Addressing Social Determinants of Health in Dallas, TX: A Case Study | Patient Care | AMA STEPS Forward | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

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.

AMA Steps Forward logo

AMA STEPS Forward™ presents actionable, practical toolkits and customizable resources that you can use to successfully implement meaningful and transformative change in your practice or organization. See How it Works

Disclaimer: AMA STEPS Forward™ content is provided for informational purposes only, is believed to be current and accurate at the time of posting, and is not intended as, and should not be construed to be, legal, financial, medical, or consulting advice. Physicians and other users should seek competent legal, financial, medical, and consulting advice. AMA STEPS Forward™ content provides information on commercial products, processes, and services for informational purposes only. The AMA does not endorse or recommend any commercial products, processes, or services and mention of the same in AMA STEPS Forward™ content is not an endorsement or recommendation. The AMA hereby disclaims all express and implied warranties of any kind related to any third-party content or offering. The AMA expressly disclaims all liability for damages of any kind arising out of use, reference to, or reliance on AMA STEPS Forward™ content.

Close
Close
Close

Name Your Search

Save Search
Close
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
Close