Grand Junction clinic may be model for wider approach

Patterning public-option health insurance to provide health care on par with what is offered at Grand Junction’s Marillac Clinic would require a complete reordering of the way health-care providers are reimbursed.

That’s because Marillac, which treats the uninsured in Mesa County, approaches patient care differently than the traditional medical model. Marillac tries to ensure health over insuring procedures, said Steve Hurd, executive director of the clinic.

Not only does the clinic render traditional medical services, it also has its staff look for things that can reassure their patients, thus making them more helpful.

Marillac staff might help ease patients’ minds by helping them find help paying utility bills, Hurd said. Helping them beat the stress associated with such issues can result in better health, he said.

“There’s no CPT for that,” Hurd said, referring to the acronym for Current Procedural Terminology, the system by which health-care providers are reimbursed for services by government programs such as Medicare and Medicaid and by insurance carriers. “But it’s a valuable health service.”

Patterning health-care change around Marillac would go deeper than that, Hurd said.

Marillac, because it receives no federal funds, has the freedom to handle its budget as it sees fit. So, it can provide medical, mental-heath, optical, dental and other care in a sort of one-stop health-care approach, Hurd said.

Mesa County has about 23,000 uninsured residents, and Marillac in 2008 had 7,650 “unduplicated patients,” Hurd said.

There is no accounting technique to say, however, how many services were rendered to each of those patients. They might have seen just a physician, or could have seen a physician and a dentist and received an eye exam, all in the same appointment.

The idea is to make the patient well, not pile up codes for reimbursement, Hurd said.

“We’re free to do what we need to do,” he said.

The traditional system pays for volume, and “effort is reimbursed, rather than what is effective,” he said.

Patients seem to like Marillac’s approach, said Dr. Amy Davis, the hospital’s medical director. She has been at Marillac for three years.

“For most people, it’s a difficult system to navigate,” even under the best of circumstances, Davis said of the health-care system.

Marillac coordinates services, even those not generally associated with health care, she said.

‘“We’re not the stereotypical idea of a clinic,” Davis said.


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