Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


A New Vision for Safety Net Care


 
James, E.K. Hildreth, PhD, MD

Indigent Care Stakeholders Look to Leave No One Behind

Last month, the Indigent Care Stakeholder Work Team, formed by Meharry Medical College President and CEO James, E.K. Hildreth, PhD, MD, unveiled their vision for a revamped safety net healthcare system that leaves no one behind.

Members of the work team included representatives of Nashville General Hospital, private hospital systems, area health clinics, city government and local churches. The recommendations in the report (click here for full report) were the culmination of 14 months of studying indigent care models in other cities and conferring with area providers who serve the underserved.

"Unfortunately, although we've made a lot of progress in healthcare and medicine, the progress has not benefitted all populations equally," Hildreth said of the impetus to form the team. "Social determinants of health have a lot to do with that," he continued, adding many researchers and public health officials now recognize a person's zip code matters as much or more than their genetic code.

In Nashville, as across the nation, there are zip codes with a shortage of primary care physicians, affordable housing, effective transportation, safe recreational areas and nutritious food ... all of which combine to make it difficult to achieve and maintain health.

"Like many, I've adopted the mantra that health is more than the absence of disease," said Hildreth. "What we really want is to keep people from getting sick or being unhealthy in the first place. That starts with social determinants and delivering care in the appropriate setting."

He continued, "When points of service are not aligned appropriately, it ends up costing much more. What distinguishes the populations are when, where and how conditions are brought to the attention of healthcare providers. When people turn up in the emergency department, it's often very late in an episode."

The work group formed shortly after former Mayor Megan Barry announced the intention to end inpatient care at Nashville General Hospital and turned their focus to the patient at the center of the system. While the decision to end inpatient care at Nashville General was rescinded, the broader focus of care delivered in the right place at the right time remained central to the vision.

"The hospital is a key component of taking care of the vulnerable in the city, but it's just one component," noted Hildreth. In addition to Nashville General, Hildreth was quick to praise the work of Ascension Saint Thomas, HCA and Vanderbilt in caring for the uninsured and underinsured, as well.

To move the needle, however, Hildreth said care had to be conveniently accessible in the community. "We have to deploy and utilize advanced practice providers including nurse practitioners and PAs," he said of delivering lower acuity care. Physicians would still play a critical role in oversight, Hildreth said, but more manpower is required on the primary care front.

Utilizing a collaborative network to deliver integrated, patient-centered care, the plan calls for the development of an indigent care management program called BetterHealth Nashville®, which will coordinate care for patients to ensure services are adequately funded, treatment is tracked and integrated across care settings, and social needs are addressed. Meharry Medical College will manage the program and assign care coordinators to help eligible patients navigate the broader healthcare system.

"When you look at Nashville as a city, I would venture to guess there aren't many cities with the kinds of healthcare resources as we have. The beauty of the proposal is it leverages the strengths we already have in the city," he said, adding the disparate voices and viewpoints at the Indigent Care Stakeholder Work Team table allowed them to come up with a plan that utilizes all those resources.

Churches, faith-based clinics, federally qualified health centers, Metro Public Health, city planners, Nashville General, and the three large hospital systems all have a role to play in addressing social determinants and delivering care to vulnerable populations at the most efficient point of contact, said Hildreth. "We're not asking the hospitals to do any more charity care than they're already doing ... because they do a lot ... and maybe we transfer some of the lower acuity patients to Nashville General Hospital, which would free up their beds," Hildreth added of utilizing the three big hospital systems for specialty services that couldn't easily be accessed in other settings.

"We have to do this in a way that is cost conscious," Hildreth stressed. "If we do this right, the cost of indigent care should go down. The next step," he continued, "is to create an organization to operationalize this plan." By next month, he hopes to begin that process.

While setting up the infrastructure will take time, he has no doubt stakeholders across the continuum will come together to create a system that leaves no one behind. "There are a lot of people in the city who want the same thing - to help those who are vulnerable or without access to care," Hildreth concluded.

More about the Stakeholder Team & Mission

 
Share:

Related Articles:


Recent Articles

Amidst Growing Measles Outbreaks, AMA Urges Public to Get Vaccinated

Reminds physicians to discuss the safety and efficacy of vaccines with patients, as well as educate them on health risks associated with not vaccinating children

Read More

Pivotal Clinical Trial Investigates New Technology for Managing Uncontrolled Hypertension

Read More

The Biggest Threats to Public Health

Noted public health expert Dr. William Schaffner shares insights on three of his top public health threats.

Read More

Covering Kids

A new study finds higher rates of uninsured children in Tennessee and other non-expansion states.

Read More

Severe Asthma Disparities

A recent study found racial disparities in ED usage for severe asthma become statistically insignificant when factoring out socioeconomic elements, paving the way for more emphasis on differences in community than biology.

Read More

Mark Your Calendar for Music City SCALE

The 14th Annual Music City SCALE meeting featuring up to 22 hours of CME for medical practitioners is set for May 9-11 at the Music City Center.

Read More

Public Health Happens in the Community ... Not Just the Clinic

Public health continues to lead the way to eliminate health disparities and create a system that focuses not just on the absence of illness but the promotion of wellbeing.

Read More

Gum Disease and Tooth Loss Associated With Higher Risk of Pancreatic Cancer in African-American Women

Poor oral health was associated with increased risk of pancreatic cancer in African-American women.

Read More

A New Vision for Safety Net Care

After 14 months of study, the Indigent Care Stakeholder Work Team has released their vision for safety net care in Nashville.

Read More

Modern Healthcare & Critical Connections Present Social Determinants of Health Symposium

Read More

Email Print
 
 

 

 


Tags:
Charity Care, Health Disparities, Indigent Care Stakeholders Work Group, James Hildreth, Meharry, Nashville General Hospital, Primary Care, Safety Net, Vulnerable Populations
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: