Concierge-Level Care for Underserved Communities: Not a Pipe Dream

Area of Science:

• Healthcare Management
• Health Services Research
• Patient Access to Care

Background:

• St. Thomas Community Health Center (STCHC) serves an urban, underserved population.
• Financial challenges arose due to Louisiana's Medicaid expansion non-adoption in 2010.
• A partnership with the Institute for Healthcare Optimization (IHO) aimed to improve patient throughput.

Purpose of the Study:

• To evaluate a novel care model balancing urgent and routine appointments.
• To assess the impact of meeting patient preferences on appointment outcomes.
• To optimize resource allocation for increased patient throughput.

Main Methods:

• Analysis of 8913 appointments and patient preferences (provider vs. same-day access).
• Categorization of appointment outcomes: occurred, no-show, canceled, rescheduled.
• Calculation of no-show rates for different preference groups.

Main Results:

• Satisfying 80-90% of same-day requests led to a significant decrease in no-shows.
• Patient satisfaction with access to care reached 97%.
• The overall clinic appointment kept rate was 87%.

Conclusions:

• This innovative care model significantly enhances patient access and clinic efficiency.
• Dissemination of these findings could lead to substantial cost savings and improved health outcomes nationally.
• Large-scale educational and implementation initiatives are recommended.