The cost of change

There is a price associated with any change that’s made in our lives, whether positive or negative. I tend to lovingly refer to this concept as “change pain.”

In our business and personal lives, we all encounter the moans and groans, typically loudest from ourselves, when faced with yet another shift to our daily dynamic. In the end though, we all must ask the question: Will this “change pain” bring improvement or detriment?

Over the past year, we here at Health Partners Free Clinic, went about asking ourselves some hard questions. As Miami County’s sole free clinic, we needed to take a hard look at what direction was needed in order to determine the amount of change we should commit ourselves to, as well.

The result was to continue meeting the needs of Miami County residents stuck in a temporary “medical gap” regarding quality health care in a timely manner. As executive director of Health Partners, I’m excited about the changes we have made.

In my personal life, I love to save money. I could care less what product I am investing in, as long as I know that I’m getting the best deal around! This character trait, or possibly gender trait, has resigned me to the philosophy of the cord-cutters, data dealmakers, and garage sale shoppers; which, also has me constantly reevaluating my monthly household bills.

My latest endeavor has been comparing my current family phone and data share plan with other available options. The recent cost-cutting trend in this sector is phone plans offered at a discount if you are willing to make use of an all-wifi phone and internet connection. As a miser and tech-junkie, I couldn’t help but dedicate an entire evening to learning this new concept and crunching the monthly savings numbers.

The result of my research turned out that I could save my household a whopping $10 per month by making this change. That’s $120 a year; over $1,000 every decade; and, I get bragging rights with all my other approaching-middle-aged buddies about how technologically savvy I am! This, of course, is about pride.

But before I sign on the dotted line and disrupt all that my family knows as true and consistent, I had to evaluate the cost of our “change pain”.

The question becomes, do I want to cause great discomfort for my family-plan shareholders for $10 a month? After all, my wife works from home and relies on the ability to contact clients from her phone, so can I justify taking a risk on this new-fangled technology in the name of a ten-spot and bragging rights? No, I thought, this one needs to be tabled for now, because the “change pain” outweighs the savings.

As the financial side of health care constantly morphs amoeba-like and will for some time, our goal is to meet the needs of the county’s uninsured and under-insured.

Our board of directors hired a consultant team with 40 plus years of experience to guide our humble clinic through the, always arduous, strategic planning process that will lead our organization into the next three years. After a flurry of community surveys, interviews and introspection; we came to the conclusion that our current free clinic model did not need sweeping change. However, a little tweaking wasn’t a bad idea either.

The environment of healthcare has changed dramatically since the implementation of the Affordable Care Act and Medicaid Expansion back in 2013. The clinic had always provided access to free quality healthcare, but now we are seeing a rise in those who have otherwise affordable health-insurance that no providers in the area are taking.

These Medicaid and subsidized plans, that are more than happy to take on new clients, reimburse the doctors and medical offices at a lower reimbursement than other plans. Therefore, these offices have to limit the amount of patients on these plans they can take or risk hemorrhaging money out of their practices. Without asking for the financial statements, we assume here that this would eventually lead these offices to closing up shop.

This has led to members of our community seeking acute care for chronic illnesses without follow up. Over-utilization of the emergency room is on the rise and folks continue to get sicker. The Affordable Care Act and Medicaid Expansion may still be able to work, but we are not there yet and this is where the community partnerships and collaborations must step in.

In recognition of these short-comings, the clinic leaders decided that the small tweaks we must make in order to have an inclusive strategic plan would need to be to our mission statement.

Health Partners Free Clinic would now serve those uninsured, those under-insured, and those underserved. The under-insured, or those who cannot afford their insurance, fit neatly within the underserved definition for brevities sake and our mission statement will be forever impacted.

Our plan is to temporarily provide care until patients are able to meet with a provider in an established practice. Unfortunately, Health Partners will not be the long-term answer for those with Medicaid coverage or private insurance and that is not our goal here.

What is the cost of this change to the clinic? We could potentially lose donors. We will inevitably cause confusion in the community. We will certainly create hurt feelings. We will lose sleep. Is the “change pain” worth the investment outcome? In this case, we feel it is.

As we have always felt a strong responsibility to provide services to the unique needs of those hurting in our community, it becomes clear that this decision is in line with our vision and values. The “change pain” can be much more costly than the actual change itself, but, nothing great comes without a cost.

Justin Coby has been affiliated with Health Partners Free Clinic as a volunteer pharmacist since 2007, and was appointed executive director in 2012.

Justin Coby has been affiliated with Health Partners Free Clinic as a volunteer pharmacist since 2007, and was appointed executive director in 2012.