Providing health care to immigrants

Case Study Submitted by: Rebecca A. Bates
Country: United States of America (USA)

Refugee populations in the US are often unable to access health care services because of policies and payment schemes that create barriers to care.  Adams Compassionate Healthcare Network (ACHN) removes many of these barriers.  A free clinic in suburban Virginia, ACHN seeks to provide high-quality, evidence-based health care to any person who is uninsured and lives in poverty. Most of their patients are immigrants and refugees from Muslim-majority countries, living with chronic conditions. They are often uninsured and have had little opportunity to access health care services in their countries of origin. Some individuals have barriers related to transportation which causes them to forgo health care services in deference to obtaining food, housing and jobs.  This leads to missed work time and hospitalisations for uncontrolled diabetes, hypertension, cardiovascular disease and undiagnosed cancers. Most of ACHN’s patients also have financial and literacy barriers.

As a primary care site, ACHN covers most of their patients’ needs, including: primary care; referral to specialty care and social services; monitoring and evaluation of chronic diseases; impact assessment through chronic disease registry to help identify the highest-risk patients for targeted interventions; calculating the cost of care for all services provided; and advocating for Medicaid expansion and refugee-friendly policies. This model of care allows for holistic evaluation and treatment of all patients.  Telehealth has been implemented as a tool to improve connection with patients and as a way to bring in translators as needed.  Community partnerships with specialists and social services help address food, housing and job insecurity to ensure patients are able to access the services they need to optimize health and wellness.

Since the clinic started five years ago, nearly US$1 million in services has been provided to care for 1500 uninsured individuals.  In the past year, patient visits have increased 31%, volunteer hours increased by 207%, and an on-site physical therapy, eye clinic and pain management started.

Patient story

Asha*, a recent refugee from the Iraq, presented with a six-month history of a breast lump that she had been unable to have evaluated because of lack of access to services.  ACHN provided the diagnostic workup and care navigation into the treatment she needed to treat her breast cancer.  They helped her apply for charity care at the local hospital; coordinate her specialist appointments; and continued to provide primary care services throughout and after Asha’s treatment.

*Not her real name

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