Carolinas HealthCare System
Community-Based Clinics:
Meeting the Needs of Underserved Populations in their Neighborhoods
Carolinas Medical Center’s hospital-based clinics deliver services to nearly 80 percent of the uninsured seeking medical care in Charlotte. Ten years ago, patients were seen in a building behind the emergency department (ED). Due to space constraints and patient demand, two new clinics were built in communities away from the hospital. Locations were chosen by mapping where Medicaid patients live, resulting in the CMC-NorthPark clinic in east Charlotte and the CMC-Biddle Point clinic in the northwest corridor of Charlotte.
The original impetus to open new clinics was to decompress the ED, increase access and hopefully, improve compliance. ED visits declined 14 percent after these clinics opened. What was not fully realized, and has become apparent over the last 10 years, is the ability of these clinics to address health care disparities for low-income Latino and African American minority patients. At CMC-NorthPark 62 percent of the patients identified themselves as Hispanic/Latino. The CMC-Biddle Point clinic—located in a historically African American section of Charlotte—indicates that 81 percent of the clinic patients are African American.
A few of the specific activities undertaken to increase access and provide culturally competent care included:
- Implementation of a bilingual recruitment initiative to recruit a staff that could better meet the needs of the patient population.
- Implementation of community outreach programs focused on wellness initiatives, including: grocery store tours, smoking cessation classes, exercise classes and nutrition education.
- Implementation of open access scheduling that increased the appointment show rate from 60 to 90 percent.
- Implementation of relative value unit billing method that improved the operating margin by 30 percent.
For more information about this program, please contact:
Kristin E. Wade, MSN, RN
Vice President
(704) 446-1952
kwade@carolinas.org