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 While the decision to end inpatient care at Nashville General was rescinded, the broader focus of care delivered in the right place at the right time remained central to the vision.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

Alexander Visits Neighborhood Health at East Side in Nashville

VIDEO of United States Senator Lamar Alexander (R-Tenn.) visiting the Neighborhood Health at East Side health center in Nashville, where he learned more about what the center is doing to provide access to health care services in urban, underserved areas of Nashville.

Read More

AMA Grants MycoDART CPT Code For Its Life-Saving Test

MycoDART, Inc., developer of proprietary DNA tests, announced its second patented assay has been granted a CPT code from the American Medical Association.

Read More

Low-level Alcohol Use Increases Miscarriage Risk

Women who consume alcohol during pregnancy -- even in small amounts -- have a 19% greater risk of miscarriage than women who don't use alcohol, according to a new study by Vanderbilt researchers.

Read More

Beating the Odds

Vanderbilt Children's Hospital researchers play key role in groundbreaking study.

Read More

Hot Topics in Healthcare Law

Never a dull moment ... the highly regulated nature of the healthcare industry keeps America's health lawyers hopping.

Read More

Vanderbilt Children's New Program Leaders, Rankings

Monroe Carell Jr. Children's Hospital at Vanderbilt has recently welcomed new leaders to oversee specialty programming and again been recognized nationally in multiple specialties.

Read More

Insuring Kids

Local experts offer insight over ongoing coverage concerns for Tennessee children

Read More

Services for Mom & Baby Expanding at TriStar Centennial

Innovative initiatives at TriStar Centennial designed to keep mom and baby safe, together.

Read More

Another Option to Address Pediatric ADHD

NeuroSigma recently received FDA clearance for the first device to treat pediatric ADHD, offering providers, patients and parents a new alternative to medication.

Read More

Back to School Reminders for Patients & Providers

Back-to-school season is here, and it's a great time to talk to patients and parents about starting off the year with healthy habits

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: