Detroit Medical Center Plans To End Outpatient Services Through 12 Clinics Potentially Disrupting Care for Uninsured, Medicaid Beneficiaries

The Detroit Medical Center, in a memo to employees on Sept. 26, announced that to reduce costs it would terminate its ownership of 12 clinics that provide primary care during more than 380,000 patient visits, the Detroit Free Press reports (Norris, Detroit Free Press, 10/1). The company, which through its hospitals and clinics provides much of the care the uninsured and Medicaid beneficiaries receive in the Detroit area, is ending its ownership of the clinics as a way to decrease its uncompensated indigent care costs by 50% by the end of the year, the Detroit News reports (Webster, Detroit News, 10/1). The health system delivered $54 million in free care in the first six months of the year, contributing to a $23 million loss. Fewer than 10% of clinic patients are uninsured, and 45% are covered by Medicaid, reimbursement rates for which have fallen while health care costs and "demands on the health system" are increasing, according to Dr. Herbert Smitherman, medical director of the clinics (Detroit Free Press, 10/1). Hospital officials are considering selling the clinics to physicians or completely withdrawing from outpatient care to focus on hospital care, Juliette Okotie-Eboh, DMC's ombudsman and senior vice president, said, adding that there are "no plans to leave patients without medical services."

Lessened Access to Care?
The medical system plans to send clinic patients to federally qualified health centers, the News reports. But Lucille Smith, director of the Voices of Detroit Initiative, a partnership of local hospitals and health organizations to help the uninsured, noted that two recent applications for more federal clinics in Detroit have been denied. Dr. Lonnie Joe, president of the Detroit Medical Society, said, "We understand the problem that the DMC continues to face in this arena; however, we still have severe patient concerns. Who and what replaces [the clinics]? In some neighborhoods and ZIP codes in Detroit, the only thing there is a DMC clinic. How this transition occurs will be the big question" (Detroit News, 10/1).