BOSTON (MainStreet) — Many people who don't have health insurance will wait until a health condition progresses to the point they can't ignore it any longer. Then they usually visit the emergency room, which can't turn anyone away regardless of insurance status, but an uninsured ER visit often is very costly for the hospital and patient.
For the uninsured or underinsured who do not want to be hit with a big bill for an ER visit, treatment at a walk-in clinic could be the cheaper alternative.
A recent study of a free clinic in Providence, R.I., showed it reaped big benefits by saving more than a million dollars in projected health care costs.
Clinica Esperanza/Hope Clinic, also known as the CHEER clinic, was founded by a University of Rhode Island professor in August 2012 and is run by nurses and medical students. The clinic often treats non-urgent health issues such as colds, the flu and urinary tract infections. The clinic holds walk-in hours for uninsured patients every day Monday through Friday. It also offers flu shots and other vaccinations, diabetes support groups and healthy lifestyle and nutrition education programs.
The study surveyed data from 256 patients who solicited CHEER's services during its first five months of operation. For each service a patient got, he or she was accorded a score that represented how much money would be saved on preventive care in the future.
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"When we incorporated the value of preventive services, we found an estimated savings of $1.28 million in future health care costs,'' Dr. Annie De Groot, the clinic's volunteer medical director, a research professor at the University of Rhode Island and director of the Institute for Immunology and Informatics, said in a press release. "From there, we calculated a return on the investment of $34 per $1.''
The study suggests that low-cost and free clinics can play an integral role in limiting unnecessary emergency room visits. In 2010, about 7% of the more than 129 million reported visits to emergency rooms were for non-emergency situations.
"With this alarming increase in ER use and the rising costs of health care, we feel strongly that communities could benefit greatly by providing increased access to non-urgent health services for the uninsured,'' De Groot said in the press release.
According to consumer debt expert and Huffington Post contributor Steve Rhode, community health centers served 20.2 million patients in 2011 alone — with 36% of them uninsured and the vast majority of them living at or below the poverty line.
In 2012, another study published in the Journal of Health Care for the Poor and Underserved on free clinics in Virginia came to a similar conclusion as the CHEER study.
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The study found that those who were uninsured but enrolled at free clinics were significantly less likely to visit an emergency room for care "with lower levels of clinical complexity." Additionally, a policy brief released by the Boston-based Pioneer Institute in October declared that the if the city allowed convenient care clinics to open in Boston it would save $6 billion over the next decade and "steer patients away from costly emergency room visits" by offering a cost-effective alternative for families to access medical care for minor illnesses and conditions.
Writing for Parade in October, contributor Frank Lalli also advised that dependent on the medical issue of the patient, a walk-in clinic could be a wisely affordable alternative not only to the emergency room, but even to one's primary care doctor. Lalli reported that a clinic visit could cost 50% less than a primary care visit and 80% less than an emergency room visit.
At this point, it is unclear how the Affordable Care Act (also known as Obamacare) will affect the rate of emergency room visits for non-emergency issues, though it can be assumed it will probably lower the rate at least somewhat. De Root believes free clinics will unquestionably continue to play a vital role in bridging gaps in access to primary care suffered by lower income individuals.
Though De Root figures that the ACA will dramatically decrease the number of those in Rhode Island who are uninsured (about 120,000), she says that there will likely still be tens of thousands of people in the state that have been "left out in the cold." These people include the approximately 40,000 immigrants who pay taxes and have Tax ID numbers, but won't be eligible for coverage under the ACA.
"So we have our work cut out for us and lots of cost savings to do," De Root said. "Following the CHEER model could result in improved health outcomes for those deeply affected by disparities in the system — and reduce health care spending.''
— By Laura Kiesel