

Brian and I then played a game of medical 'what if', and went back over these same records and assumed that if only half of these patients had been able to receive proper routine medical care, what would the cost of providing that care have been as opposed to what we knew it had been. The results surprised us, because we found that we could, for an average of 8-percent of the cost of writing off the care we did, have likely prevented those patients having been hospitalized at all. With these figures in hand, we approached former SBLHC Administrator and CEO Gene Le Blond with a radical proposal: if the health system could create a program to offer routine care at low or no cost to the medically-indigent, it could improve Sarah Bush's overall financial picture."

After consulting with the health center's board of trustees, Le Blond appointed a committee to study the feasibility of creating a health-care plan such as the one envisioned by Drs. Whalen and Young. All departments involved in the delivery of medical care were involved, as were members of the medical staff, facilities planning board and finance office; what emerged from the committee after six months of work and study was the 'Partners in Health' program. After reviewing the program and making many modifications, the board approved the program in January 2004, and it was officially inaugurated the following February 23rd.

'Partners' offers free or reduced-cost primary and specialty health-care to area residents who have a household income of no more than 200 percent of the federal government's definition of 'poverty level'; a sliding income scale is used to determine how much, if anything, a patient must pay for services and medications. All physician services, including specialties and sub-specialties, laboratory and x-ray services, pharmacy, physical and rehabilitation therapy, nutrition and adult day-care are available to program participants.

One year later, the program has proven to be not only enormously popular, but a savvy financial move. "As a result of this program, our out-of-pocket losses have been cut by over 70 percent," according to Dr. Young. "Many of the patients we used to routinely see in the emergency room who were in pretty rough shape, we now see in our offices while the problem is still manageable without the need for hospitalization. We are also able to take advantage of the benefits of preventative medicine and education, to keep them from becoming so ill. We make sure that our patients know that it's not only OK to call the doctor, it's better to do so than it is to wait and just hope things will get better on their own. Our patients are not afraid to get prompt care, and that helps us all play a part in controlling the cost of health-care delivery."

Dr. Whalen has hopes that other hospitals will look at the 'Partners' program and consider adopting it, or one like it. "It's fairly obvious that for whatever reason, neither the state nor the federal government are going to seriously address the issue of providing medical care to all citizens, and until they do, the system is going stay incredibly expensive and wasteful; that high cost and waste actually compound the problems inherent in our system, so until such time as the government decides to step in and help solve the problem, we who make up the system have to innovate and try and solve it ourselves. Our program isn't perfect, because we still lose money, but I think it clearly demonstrates what good can come from providing a basic level of primary health care to every man, woman and child, regardless of their ability to pay. The old saying is, 'you can pay me now, or you can pay me later, but you're going to pay me either way', and it was never more true about anything than it is about health care."

[Illinois_Dem]

1. I'm one of the people they help.

I'm from Charleston, which is right next to Mattoon. I was laid off from a good wage/good benefits job in 2001 and have basically been under-employed ever since. I don't earn enough to afford private health insurance, yet I make too much to qualify for Medicaid. The Partners program has been a godsend for me and 1000's like me in this area by making quality health care available at a price I can afford.

Thank you for posting this.