Partnership offers ‘best of both worlds’ to community health patients, residents
By Bruce Coleman
It may be one of the biggest “Win-Win” relationships in residency training programs today.
And health-care institutions across the country are beginning to take notice.
A dynamic collaboration between the University of Mississippi Medical Center and the Jackson-Hinds Comprehensive Health Center (JHCHC) has rejuvenated the community health clinics at the Jackson Medical Mall Thad Cochran Center.
In just two short years, the partnership has streamlined the patient-care experience for uninsured and underserved populations in the Metro Jackson area while transforming the clinics’ fundamental approach to resident education.
Seeded by an initial $1.85 million community benefit grant from the Medical Center to offset the cost of providing care to the uninsured that is renegotiated annually, the partnership provides for JHCHC administration of internal medicine, pediatric and ob-gyn clinics at the medical mall.
The clinics are staffed by UMMC faculty who have full-time or part-time appointments with a federally qualified health center (FQHC) and JHCHC practitioners who have earned the credentials to provide residency training.
According to Dr. James Keeton, vice chancellor for health affairs, the partnership is a health-care model that is redefining community health residency training in Mississippi.
“This is a true collaboration between the state’s largest federally qualified health care center and its only academic medical center, which is unique in the country,” Keeton said. “This effort matches our missions of providing care to the underserved and addressing the state’s health disparities.
“This collaboration is the essence of what we ought to be about as an academic medical center: helping people.”
Dr. Jasmine Chapman, CEO of the JHCHC, agrees.
“With this collaboration, the residents get the opportunity to receive real-life experiences in working in a community health center where we deliver primary care to vulnerable communities who often rely on us as their only source of care,” Chapman said. “Once the residents graduate, hopefully their experiences will give them the desire to work in a community health center where they can continue providing quality medical services to the underserved, uninsured and the poor.”
The agreement is an outgrowth of the Medical Center’s Healthy Linkages Initiative, a collaboration of the Medical Center, the Mississippi State Department of Health and Mississippi’s 21 FQHCs, to improve communication and provide better access to primary and specialty care for the state’s most vulnerable citizens.
Dr. Claude D. Brunson, professor of anesthesiology and senior advisor to the vice chancellor for external affairs, said the partnership allows residents to observe how a “real world” clinic can provide efficient care for patients.
“Because Jackson-Hinds runs it as a community-based clinic with a teaching limb to it, you get the best of both worlds,” Brunson said. “It allows our residents to . . . talk with the doctors about dealing with problems that come up in group practice in primary care. They also see that being a community health practitioner is not necessarily a bad life.
“Specialists may get all the glory, but these residents get to see doctors doing things that are valuable to the community.”
While the total number of patients being seen at the medical mall has increased approximately 30 percent since the partnership began in 2010, the clinics run so effectively that patients are offered same-day appointments if requested. That’s a far cry from the three- to six-month waiting period that used to be the norm for the clinics.
And the initial $1.85 million community benefit grant the Medical Center provided the JHCHC has decreased by $100,000 going into the partnership’s third year.
Brunson said the better the JHCHC does financially, the lower the community benefit grant will be.
“Immediately when we signed the grant, we saved $450,000,” he said. The Medical Center had absorbed an annual $2.2 million loss on average while running the clinics on its own. “As we go forward, the amount the Medical Center will provide to support the partnership each year should decrease as the clinics become more payer-performing than in the past.”
The collaboration carries additional benefits to the Medical Center. For example, all of the pregnant patients receiving care at the Jackson Medical Mall clinics will deliver their babies in the Winfred L. Wiser Hospital for Women and Infants at UMMC.
“That has taken the pressure off our OB program to keep up the number of patients so our residents will get an adequate number of deliveries for their training,” Brunson said.
Dr. Nadine Zekam, affiliate faculty in ob-gyn, has a joint appointment at the JHCHC with admitting privileges at UMMC. “Her presence has increased our deliveries greatly,” Brunson said.
According to Michael Jones, director of Healthy Linkages, the partnership has provided an avenue for improved communication between the JHCHC and UMMC – a primary aim of the Healthy Linkages Initiative.
“Uninsured patients who are financially screened at Jackson-Hinds don’t have to go through the process twice when referred to UMMC from Jackson-Hinds for specialty care,” Jones said. “There’s no more calling around to get patient records, because all of the Jackson-Hinds staff that see patients are now affiliate staff of the Medical Center. That’s never happened before.”
The UMMC-JHCHC partnership has been so successful that it has drawn inquiries from health-care institutions around the country.
Information about the collaboration was included in an article Brunson wrote that was recently published on the Agency for Healthcare Research and Quality’s Innovations Exchange website. Keeton made a presentation on the partnership to a meeting of the Association of American Medical Colleges representatives in Washington, D.C. And just last month, site visitors from the AAMC spoke highly of the clinics during a trip to the Medical Center.