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Addressing Social Determinants of Health in Dallas, TX: A Case Study

Across the Northern Texas communities of South Oak Cliff, Garland, Pleasant Grove and West Dallas, one innovative team is making a difference. With the ever-changing reimbursement landscape, more and more clinics are focusing on serving populations with commercial insurance in order to cover costs and maintain a level of profitability. MD Medical Group, however, has taken the opposite approach and is focusing on serving patient populations that are almost exclusively covered by Medicaid, are uninsured or self-pay. In fact, MD Medical Group's payor mix is comprised of approximately 70 percent Medicaid and 18 percent uninsured or self-pay patients. Providing care to patients living in these communities can be a daunting venture, but MD Medical Group seems to have cracked the code. In 2007, MD Medical Group received $1.5 million to invest in technology, staffing and infrastructure to provide care for the region's low-income patient population. Thanks to innovative leadership and a sense of mission, they have been able to accomplish a great deal.

This generous infusion of funding led MD Medical Group to begin testing workflows to enhance care coordination and, ultimately, patient health outcomes. Approximately 73 percent of the patients that MD Medical Group serves are children on Medicaid. Because of this robust pediatric population, the clinic decided to focus on initiatives aimed at improving health outcomes for children. After assessing common areas of need across clinics, MD Medical Group decided to focus on addressing pediatric asthma. Many of MD Medical Group's pediatric patients reside in housing environments with risk factors for allergies and asthma. Living in these environments often results in a higher incidence of asthma, as well as more frequent visits to the emergency department. Further complicating the situation was the fact that the majority of these patients are insured under Medicaid yet less than 40 percent of specialists in Texas accept new Medicaid patients.

All of these factors combined motivated MD Medical Group to take matters into their own hands. They started with assessing their current protocols for treating asthma. This review quickly showed that across physicians, there was an immense amount of variability in treatment protocols. MD Medical Group understood that to be successful they would need to standardize their asthma protocols and treat consistently across their patient population. In addition to standardizing treatment protocols and developing clinical pathways, MD Medical Group also invested in their own technology. The clinic purchased new equipment, such as pulmonary function testing machines and spirometers. They also added an asthma specialist to the care team to conduct one-hour educational sessions for parents and patients. During the session, the asthma specialist would review the child's chart, tests and living conditions, as well as teach parents how to use an inhaler and proactively recognize and avoid asthma attacks. With “Asthma Champions” stationed at multiple clinic locations, the treatment adherence rate went from 29 percent to 60 percent. Word that MD Medical Group was offering this educational resource quickly spread through the community and other parents began calling to join the sessions as well. Not only did adherence rates improve, but a local health plan also took notice. Parkland Hospital Health Plan found patient outcomes for MD Medical Group were significantly better than surrounding providers. Parkland tracked 10 patients over a short period of time and found that since the implementation of MD Medical Group's Asthma Pathway Program, they had realized a cost savings of over $750,000.

No question, MD Medical Group is making a difference in their community. Their innovative approach is not only reducing the cost of care, but also enhancing the quality of life for so many of their patients.

Our websites may be periodically unavailable between 7:00pm CT December 9, 2023 and 1:00am CT December 10, 2023 for regularly scheduled maintenance.
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