“As healthcare organizations scramble to prepare for major changes to the Medicaid program, CommunityHealth CEO Steph Wilding said reaching patients where they live is more important than ever.
As healthcare organizations scramble to prepare for major changes to the Medicaid program, Community Health CEO Steph Wilding said reaching patients where they live is more important than ever.
The Chicago-based, volunteer-based free clinics recently announced its first expansion in response to the looming work requirements and other changes that are expected to cause hundreds of thousands of Illinoisans to lose coverage.
The clinic in the Belmont Cragin neighborhood s a collaboration with organizations like Onward Neighborhood House and IWS Family Health. It will focus on serving Medicaid patients, with a focus on maternal care and community care for adults.
Wilding recently spoke with Health News Illinois about the plans and how it is preparing for an anticipated rise in demand for care once work requirements and other changes occur to the Medicaid program.”
Edited excerpts below:
HNI: What led to the expansion at CommunityHealth?
Steph Wilding: CommunityHealth has actually been anchored inside of Onward House since 2021. This was our first location that we call a microsite, and this microsite was born out of lessons we learned in the first few months of the pandemic. Like everyone else, we saw our patient no-show rates plummet, and we asked ourselves why. We realized that’s because we were going to our patients. We were where they were at. At the same time, we saw firsthand the value of social drivers of health. All of a sudden, our patients who had to miss a shift of work because of the pandemic were far more food insecure that week than they had been the week before. So CommunityHealth had been delivering medications. We had been delivering personal toiletries, and what we learned is how valuable those services are — and how much work those services are. They’re core to the wellness of our patients, but not necessarily mission core for CommunityHealth. So in the summer of 2020, we received a very major contribution from the Health First Collaborative so that we could aim to meet our patients where they’re at, rather than requiring them to come to us. And at the time in Belmont Craigan, over 20 percent of our patients came from that community. And so, in this sprint of vaccine rollout, we opened a microsite, so two exam rooms plus a lab out of Onward House, where our patients could receive care, lab services, as well as pick up their medication. We do have some on-site behavioral health there. So we’ve had this ongoing partnership with Onward House. We have replicated that model with three other organizations now located inside Rincon Family Services in Irving Park, inside of Enlance in Little Village, and also inside of (The Resurrection Project) in Back of the Yards. And as we began to investigate how we could expand our impact with the (Medicaid) changes, we partnered with some consultants who did some really critical geomapping for us to say, ‘where is this population going to be impacted in the city of Chicago?’ Belmont Cragin will be our first foray into that expansion, really taking our micro clinic and making it more like a small community clinic, if you will. But being able to significantly increase access in the Belmont Cragin community.
HNI: Why the push for expansion in these uncertain times?
Steph Wilding: I’ve worked in safety-net healthcare my entire career, and I’ve always hoped that my job would be to put myself out of business. It is always very bittersweet because CommunityHealth is a free clinic that’s designed and built to help uninsured folks. So when we need to expand, it means the system is just broken, and as we know, the HR1 changes are going to take the system even further. CommunityHealth sees it as our responsibility to be there for as many folks as we can for a couple of reasons. Our business model is built to serve these patients, so the more people that we can care for, that helps to support the other safety net providers who are expecting big shifts in their payer mix, but not additional funding to care for the uninsured population. So we really see it as a way to support our safety net. I think the second reason this is important is that we know where folks are going to go: the emergency departments. And particularly for our safety hospital, we want to support them, we want to make sure that we’re serving the patient population and keeping them out of emergency departments. And so the way to describe CommunityHealth is, on the one hand, yes, we’re a key pillar, as are all free clinics. But in many ways, we’re also kind of like the foam, and the more foam spray you put in the cracks and other pillars, the more you support them.
HNI: What demand do you expect at the new location?
Steph Wilding: It will be pretty significant. We’ve already had many stints where we’ve had to close the site because the pace was so high, and I think we can anticipate that that will occur again. I’m sure after January 1, I think that’s one thing, all safety nets have that uncertainty… but CommunityHealth will, in the months leading up to January 1, have the community engagement team on the streets, hitting the pavement, meeting with the community, ensuring that they know what’s coming. Make sure you’re communicating with HFS, and also, if you are ineligible for any reason, or you’ve lost it for any reason, that CommunityHealth is a place for you. It’s free of charge, no sliding scale fee, $0 every time you come to our organization.
HNI: What do you anticipate CommunityHealth’s work looking like post-January 1?
Steph Wilding: So for CommunityHealth, we’ve already been looking at all of our vocations and staffing those up even further. We have a volunteer model, so anyone looking to have an impact in a post-HR1 environment can volunteer; the more the merrier. We had one clinic session that had a lot of impact, so we’ve already been seeing increased demand before January 1. Hundreds of thousands of folks chose not to renew their health plan due to the cost. In October, we’re going to see around 10,000 individuals lose their Medicaid due to their immigration status. So we’ve already been seeing this and preparing for this. We’ve been doing exam room capacity analysis, really understanding: Are we maxing out our capacity? Of course, we’re opening the new care center, which is going to triple our ability to care for that community. And then we’re aiming to increase hours where we can, because being able to deepen our impact and our existing hours of operation will allow us to expand impact without dramatically expanding cost of care.
HNI: Do you see further expansion on the horizon?
Steph Wilding: I believe with the current policy around work requirements and twice-a-year redetermination in place for the Medicaid population that CommunityHealth has really no choice but to continue to expand. We want to expand in a way that maintains our high-quality care and physician experience for our patients, and we know that we need to serve more people again because we want to stay safer. CommunityHealth will continue to do everything we can to expand our so that we can support our safety net siblings.