UMMC and Jackson Medical Mall Unite on Revolutionary Program to Increase Primary Care Access, Alleviate ER Burden
Just in time for the new fiscal year, the University of Mississippi Medical Center (UMMC) and Jackson-Hinds Comprehensive Health Center (JHCHC) will embark on an innovative collaboration to provide better access to primary care medical services to medically underserved Mississippians.
Effective July 1, pending federal approval, JHCHC, a federally qualified health center (FQHC), will take over UMMC’s primary care outpatient clinics at the Jackson Medical Mall Thad Cochran Center (JMM) to serve obstetrics and gynecology, pediatrics and internal medicine patients. Last year, more than 18,000 patients were treated at 14 clinics in the tri-county metropolitan area.
As part of the agreement, UMMC will pay JHCHC $1.8 million annually for five years to support the educational mission of the clinics, and will sublease space for those clinics for a year. UMMC physicians in residency training will continue to see patients at the clinics; operational responsibility for those clinics will shift to JHCHC. A $16 million per year operation, JHCHC employs more than 180 health professionals throughout the tri-county service area.
The pact between UMMC and JHCHC represents one of few collaborations of its kind nationwide involving an academic medical center’s educational and training efforts at an FQHC, said James Keeton, MD, vice chancellor for health affairs at UMMC, and could serve as a model for other states.
As an FQHC, JHCHC-the largest community health center in Mississippi-receives federal operating grants and higher reimbursement rates because of its locale in a designated underserved area and by treating patients regardless of their ability to pay. Instead, patients are charged on a need-based sliding scale.
The operational change will improve access to care, Keeton said, while also reducing demand on emergency rooms in the metro Jackson area. Roughly 17,000 adults visit UMMC’s emergency room annually for treatment that could be provided by a primary care physician.
“Jackson-Hinds and UMMC have been looking for some time for a collaboration that would provide better service to patients who will get a medical home and more timely care,” he said.
In 2008, UMMC collaborated with the Mississippi Primary Health Care Association and the Mississippi State Department of Health to form the Mississippi Healthy Linkages Project, a process that connects patients to one of the state’s 21 FQHCs. That program provided UMMC emergency room patients with contact information for FQHCs in their counties that could serve as their primary care providers.
Even though UMMC’s primary care operations at the mall do not have adequate capacity to manage all patients who need comprehensive primary care, the new paradigm-combining residency training with an FQHC-will provide a unique way to address the shortage of primary care physicians, while also allowing JHCHC to continue building capacity in the growing metro community, said Jasmin Chapman, DDS, CEO of Central Mississippi Civic Improvement Association Inc., also known as JHCHC.
“We started talking about this collaboration three or four years ago, before healthcare reform,” she pointed out. “We were both looking for ways to better serve our patients-to provide a better continuum of care-and it took us a long time to look at how we could do this, and to establish a model.”
Initially, there will be very little noticeable change, said Chapman.
“What will change with patients coming to a community health center instead of an ER is that they’ll receive primary care and also get instructions on preventive care,” she said. “That’s the biggest difference.”
Studies conducted by the Center for Medicare & Medicaid Services (CMS) have shown that for every dollar spent at a community health center, $3 is saved. The Bureau of Primary Health Care recently published research showing that community health centers have a tendency to improve the health disparity in medically underserved areas, said Chapman.
“Community health centers have been found to be very efficient,” she added. “UMMC studied that data, and was interested in pursuing this arrangement to better serve patients.”
UMMC will maintain operation of its ancillary services and specialty care clinics at the JMM, including the Cancer Institute, dialysis clinic and several administrative and educational support offices. Also, within the next fiscal year, UMMC plans to occupy an additional 60,000 square feet of support space.
In June, the Board of Trustees for Mississippi Institutions of Higher Learning approved the plan, which is pending approval from the Health Resources and Services Administration, the primary federal agency responsible for improving access to healthcare services for people who are uninsured, isolated or medically vulnerable.