Making the Best of Free Care

Massachusetts and the health care industry have struggled for many years to provide care for hundreds of thousands of residents without health insurance. During the last two years, the state has spent more than $1.2 billion through the uncompensated care pool and that didn’t even cover the costs hospitals like BWH absorb as many uninsured patients seek care in emergency departments.

Last year, however, Partners HealthCare Community Benefits and BWH secured a grant from the Boston Foundation to attack this dilemma. BWH hired a full-time access coordinator to direct free care patients to primary care sites in the community. In recent years, state policy has called for providing care for free care patients in community health centers rather than acute-care hospital-based offices.

BWH and Partners Community Benefits invested a significant amount of time and resources in establishing this program and securing grant funding for its launch. With this program, BWH and PHS successfully can balance two challenging and somewhat divergent aims. “We’re proud that this program fulfills our mission to provide care for everyone and meets a state policy of providing care for free care patients in our community primary care settings,” Kim Simonian, of Partners Community Benefits, said.

Lisa Whittemore, Primary Care Department Administrator for Brigham and Women’s Physicians Organization, said, “The high demand for this service was evident almost immediately, and this adds value to the relationship between the patient and their care providers and helps us stem the influx of patients coming into the system through the ED.”

BWH appointed Josefina Roques, who had been working as a bi-lingual outreach worker at Brookside Community Health Center, to serve as access coordinator. She is available to work with patients who have free care or MassHealth pending and is not available to assist with other patients.

Since October, Roques has handled more than 500 patient referrals from Outpatient Financial Counseling, Registration, Case Management, Social Work, Emergency Medicine and Teleservices. She directed these patients to primary care providers at 850 Boylston St., Faulkner Hospital, Brookside Community Health Center and Southern Jamaica Plain Health Center, all of which are affiliated with BWH, as well as Dorchester House Community Health Center, South End Community Health Center, Uphams Corner Health Center and Whittier Street Health Center.

“Our goal is to make sure patients get routine primary care in appropriate settings, rather than delay care and use the ED when they become very ill,” Roques said.

In March, Roques helped a patient, who initially came to BWH’s ED with abdominal pains, secure an appointment with a primary care physician. It was at that appointment that this man was able to complete state-required disability paperwork in order to gain a slot in the city’s public housing.

“This is a good example where a patient had a need for primary care and limited time to get specific services to complete disability forms, and he would not have been able to get an appointment without this program,” Roques said.