Alliance Medical Ministry – Saturday and Acute Care Clinics

Location:
Raleigh

Area of Impact:
Wake County

Project Description:
Making More Time for their Patients

There aren’t many places outside the hospital Emergency Department (ED) where the working poor in Raleigh can receive care in the evenings or on the weekend – one place is Alliance Medical Ministry (AMM). Since early 2007, AMM has offered clinic hours on Saturdays, and starting in 2009, an acute care clinic in the evenings – for many, those hours make all the difference.

Established in 2003, AMM provides care through approximately 15,000 patient visits a year to Wake County residents – most of whom have household incomes under $25,000 a year – too much to qualify for Medicaid, but often not enough to allow for routine medical care.

“Our patients don’t need a hand out, they need a helping hand,” says Sean Harrison, Executive Director of AMM.

Of course, not everyone can make typical weekday appointments: for hourly workers, missing shifts means not getting paid. Therefore, many skip scheduled visits. For example, one of the clinic’s diabetic patients would miss two out of every three appointments due to work conflicts, limiting his access to essential medication, and increasing his risk of serious health complications. Since the addition of Saturday hours, he made every appointment.

Results: Providing access to a medical home for more of the uninsured population and trimming the cost of care.

Offering 11,000 appointments annually prior to the Saturday Clinic, AMM had maxed out their space during the week but could schedule additional appointments on Saturdays. In the first year of the project, they created 400 new medical homes for uninsured adults.

The acute care clinic is open to patients who are not currently receiving care at AMM. Many of them go on to develop a primary care relationship with the providers there. In the first four months of the project they provided approximately 600 medical visits and established 249 new patients with a medical home at Alliance.

Many uninsured adults visit hospital Emergency Departments (ED) because other providers require payment up-front; the number of visits spikes even higher when other providers aren’t open for business. Approximately 25 percent of new AMM patients come in as the result of a direct referral from local hospital EDs.

In Wake County, the average cost of an ED visit exceeds $1,100 and approximately 60 percent of ED volume is non-urgent. By contrast, the average cost of an AMM primary care appointment is $98 ($10 of which is paid by the patient; the rest is raised by AMM) and an acute care visit, $50, ($25 of which is paid by the patient). The acute and primary care clinics save patients money and have overall lower medical costs. What’s more, established AMM patients make 68 percent fewer visits to the ED once they start receiving care at the clinic. More information can be found at www.alliancemedicalministry.org.

Alliance Medical Ministry was the recipient of a $22,000 Health of Vulnerable Populations grant in 2007 to support the establishment of a Saturday clinic for the uninsured. Most recently, a two-year $200,725 grant supported the establishment of the acute care clinic and enhancement of pharmacy services for patients with chronic conditions.