Colds, small cuts and other minor ailments often call for a trip to the family doctor, but for thousands of Atlantans without insurance, it can mean a visit to the emergency room -- one of the most costly settings for care.
Some 20,000 or more of the 100,000 patients that flood Grady Memorial Hospital’s ER each year come for problems that could be treated by primary care physicians in a local clinic that offers low-cost or free care. Some people come out of habit; others don’t know how to access community resources, Grady spokesman Matt Gove said.
While doctors will see them, emergencies take priority, so they may sometimes have to wait 10 or 12 hours, Gove said.
Starting Monday, those patients will have a new option when the downtown hospital opens its $1 million walk-in clinic down the street.
People who enter Grady’s ER will be screened, and if their problem isn’t an emergency they will be given the choice of going to the walk-in clinic -- where care is less expensive and waits are shorter. Once a patient is seen, workers called navigators will connect them with one of Grady’s neighborhood clinics or other community health care providers.
The goal is for those providers to become a primary care home where people can get more consistent care and help with managing chronic illnesses, Gove said.
“It’s not simply about what Grady needs,” he said. “It’s also about what the patients need. This is going to ultimately keep them healthier.”
Grady will be looking at how effective those efforts are in keeping people from having to return to the ER or walk-in clinic, said Denise Williams, executive vice president of operations. If the program is successful, it could save Grady and the community millions of dollars, Williams said.
“It will free the emergency room, cutting down on wait times -- making it a more efficient system all the way around,” she said.
Hospitals across Georgia and the nation are struggling to unclog ERs that have become increasingly overcrowded as people lost their jobs and insurance coverage in the recession. Some are opening urgent care clinics. Others are raising ER co-pays to encourage people to consider cheaper alternatives, such as urgent care or retail clinics, when possible.
It’s a huge driver of health care costs, said Kevin Bloye with the Georgia Hospital Association. The cost of indigent care is rising, and hospitals shift those costs to insured people who can pay, Bloye said.
As part of the walk-in clinic project, Grady will increase its ER co-pay to $150, up from between $50 and $75. Meanwhile, the walk-in clinic will cost $50 per visit.
The clinic will be staffed mostly by midlevel providers, such as nurse practitioners and physician assistants, who will be overseen by a doctor. It could see upward of 50 patients a day, Williams said.
People who have gone years without insurance know they have to be treated if they walk into the ER, so educating them on the benefits of a medical home will be key, said Tom Andrews, president of St. Joseph’s Mercy Care Services, one of the providers working with Grady.
Through a program started last year, Grady ER patients can be referred to Mercy Care and it sends people to the hospital for specialty services. Mercy Care has received more than 320 medical referrals and 480-plus dental referrals since November -- a trend that will likely keep growing, Andrews said.
“It’s trying to change the mind-set," he said, "that the only place I have to go is the emergency room.”
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