cchfnews
encouraging, equipping, and engaging Christians to live out the gospel through health care among the poor
SUMMER
2016
Left: Dr. Robert Forester visits with a patient in his office at St. Luke’s
Family Practice in Modesto, CA. Right: Dr. Nicolas Tomsen in front of the
newly opened Antioch Med in Wichita, KS.
2
DIRECT PRIMARY Care and CCHF
Clinics at a Glance
The rise of the direct primary
and patient. The median fee for Direct
care model has not gone unnoticed
Primary Care practices is around $80
within the CCHF community. The past per month, with many practices
few years has seen an uptick of doctors
offering discounted fees for family
interested in this model. Between five
enrollment. As a result of a legislative
and ten new DPC
provision within the
practices who fit
ACA, there are three
within the CCHF
states who have
framework are
included DPC in
currently in
healthcare exchangesvarious stages of
Washington, Nevada,
development and
and Colorado.
early practice.
Washington State has
This matches the
reduced costs and
national trend;
expanded primary
there were
care through an
roughly 4,400
integration of DPC
Above: Dr. Richard Heck of St. Luke’s Family
DPC physicians
and Medicaid
Practice in Modesto, California
in 2012, up from
managed care;
756 in 2010.
however, in most
Direct Primary Care can be
states, direct primary care exists as a
defined as comprehensive primary care health benefit outside of state insurance
and prevention services offered through regulation.
a direct agreement between a doctor
(Article continues on page three.)
Christ Community
Health Coalition
2
South Oklahoma City
3
Direct Primary Care
and CCHF
(continued)
4
Financial Update
clinics
at a
glance
Three hundred
clinics nationwide
are striving to deliver
distinctively
Christian healthcare
to the poor. There’s
almost always two or
three dozen groups
in various stages of
development. Here
are three clinics who
are a valuable part of
our community.
Please offer them
your prayer, counsel
and encouragement.
SHAWNEE CHRISTIAN HEALTH CENTER louisville, ky
INNER CITY HEALTH CENTER denver, co
6,700
sq feet in Shawnee’s expanded
facility, up from 2,800 sq feet.
Plans to increase the number of
staff from 20 to 35 and offer
expanded services. The new
space opened in August 2016.
School based health clinic in
Jefferson County was
established in the spring of
2016.
rochester, ny
1978
Dr. William Morehouse
opened His Branches, one of
the original 4 CCHF clinics.
79%
of Inner City patients are
uninsured. ICHC describes
themselves as a “community
funded safety net clinic”.
1st
HIS BRANCHES HEALTH SERVICES 2
Locations; the second site
opened its doors in 2008.
Last year the clinic began the
planning process to become
an FQHC.
1983
Jan & Bob Williams &
Duane Claussen
established ICHC in one of
the poorest neighborhoods
in Denver.
Contact:
Contact:
Contact:
Phyllis Platt
Kraig Burleson
Bill Morehouse
Christ Community
Health Coalition
About six years ago, seven people
began to plant a church on the
south side of Oklahoma City. The
neighborhood is largely a medically
underserved area, and three of the
7 were healthcare professionals.
Thus, a vision for a medical home
for the uninsured and underinsured
was born in January 2015. The
Above: Chauncey Shillow is involved with CCHC in OKC;
goals are threefold: a medical home here pictured giving a CCHFx talk at Conference 2016. You
can watch his poem, “Can You Help Me?” at cchf.org.
for the neighborhood, health
education & advocacy, and
leadership development of indigenous leaders. Right now these goals are primarily
accomplished through an after-hours pediatric clinic, a monthly adult clinic, and
screenings within apartment complexes and charter schools. Christ Community
Health Coalition is beginning their journey towards establishing a flourishing
health center in the midst of a medically disadvantaged neighborhood. Please pray
for them and offer your support!
Employment
Opportunities
Jobs are frequently
posted on the CCHF
website, and through
social media. Take a
look at some of our
most recent postings.
Pharmacist at Lawndale
Christian Health Center
(Chicago, IL)
Pediatrician or Family
Medicine Doctor at Baptist
Community Health Services
(New Orleans, LA)
Assistant Nurse Manager at
Christ Community Health
(Augusta, GA)
Licensed Vocational Nurse
at Los Angeles Christian
Health Center (Los Angeles,
CA)
DIRECT PRIMARY Care & CCHF (Continued) At a GLANCE
Dr. Nicholas Tomsen, a recent graduate of Via Christi Family Medicine
Residency, recently cut the ribbon on his new practice, Antioch Med in Wichita,
Kansas. Dr. Tomsen and Dr. Alleman co-founded the direct primary care practice
with the intention to use medicine as a means for ministry. This new practice is just
one example of a growing trend within the larger
market. There are currently 7 different CCHF clinics
from Seattle, WA to Madison, WI that utilize the DPC
model. In addition to the traditional subscription-based
“direct access” practices, there are several healthcare
centers- such as St. Luke’s Family Practice in Modesto,
CA- that offer a model where “benefactors” can
subscribe to receive direct access to the physician group,
and in turn, the doctors run a daily free clinic as a result
of the financial support they receive from their paying
patients.
As with any novel model, there is no shortage of
skepticism regarding direct primary care and its
Above: Dr. Nicolas Tomsen with
his youngest child at the Direct
perceived effectiveness in reaching underserved
Care Summit earlier this summer
communities with Christ-centered healthcare. In
multiple interviews with leaders in the CCHF
community, leaders have expressed concerns regarding healthcare access. One
prevalent concern is location, as one of the social determinants of health is access to
transportation. Placement of practice location within economically disadvantaged
neighborhoods eliminates a community barrier to quality healthcare. There are
concerns that, because of subscribers’ wishes, practices would be necessarily located
near more affluent neighborhoods where there may be more opportunity to gain
subscribing patients. Another valid concern is in many states, government legislation
prevents Medicare recipients from concurrently opting-in to Medicare and paying a
subscription fee. While technically these Medicare patients can still become DPC
subscribers, they are not able to submit fees for insurance reimbursement. This
functionally eliminates an entire demographic from this model, a major negative as
we look at the effectiveness of the DPC model to serve the underserved.
Direct Primary Care practitioners are overwhelmingly positive, and even
evangelical about the model. They believe that they improve patient outcomes &
reduce costs by eliminating third parties. Dr. Farr Curlin of Duke University
describes DPC as a “compelling model for people who want to practice good
medicine and cultivate mutually respectful relationship with patients, where patients
are invested in their own healthcare”. Indeed, the patient investment within the
DPC model can be perceived a positive aspect, as patients who invest financially in
their own healthcare may be more likely to trend towards proactivity and
compliance. In addition, a crucial long-term challenge for the safety net is recruiting
and maintaining physicians. The DPC model could be helpful in reducing physician
burn-out by eliminating the bureaucracy of the third-party payer.
The Direct Primary Care model has been rapidly expanding in the past few
years. We need to seriously consider any model which allows the Kingdom of God
to advance through healthcare within marginalized communities. As the CCHF
community encounters this growing type of model, please offer them your prayers
and support. After all, communities are made of diverse people, and the importance
of the mission far exceeds any one particular model.
Would you like to share your questions or experiences? Send us your comments!
Other pros and cons of
Direct Primary Care
PROS:
Excellent outcomes at
reduced cost, including
labs & medication
Providers not tied-down with
government & insurance
bureaucracy; cut free from
meaningful use & QI metrics.
More time for extensive
spiritual care & relationship, as
providers need not see prolific
numbers of patients daily.
CONS:
Excludes patients with
government insurance.
Smaller patient panel per
healthcare provider, which some
argue takes doctors “out of the
system” at a time of critical
shortage.
There’s not much precedence
that the model can offer
scalable, sustainable
healthcare to the underserved
Core Values
-Supremacy of Christ
-Prophetic Voice
-Holistic Care
31%
34%
16%
-Justice
-Reconciliation
-Partnership
You are part of a movement of God’s people who, like the Good
Samaritan, bind up the wounds of our poorest neighbors. We are an
extension of you and the CCHF community, providing support and
collective efforts so that this movement can stay strong and continue
to grow. It is individual contributions – contributions of ideas, of
prayer, of efforts, and of finance - that enable us to serve you and this
community. We are grateful, and invite you to help us grow with this
growing movement.
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