Basic screening, diagnosis and treatment remain the building blocks of providing health care for those in need, and Cape Cod for some years has taken a huge leap in that direction through its partnership with community health centers from the Canal to Race Point and Martha’s Vineyard.
But what happens when those who lack adequate insurance require often expensive specialty care?
From a fledgling start two years ago, that problem is being addressed by a group of dedicated physicians known as the Specialty Network for the Uninsured (SNU).
Following a year of planning-with encouragement from Doctors Arthur Bickford and Bernard Maney-SNU began operations in April 2005 with three physicians on its rolls: Doctors Garrett Gillespie, John White and Stephen Mucci. Dr. Gillespie, a neurologist, and Dr. White, a surgeon, were both retired from active practice; Dr. Mucci is a practicing otolaryngologist.
These pioneers quickly were joined by a host of colleagues. As of this writing, the growing roster includes 56 specialists in 17 different categories.
The specialists see patients at any of the five clinics for free or in their offices for what Program Coordinator Milene Chioatto describes as “a very low fee.” Interpreter service is provided where necessary and treatment is available to those who may not qualify for MassHealth because of their immigration status. The eight cardiologists rotate to provide continuing coverage.
Ms. Chioatto is assisted by Gail Melix in first screening patients to see if they have no other insurance and therefore qualify for free or low-cost care and then to refer them to the appropriate specialist. This process also assures a balanced case load among participating physicians.
The specialists who see patients in their own offices tell SNU in advance what they will charge as a reduced fee and how many patients they will be able to see in a given month. The community centers also have formal understandings with SNU and will call the network as to where to send patients who are referred by their primary care physicians to undergo specialty treatment.
This pre-screening for financial and medical need, case load limits set by the physicians themselves and the fact that office fees must be paid at time of service are among the advantages cited for doctors to volunteer.
In its first year, SNU accepted 72 referrals. In the first five months of their second year through February, they had seen 182 more.
In addition to the critical support of the specialist physicians, the SNU partnership includes the Cape Cod Free Clinic and Community Health Center in Falmouth and Mashpee, Duffy Health Center in Hyannis, Island Health Care in Edgartown, Mid-Upper Cape Community Health Center in Hyannis, and Outer Cape Health Services in Provincetown and Wellfleet.
The Cape and Island Integrated Network collaborates with Cape Cod Healthcare, the Vineyard Health Care Access Program and the Community Health Centers in developing this service. Funding has come from the Cape Cod Healthcare Community Benefits Program and the VNA of Cape Cod provides the interpreters.
Ms. Chioatto may be contacted at 508-778-0300, extension 124, for further information.
As Dr. Bickford writes in his recruiting letter to potential specialist volunteers, “SNU’s mission is to reduce health care disparities of low-income, uninsured patients in a way that will benefit both clients and specialists.”