Alabama Pilot Project Aims To Shift Primary Care from Emergency Rooms to Public Clinics

The Birmingham News on July 7 reported on an Alabama pilot program called HealthPlus that aims to shift uninsured individuals from receiving nonemergency care in emergency rooms to obtaining treatment in a primary care setting. The project, launched at Baptist Medical Center Princeton last September by the Coordinated Health System of Jefferson County, offers free follow-up visits at public health clinics to uninsured individuals who seek care in Baptist Princeton's emergency room. Fewer people than expected have enrolled in the program, and only 25% of project participants kept their appointments at the clinics, the News reports. Instead, many people returned to the emergency room for follow-up care. Baptist Princeton President Charlie Faulkner said, "We thought, if we just brought these opportunities to qualified individuals, they'd jump at it. Well, not really. For the ones who come here a lot, maybe they think they have a primary care physician. It's the emergency room doctor." As a result, the project no longer is referring Baptist patients to public clinics for follow-up care and is allowing them to return to the emergency room for treatment. Under a new focus, the project now aims to teach patients why primary care is "a good idea" and has hired a nurse who will help determine the "needs of the most frequent patients" to the emergency room. In the interim, Coordinated Health System has expanded the project to two other hospitals, which will refer uninsured emergency room patients to public clinics for follow-up treatment (Velasco, Birmingham News, 7/7).