Kaiser Permanente gives $1M to Summit Community Care Clinic, other safety-net clinics | SummitDaily.com

Kaiser Permanente gives $1M to Summit Community Care Clinic, other safety-net clinics

Helen Royal

The Summit Community Care Clinic and three other Colorado community health centers are collaborating with the nonprofit health care provider Kaiser Permanente to improve access to specialty care for underserved patients.

To fund the program, Kaiser has provided $1 million in grants over the next three years to the Care Clinic as well as to Mile High Health Alliance in Denver, the Boulder County Health Improvement Collaborative and the Hopelight Medical Clinic in Longmont. The Care Clinic's share will be almost $300,000. The grants will be used to develop an e-consult and communication system to connect clinics and their patients to Kaiser specialists.

While safety-net clinics provide primary medical care, patients often need to be referred to outside specialists like ophthalmologists, neurologists and cardiologists. However, patients with Medicaid or without insurance may find it almost impossible to see the right specialist.

"Especially in the mountains, it's still very difficult for uninsured and Medicaid patients to get specialty care," said Helen Royal, CEO of the Care Clinic. "The Medicaid reimbursement rate is horrendous, and specialists don't usually accept it. Uninsured people don't usually have the money to pay specialist fees."

Royal recalls the difficulty in finding care for a Care Clinic patient who developed a malignant tumor.

"He had a lot of hoops to jump through to get his cancerous tumor treated," she said. "It was incredibly hard to get someone to care for this patient and save his life."

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Dr. Chris Fellenz is a primary care physician at Kaiser who saw the problem firsthand while working at safety-net clinics for over a decade in Vermont and Colorado. "I struggled to find specialty care access for my patients, especially in Colorado," he said.

To help address the problem, Fellenz started an e-consult program at Kaiser that allows doctors to remotely access patient records and help come up with a diagnosis whenever possible.

"It's an e-mail type of system that allows transmission of lab reports, photos, studies and other information to specialists who can use that information to build a health care plan for patients," Fellenz said.

After conducting a community health needs assessment, Kaiser confirmed the urgent need for such a system. Fellenz helped approve the grant for the pilot program with the four safety-net clinics, and is personally invested in its success. "Helping those patients get that care was a personal mission for myself and other physicians who guided this program," he said.

Aside from allowing the Care Clinic to send information and remotely interact with over 100 specialists at Kaiser, the program allows for patients who need closer consultation to see Kaiser specialists in person and receive better, faster treatment options.

"If specialists deem it necessary to see patients," Fellenz said, "there is a menu of several health conditions that will allow those clinic patients to be seen at Kaiser. Some of the most utilized procedures include cataract surgeries, endoscopies, colonoscopies and other semi-invasive procedures."

Royal said she is hopeful that the program can help tackle critical health care needs in the mountains.

"We hope that this will give our patients with Medicaid and without insurance more access and a smoother referral system," Royal said. "It will help people get treated for conditions that can become more serious or fatal down the road."

As the program is in the early stages, issues such as how to reimburse specialists have yet to be fully mapped out, but Royal hopes that the three-year program will produce solutions that reduce health care costs while not reducing quality of care.

"My hope is that the program helps create systems that are less expensive," Royal said. "Instead of specialty care doctors needing to reduce their fees, we hope to find a way to use technology to make specialty care more efficient and cheaper."

Fellenz said that he hopes the program is successful and leads to positive results that can be adopted elsewhere. "This could be a really successful model for the rest of the state for how to properly treat patients with Medicaid or without insurance," he said.

Royal added that she is grateful to Kaiser for taking a chance with this kind of program. "Thank you to Kaiser for being innovative for this project," she said. "This can really be a system that actually saves lives."