An elderly man can't control his diabetes. A nurse visits his home to find out why. The man, nearly blind, injects himself as instructed, but the syringe contains nothing but air.
These realities defy the best intentions of doctors, and are the reason the Chicago-based John D and Catherine T MacArthur Foundation awarded a prestigious "genius" grant to Jeffrey Brenner, a doctor and founder of an organization that sends medical professionals to the homes of Camden, NJ's poorest residents. Brenner was one of 24 people receiving a $625,000 grant.
His Camden Coalition of Healthcare Providers finds the poorest patients in homes or shelters and escorts them to doctor's appointments.
"Sometimes called super utilizers, high utilizers, or frequent fliers, these patients have complex medical conditions and often lack social services, such as transportation or knowledge about how to use the health system most effectively," reports Joseph Burns for Covering Health. "High utilizers account for a disproportionately high share of overall spending. By some estimates, 5 percent of these patients account for more than 60 percent of all health care costs."
Although Brenner's group cares for people who should qualify for Medicaid, its work isn't paid for by the government. Neither is the work of South Florida's free clinics, such as Open Door in Homestead, which also cares for the needy.
Ironically, while Medicaid only pays for expensive care in an emmergency room or hospital, these frontline healthcare organizations try to prevent the need for more costly medical intervention -- and do so without a billing code.