CLINICA ESPERANZA HOPE CLINIC

As a way to achieve our the problems of high chronic disease prevalence among our patients, we initiated the “Bridging the [Health Equity] Gap” (BTG) program. BTG is a chronic disease management program that provides continuity of care and convenient access to non-emergent walk-in care for uninsured Hispanics living on the West and South sides of Providence, RI.

While we continue to provide high-quality culturally-sensitive care to our patients, we also seek to evaluate the clinical and fiscal impact of these services. We hypothesize that engaging uninsured participants in BTG will improve clinical indicators and provide significant cost-savings to the state. We believe that that engaging uninsured participants through a chronic disease management program (BTG) engaging uninsured participants in a chronic disease management program could promote substantial health and financial benefits. A preliminary report of our findings was published in the Rhode Island Medical Journal in November and is available online.

Participation in BTG is open to all uninsured, non-Medicaid-eligible people residing in RI, who are living with pre-diabetes, type 2 diabetes, hypertension, hyperlipidemia, and/or obesity. Participation is voluntary and involves quarterly clinic visits and semi-annual health education classes. Participants sign a partnership form that gives CEHC permission to track progress throughout their healthcare journey, whether they remain at CEHC or gain insurance coverage and transfer care to another clinic. This allows for documentation of the impact of free healthcare on patient wellbeing longitudinally.

Participants are recruited at CEHC and through outreach events in local churches and community centers. After enrollment, participants select between several healthy-lifestyle change programs: the Vida Sana Program (a culturally-sensitive lifestyle change program developed by CEHC), the Diabetes Prevention Program (DPP, CDC ), or 1-on-1 health education visits with Comm. Health Worker.

In RI, prevalence of being uninsured, having no primary care provider, experiencing cost barriers to seeing a doctor, and having had no “checkup” in the past 12 months are highest among Hispanic adults as compared to other racial/ethnic groups. At CEHC, we have tracked and documented healthcare utilization, quality of care, and the impact of our programs on patient well-being over time. We are in the process of publishing a paper, thus we hypothesized that engaging uninsured participants in a chronic disease management program (BTG) could promote health and financial benefits.

We do significantly reduce the cost of care. Assuming that 75% of ED visits are preventable, BTG could prevent 1,851 out of 2,468 visits. This reduction in ED burden would yield an average potential savings to the RI healthcare system of $781,122 annually.

We are a place to be healthy for volunteers, staff and patients. Every night, our bright yellow clinic on the West side of Providence becomes a haven for patients seeking assistance from altruistic healthcare providers.