Between 70% and 80% of the patients at Emma Jones Family Health Center are Medicaid recipients, yet the Portland, Ore.-based clinic has managed to stay financially viable.
Scott Fields, M.D., Emma Jones' medical director, and Ann O'Connell, its clinical manager, will discuss the clinic's secrets to success at the Medical Group Management Association session "Integrating Medicaid Patients into the Fabric of a Health Practice" Monday, Oct. 5, at 3: 45 p.m.
Emma Jones is one of 11 primary-care clinics run by the Oregon Health Sciences University in Portland, but it is the only one with such a high percentage of Medicaid patients.
The clinic has identified four key issues in serving the Medicaid population.
First, to provide access for this group, the clinic's hours extend into the evenings and into Saturdays and some Monday holidays.
Second, the clinic has a care coordination system it believes decreases inappropriate utilization and increases appropriate use.
"Some patients don't come to see the doctor enough," Fields says. "When they come in, they're too sick for us to manage in an economically viable manner."
A care coordinator follows a patient's file and tracks immunizations and diagnostic and preventive procedures such as Pap smears and mammograms.
"It's expensive because we have to dedicate a person to do this, but we can pay for this one (full-time-equivalent) simply by avoiding one hospitalization," Fields says.
Third, the clinic provides interpreter services for nearly 30% of its patients who don't speak English.
Finally, the clinic has a dedicated staff of doctors, nurses and administrators who enjoy caring for the Medicaid population, Fields said.
"If you don't see this as being fun, it won't be and can be very frustrating," Fields says. "This is a practice that has a commitment to serving the underserved. We're willing to take on the more challenging cases. That has been a commitment that's been there from the very beginning, with our first chairman (in 1971), and continues today."
Meeting patients' needs in those four ways helps the clinic stay afloat financially. Even though Emma Jones receives only $12.75 per Medicaid beneficiary per month for primary care, the clinic has proved that physician practices can serve a large Medicaid population and still survive. From February 1994 through June 1997, Emma Jones spent an average $6.96 per member per month on primary care, excluding overhead costs.
"We're one of the most viable clinics in the system," O'Connell says.
"We've done away with some of the stigma around these patients and proved to the entire system at OHSU that these patients deserve care," O'Connell says. "We can be financially viable and serve patients at the same time."