KANSAS CITY, Kan. — In the old days, when an indigent patient of Dr. Sharon Lee’s low-cost Family Health Care clinic needed specialist care, “We’d call up a buddy and beg,” she said.
Sometimes she is still reduced to beggary.
But Lee said the metrowide adoption of the “Project Access” model over the last four to five years has improved the availability of specialty care to working-poor people in greater Kansas City.
“In some cases, it’s well organized,” Lee said. “In other cases, you call a friend and say ‘Can you help?’ It’s quite variable throughout the state.”
Lee and her fellow safety-net clinic operators were one of the driving forces behind the establishment in 2006 of Wy/Jo Care under the auspices of the Medical Society of Johnson and Wyandotte Counties.
The program pairs the primary care offered in the clinics with the donated specialty services provided by doctors, using a coordinated referral system that benefits those who otherwise might not get the medical attention they need.
Kansas has been a pioneer in these charity efforts dating back to Wichita’s Project Access – the second of its kind in the nation – in 1999. Topeka’s Health Access program followed in 2002.
On the Missouri side, MetroCARE/NorthlandCARE of Greater Kansas City took off in 2007 with the support of the Metropolitan Medical Society of Greater Kansas City and the coalition known as Health Care Access of the Northland. It covers Jackson, Clay and Platte counties.
The programs serve those who make too much money to qualify for Medicaid but not enough to afford private medical insurance.
Qualified patients may be referred to the clearinghouses by safety-net clinicians such as Dr. Lee or by city or county health-department workers. The specialists sign up for as many charity patients as they think they can handle in a given year.
Jill Watson, executive director of the Metropolitan Medical Society, said the basic idea of volunteer doctors treating uninsured patients for free has not changed since the program’s inception, “but we continuously make changes … to improve the patient and physician experiences and program efficiency.”
“MetroCARE is convinced that our model is working because the renewal rate of our volunteer physicians is around 100 percent,” Watson said.
Dr. James S. Appelbaum, a neurologist and past president of the Medical Society of Johnson and Wyandotte Counties, has been a volunteer participant since the inception of Wy/Jo Care.
“I think it’s part of our duty as physicians to take care of everyone, regardless of ability to pay,” he said. “The hope is to reduce the cost of care by treating someone’s gall bladder, for example, before it ruptures and they wind up in the emergency room. That is the logic that convinced all the Kansas hospitals to sign on.”
Thus, not only is the time of specialists like Dr. Appelbaum counted in the total of $14 million worth of care donated since the August 2006 inception of Wy/Jo Care, so are the services of the various participating hospitals.
Wy/Jo Care has helped more than 3,500 patients during its existence.
There are 400 participating physician volunteers, plus more than 70 dentists, on the Kansas side of the KC metro area.
The numbers are similar on the Missouri side. Since its 2007 inception, MetroCARE/NorthlandCARE has served 1,291 patients, making 4,416 referrals. Just under 700 doctors in more than 40 specialties have participated. The value of services they and local hospitals provided is “conservatively” estimated at $7.65 million, Watson said.
“Many patients come to us with pent-up demand for medical care,” noted Watson. “Most patients receive care for more than one physician, which is why the number of referrals is so much higher than the number of patients.”
Of course, even these Project Access systems can’t meet the health-care needs of every uninsured person. There are backlogs in the system.
“We are seeing more patients each year being referred to us,” said Jacque Amspacker, executive director of the Medical Society of Johnson and Wyandotte Counties. “This has caused us to close some specialties from time to time. We hope to hire a recruiter in 2012 that will be able to expand our physician and dental volunteers. “