For an uninsured woman, a breast screening can mean a $300 bill — quadruple the cost of just a few years ago. Across the Great Lakes Region, UChicago Medicine AdventHealth hospitals are partnering with community organizations to create better access to care and health education for those who need it most.
Open Arms, started in mid-June by UChicago Medicine AdventHealth Hinsdale, covers the cost of screening and diagnostic mammograms, breast ultrasounds, breast MRIs and breast biopsies for low-income women. It is one of several outreach initiatives that Hinsdale, La Grange and their sister hospitals in Glendale Heights and Bolingbrook are using to help bring healthcare — particularly preventive care — into their communities.
“You can’t imagine what this means for women in our community,” says Jennifer Swoyer, DO, chief medical officer of Pillars Community Health, which provides healthcare to low-income people. “This is amazing. It meets such an important need.”
The hospital foundations also provide funding for Open Arms and last year they invested $522,000 in these programs.
“They’re truly committed to helping the community be healthy,” Swoyer says.
The outreach programs are carefully selected. Every three years, each hospital reviews local health data for the area they serve, then works with local agencies to identify the biggest health problems in its community. “Conducting a Community Health Needs Assessment (CHNA) is an IRS requirement for nonprofit hospitals, but AdventHealth takes it seriously,” says Fabiola Zavala, director for community advocacy for the AdventHealth Great Lakes Region “It’s more than checking a box.”
The hospitals work closely with local health departments, social services and community organizations to identify social issues that impact health but may not be commonly addressed.
Five years ago, UChicago Medicine AdventHealth La Grange started working with Pillars Community Health to address an issue not normally considered by hospitals: Where do people who lack stable housing go to recover after hospitalization for surgery or intense treatments?
The hospital provided a community nurse case manager to help identify patients who lack stable housing and connect them with community resources. That position still exists today, but the program has since grown into an 18-bed medical respite unit and healthcare clinic. In addition to providing financial support, family medicine physicians in the hospital’s residency program staff the clinic. They see more than 350 patients a year.
Sometimes the outreach programs aren’t as visible as a building, but they can be equally powerful. Through its CHNA, UChicago Medicine AdventHealth GlenOaks identified diabetes as a pressing community issue. The hospital developed a diabetes education and screening program — with a twist.
Rather than providing the program in doctors’ offices or the hospital, they partnered with community organizations to screen and educate people at established events. The team goes quarterly to the food pantry at Family in Faith Church to screen clients with a simple finger prick to measure their A1c levels, an indicator of diabetes. If the results indicate prediabetes or diabetes, they provide education and connect the person to DuPage Health Coalition for care.
“If we go to a trusted organization with an established relationship with the people we’re trying to reach, they are much more likely to trust us and engage with us,” Zavala says. “Knowing this is such a big need, we want to reach the most vulnerable.”
Zavala’s team uses data from the Social Vulnerability Index to target their outreach to the most vulnerable communities. Of the 27 people screened this year, seven were identified as having diabetes, with two of those at critical levels. Importantly, 13 were identified as being prediabetic, a stage where lifestyle changes can prevent the onset of diabetes.
Diabetes is the most expensive chronic health condition in the country, accounting for $1 out of every $4 of healthcare costs. Without early identification and control, it can result in amputation, blindness, heart disease and stroke. More than half of all healthcare expenses for people with diabetes are to treat complications, according to the U.S. Centers for Disease Control and Prevention.
The outreach teams sometimes have to adapt to real-world circumstances to fulfill their mission. During a time of intense immigration scrutiny in the community, people were afraid to get out of their cars to go into the food pantry, so Zavala and her team used a golf cart provided by the Village of Glendale Heights police department to pull up to residents’ cars and provide screenings.
“We’re always innovating to see how we can get information to more people and to get more people screened,” she says.
UChicago Medicine Bolingbrook has partnered with community organizations to host a whole-person wellness workshop and eight community outreach events featuring interactive activities focused on nutrition and physical activity that reached more than 900 residents.
The four hospitals also have developed a social media campaign addressing mental health, which has garnered over 1,000 engagements. They also are continuing work to assess inpatients and emergency department patients for social issues — from transportation challenges to food insecurity — and connect them with community resources to address those needs.
“Our mission is to address a person’s whole health, and that includes factors other than traditional medical services,” Zavala says. “Through community benefit, we have an opportunity to invest in interventions that improve health outcomes, address needs earlier and reduce avoidable hospital and emergency room use.”
Michele Conklin is a writer for AdventHealth.